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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Wiles, R. Ward, J. Steiner, A. Pickering, R. M. Brooking, J. I. Walsh, B. |
| Spatial Coverage | England |
| Description | Author Affiliation: Steiner A ( Departments of Geriatric Medicine and Social Work Studies, University of Southampton, Murray Building, Southampton SO17 1BJ, UK. steiner@cats.ucsc.edu); |
| Abstract | OBJECTIVES: To compare post-acute intermediate care in an inpatient nurse-led unit with conventional post-acute care on general medical wards of an acute hospital and to examine the model of care in a nurse-led unit. DESIGN: Randomised controlled trial with six month follow up. SETTING: Urban teaching hospital and surrounding area, including nine community hospitals. PARTICIPANTS: 238 patients accepted for admission to nurse-led unit. INTERVENTIONS: Care in nurse-led unit or usual post-acute care. MAIN OUTCOME MEASURES: Patients' length of stay, functional status, subsequent move to more dependent living arrangement. RESULTS: Inpatient length of stay was significantly longer in the nurse-led unit than in general medical wards (14.3 days longer (95% confidence interval 7.8 to 20.7)), but this difference became non-significant when transfers to community hospitals were included in the measure of initial length of stay (4.5 days longer (-3.6 to 12.5)). No differences were observed in mortality, functional status, or living arrangements at any time. Patients in the nurse-led unit received significantly fewer minor medical investigations and, after controlling for length of stay, significantly fewer major reviews, tests, or drug changes. CONCLUSIONS: The nurse-led unit seemed to be a safe alternative to conventional management, but a full accounting of such units' place in the local continuum of care and the costs associated with acute hospitals managing post-acute patients is needed if nurse-led units are to become an effective part of the government's recent commitment to intermediate care. |
| ISSN | 09598138 |
| e-ISSN | 17561833 |
| Journal | BMJ (British Medical Journal) |
| Issue Number | 7284 |
| Volume Number | 322 |
| Language | English |
| Publisher | British Medical Journal Publishing Group |
| Publisher Date | 2001-03-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Hospital Units Organization & Administration Intermediate Care Facilities Nursing Service, Hospital Progressive Patient Care Acute Disease Follow-Up Studies Length Of Stay Logistic Models Patient Readmission Statistics & Numerical Data Patient Transfer Quality Of Life Rehabilitation Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't Medicine |
| Content Type | Text |
| Resource Type | Article |
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