European Geriatric Medicine - Supplement 1 - Volume 6

S66

Poster presentations / European Geriatric Medicine 6S1 (2015) S32

–

S156

(895, 36%), lower limb fractures (386, 15.5%) and pelvic fractures

(218, 8.8%). Functional and cognitive impairment was greater in

patients referred to long-term stay units, nursing homes and in

patients who died (p

0.001).

Conclusions:

Orthopaedic patients requested to Geriatrics met

criteria for Geriatric patients. Two thirds of them need clinical

follow-up until discharge. Geriatric assessment classified them in

different profiles at discharge.

P-127

Algoplus

performance to detect pain in depressed and/or

demented old patients

S. Bonin-Guillaume

, E. Jouve

, R. Lauretta

, R. Truillet

, P. Rat

Aix Marseille University, Assistance Publique des Hˆopitaux de

Marseille, Marseille, France;

Aix Marseille University, Marseille,

France;

Medecine department, General Hospital, Salon, Salon De

Provence, France;

Assitance Publiqeu Hˆopitaux Marseille, MARSEILLE,

France

Background:

Algoplus

detects acute pain in uncommunicative

elderly with good psychometric properties. However, depression

or dementia might modify the Algoplus

score and/or item

expression. Algoplus

performances on demented and/or depressed

old populations were tested.

Methods:

This multicenter cross-sectional study included patients

≥65 years old with or without pain assigned to depressed,

demented, depressed & demented or control groups. Each

group was subjected to the Numerical Rating Scale (NRS)

and behavioral scales (Algoplus

, Doloplus

). Depression and/or

dementia status was rated and confirmed by blinded experts.

Algoplus

psychometric properties tested were: discriminant

validity, convergent validity, item analysis, sensitivity to change

after pain treatment and threshold determination.

Results:

The analysis concerned 171 patients (mean age 82.3

6.3

years). Patients with and without pain in each group were compara-

ble. The mean Algoplus

score was significantly higher for patients

with than without pain, regardless of group assignment (Wilcoxon

signed-rank test, p

0.001). Algoplus

and NRS or Doloplus

had high convergent validity (respective Spearman correlation

coefficients: 0.79 and 0.87). The mean Algoplus

score decreased

significantly after starting pain management, regardless of group

assignment. Some behaviors (i.e., “look”) occurred more often in de-

pressed patients, even those without pain. A threshold of 2 yielded

respective sensitivity and specificity values of 95% and 96% for

dementia patients, 62% and 79% for depressed patients, 96% and 71%

for demented & depressed patients, and 80% and 100% for controls.

Conclusion:

Algoplus

accurately detected pain in depressed

and/or demented patients; and was sensitive to change after pain

treatment.

P-128

Nurses’ roles and responsibilities in inpatient geriatric

consultation teams (IGCTs) in acute care hospitals

V. Claes

, M. Deschodt

, B. Van Grootven

, B. Boland

, J. Flamaing

K. Van den Heede

, K. Milisen

Institut of Nursing Science, University of Basel, Basel, Switzerland;

Department of Public Health and Primary Care KU Leuven

and University Hospitals Leuven, Leuven, Belgium;

Department

of Public Health and Primary Care, KU Leuven and University

Hospitals Leuven, Leuven, Belgium;

Geriatric Medicine, Cliniques

Universitaires Saint-Luc, Brussels, and Research Institute of Health

a, Louvain-la-Neuve, Belgium;

Department of Geriatric Medicine

University Hospitals Leuven and KU Leuven, Leuven, Belgium;

Belgian

Healthcare Knowledge Centre, Brussels, Brussels, Belgium

Objective:

A scoping review was conducted to explore nurses’

roles and responsibilities in IGCTs internationally. IGCTs are

interdisciplinary teams assessing frail older patients and advising

healthcare professionals in acute care hospitals for geriatric care.

Methods:

An electronic database search in Ovid MEDLINE, CINAHL

and EMBASE and hand search were applied for identification of

descriptive and experimental studies published in English, French

or Dutch until April 2014. Thematic reporting with descriptive

statistics was performed and study findings were validated through

interdisciplinary expert meetings.

Results:

Forty-six papers reporting on 25 IGCT services in eight

countries were included. Nurses were core members in all IGCTs

and 80% of teams required nurses to have completed geriatrics

training. Advanced practice nurses were only team members in

44% of IGCTs. Only 32% of teams used formal screening to identify

patients amendable for IGCT intervention, applying heterogeneous

screening methods and scarcely providing information on the

responsibilities of IGCT nurses. Nurses were widely involved in the

medical, functional and psychosocial assessment of patients, either

in a leading role (24%) or collaboratively with other disciplines

(48%). Responsibilities of IGCT nurses regarding in-hospital follow-

up of consulted patients or transitional care at hospital discharge

were infrequently specified (16% of teams).

Conclusion:

Despite nurses being put forward as key members

of IGCTs, limited information on their specific roles and

responsibilities in IGCT care was identified. More research in this

area is required in order to inform health care policy and practice

oriented recommendations to improve the effectiveness of the IGCT

care model.

P-129

Functional assessment of hospitalized elderly in an internal

medicine ward

H. Clemente

, R. Ferreira

, J. Fonseca

, D. Ferreira

, P. Mendes

P. Lopes

, A. Nogueira

, J. Gomes

, H. Esperto

, J. Correia

M. Ver´ıssimo

, A. Carvalho

Centro Hospitalar e Universit´ario de Coimbra, Coimbra, Portugal;

Centro Hospitalar e Universit´ario de Coimbra, Tent´ugal, Portugal

Introduction:

Functional capacity refers to autonomy in performing

activities of daily living (ADL) and has a prognostic value in elderly

patients. We aimed to assess functional capacity of hospitalized

elderly using the Barthel index (BI), its association with primary

diagnosis and prognostic impact on length of stay and mortality.

Methods:

Retrospective study of a convenience sample of elderly

patients hospitalized in an Internal Medicine ward of an university

hospital for 6 consecutive months. The BI was applied on admission

and discharge.

Results:

We studied a sample of 95 patients with mean age

of 82.3

7.5 years old. The average length of stay was 9.1

5.2

days, the mortality rate was 13.7% and 42.7% of patients were

previously institutionalized. On admission, 41.1% of patients

were totally dependent for ADL, 23.2% were moderate or

severely dependent, 13.7% had mild dependency and 22.1% were

independent. We verified a positive correlation between age,

previous institutionalization, mortality and greater dependence

0.05). No statistically significant differences were observed

between the length of stay, primary diagnosis and prior functional

status. The BI remained unchanged in 72.6% of patients while a

functional improvement was achieved in 13.7%, with an average

gain of 17.7 points (p

0.05).

Conclusions:

A large proportion of elderly patients in this Internal

Medicine ward were highly dependent for ADL when evaluated

by BI. Greater dependence was associated with advanced age and

worse vital prognosis. The percentage of elderly who improved their

functional capacity was reduced and this highlighted the need to

endorse strategies that promote functional recovery.