Evaluation Checklist to Assess Care of the Hospitalized ...



Evaluation Checklist to Assess Care of the Hospitalized Elderly

Patient ID (Initials):

Admission Date:____________ Discharge Date: _____________

Days in the Hospital: ____

Admission Principal Diagnoses:

|Team Practice |YES |NO |N/A |

|Performed functional status assessments upon admission and during the | | | |

|course of hospital stay? | | | |

|Performed cognitive assessments upon admission and during the course of | | | |

|hospital stay? | | | |

|Performed risk assessment for delirium with measures to prevent | | | |

|occurrence during the course of hospital stay? | | | |

|Screened for depression in hospitalized older adult patients? | | | |

|Reduced polypharmacy and use of high risk/low benefit drugs in | | | |

|hospitalized older adult patients? | | | |

|Routinely performed a complete skin exam in the hospitalized older adult| | | |

|patient? | | | |

|Assessed nutritional status for malnutrition and dehydration during the | | | |

|course of hospital stay? | | | |

|Venous Thrombosis Prophylaxis | | | |

|Central Venous Catheter Infection Precautions: Maximal Barrier and Daily| | | |

|Assessment of site for infection | | | |

|Fall risk assessment for all hospitalized older adults and inpatient | | | |

|fall evaluation (for the patient who sustains a fall – evaluation of | | | |

|prodromal symptoms and medications within 24hours) | | | |

|Mobilized hospitalized older adult patient within 48 hours to prevent | | | |

|deconditioning | | | |

|Determined appropriateness of urinary (Foley) catheter use, by | | | |

|conducting assessments every 72 hours for continued need for the | | | |

|catheter and discontinuing when inappropriate | | | |

|Assessment for stability at discharge – day before and on the day of | | | |

|discharge | | | |

|Discharge Assessment - assessment of level of independence, need for | | | |

|home health services, and patient and caregiver readiness for discharge | | | |

|and appropriate discharge location | | | |

Adapted from the Society of Hospital Medicine Best Practices on Management of the Hospitalized Geriatric Patient and Assessment of Care of the Vulnerable Elder (ACOVE – 3) Quality Indicators for the Hospitalized Patient.

References

a. Hazards of Hospitalization of the Elderly by M.C Creditor Annals of Internal Medicine. 1993; 118:219-223.

b. Acute Hospital Care of the Elderly: Making a Difference; Caring for the Hospitalized Elderly, Current Best Practice and New Horizons. A Special Supplement to The Hospitalist. The official publication of the Society of Hospital Medicine Pgs 4-7

c. ACOVE – 3 Quality Indicators for Hospitalized Patient

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