Providing a Geriatric-Friendly Environment for the Older Surgical Patient

The acute-care hospital is rapidly changing with respect to both patients and the nursing workforce, and has challenged traditional models of nursing care delivery. Patients spend less time in the hospital, the acuity level is higher, and the aging patient population is more vulnerable to iatragenic complications when hospitalized. The Miriam Hospital has implemented a new and holistic model of nursing care delivery, incorporating the principles of primary nursing and geriatric nursing in a professional practice framework. The project has provided a geriatric model based on the prevailing literature showing that simple nursing measures such as optimizing nutrition, mobility, and sleep can improve outcomes in older surgical patients. Preliminary findings reveal a decrease in injurious falls and hospital-acquired pressure ulcers, as well as a decrease in restraint and sitter use.