A National Frailty Education Programme
Authors: Deirdre Lang , Carmel Hoey, Diarmuid O’Shea, Helen Whitty
Abstract Rationale for Training: Population ageing is occurring rapidly and between 2015 and 2050, the number of people aged 60 years and older is expected to increase from 12% of the global population to 22% (WHO, 2012). In Ireland, currently 13% of the population is 65 years or older and this number is expected to double by 2040 (Central Statistics Office, 2008). As older people have different healthcare requirements, the Irish healthcare system needs to adapt to meet the demands associated with this demographic change. Healthcare spending in Ireland is expected to rise from 5.8 to 6.7% of GDP by 2035 (European Commission, 2009). Almost 22% of all hospital emergency department attendees are aged 65 and over and this age group account for 40% of all acute emergency medical admissions and 47.3% of total hospital bed days (HSE, ED Task Force Report, 2015, NCPOP, 2012). One of the greatest challenges posed by an ageing population is the ability of healthcare professionals to understand, recognise and manage frailty.Frailty: Frailty is theoretically defined as a clinically recognisable state of increased vulnerability resulting from age-associated decline in reserve and function across multiple physiologic systems (Qian-Li Xue, 2011). Frailty affects approximately 8-10% of people over the age of 65 and 25-50% of those aged 85 and over (Mytton et al., 2012; Collard et al., 2012; Savva et al., 2013). Although frailty is an increasingly common condition in older people, it is not an inevitable part of ageing and in some cases it can be treated or prevented depending on its underlying cause. A lack of consensus regarding the operational definition of frailty makes it difficult to identify and manage in clinical practice (Rodríguez-Mañas, et al., 2013). However, conceptualizing frailty as a continuum from not frail, to pre-frail, to frail is considered a valid way to identify subgroups of older adults at risk of adverse outcomes such as falls, worsening disability, prolonged hospitalization and death (Clegg & Young, 2015). The potential for serious adverse outcomes is a central problem associated with frailty. For people with frailty even a relatively minor event such as an infection can result in a dramatic change in health state: from independent to dependent; mobile to immobile; postural stability to falling; lucid to delirious (Clegg, 2013).Further to this, frailty has been shown to be a strong and independent predictor of emergency department visits and hospitalizations (McNallan et al., 2013), hospital re- admissions (Pugh et al., 2014) and in-hospital mortality (Bagshaw et al., 2013). Unplanned admissions to hospital in an emergency situation can be both distressing and disruptive for frail older people, their families and carers. These admissions create rising demands on acute hospital beds and result in enormous costs to Ireland’s health service. Therefore, this topic has relevance for policy makers, clinicians and nursing staff who need to understand the risk factors for frailty to enable them to implement programmes for early detection, prevention and management. By increasing awareness and understanding of frailty, we can improve outcomes for these older adults and reduce demands on the health service.Methodology: It is proposed that the methodology applied to the implementation of the National Early Warning Score would be applied to the roll out of a frailty education programme. This includes:- Providing a training programme for a cohort of national trainers (N= to be agreed) who will:- Provide local education programmes- Maintain a database of locally trained staff- Lead local governance groupEstablishment of National Steering Group (incl. cohort of national trainers, and nominated stakeholders) to:- Develop an educational programme for delivery locally- Develop a framework for interdisciplinary education- Develop an e-learning programmeThe Longtitudinal Study on Aging (TILDA): Using cutting edge research and the unique resources at the TILDA Health Assessment Centre in Trinity College, TILDA will deliver a one-day training course to nurses interested in learning more about frailty. The course will incorporate key research findings from TILDA, provide an overview of the theoretical models underpinning frailty and include training in key frailty assessment tools. Nurses are an integral part of the collaborative approaches to services for patients with frailty. This training will encourage nurses to be proactive members in the early identification and assessment of frailty, ensuring effective management to improve outcomes for these vulnerable adults.
frailty, education, interprofessional education, tilda
How to Cite:
Lang D, Hoey C, O’Shea D, Whitty H. A National Frailty Education Programme. International Journal of Integrated Care. 2017;17(5):A341.
DOI: http://doi.org/10.5334/ijic.3659Published on 17th October 2017
"Mwandishi wa ""Mafunzo ya Ubora wa Ubora"" Deirdre Lang, Carmel Hoey, Diarmuid O'Shea, Helen Whitty, na wengineo, wanaamini kuwa idadi ya watu wenye umri wa miaka 60 na zaidi itaongezeka kutoka 12% hadi 22% ya idadi ya watu duniani." Kwa sasa, asilimia 13 ya watu nchini Ireland wana umri wa miaka 65 na zaidi, na idadi hiyo inatarajiwa kuongezeka mara mbili kufikia mwaka 2040. Kwa kuwa wazee wana mahitaji tofauti ya huduma za afya, mfumo wa huduma za afya wa Ireland unahitaji kubadilika ili kukidhi mahitaji yanayohusiana na mabadiliko haya ya idadi ya watu. Matumizi ya huduma za afya nchini Ireland yanatarajiwa kuongezeka kutoka 5.8% hadi 6.7% ya Pato la Taifa ifikapo mwaka 2035, kulingana na Tume ya Ulaya. Karibu asilimia 22 ya wagonjwa wote katika idara za dharura za hospitali ni watu wenye umri wa miaka 65 na zaidi na kundi hili la umri linawakilisha asilimia 40 ya wagonjwa wote wa dharura na asilimia 47.3 ya jumla ya siku za kulala hospitalini (HHS, Ripoti ya Kikosi cha Kazi cha ED, 2015). "Kama ilivyoelezwa hapo juu, ""Uwezo wa wataalamu wa huduma za afya kuelewa, kutambua na kusimamia udhaifu"" ni hali ya ""kujulikana kliniki ya udhaifu ulioongezeka kutokana na kupungua kwa hifadhi na kazi inayohusiana na umri katika mifumo mingi ya kisaikolojia.""" Ugonjwa huu huathiri karibu asilimia 8 hadi 10 ya watu wenye umri wa miaka 65 na zaidi na asilimia 25 hadi 50 ya watu wenye umri wa miaka 85 na zaidi (Mytton et al., 2012; Collard et al., 2012; Savva et al., 2013). Ingawa udhaifu ni hali ya kawaida katika watu wazima, sio sehemu ya kukosa ya kuzeeka na katika hali zingine inaweza kutibiwa au kuzuiwa kulingana na sababu yake ya msingi. Ukosefu wa makubaliano kuhusu ufafanuzi wa uharibifu wa utendaji hufanya iwe vigumu kutambua na kusimamia katika mazoezi ya kliniki (Rodríguez-Mañas, et al., 2013). Hata hivyo, kuelezea udhaifu kama mfululizo kutoka kwa udhaifu, hadi kabla ya udhaifu, hadi udhaifu, ni njia halali ya kutambua vikundi vya watu wazima wenye umri mkubwa katika hatari ya matokeo mabaya kama vile kuanguka, kuharibika kwa ulemavu, kulazwa hospitalini kwa muda mrefu na kifo. Uwezekano wa matokeo mabaya mabaya ni tatizo kuu kuhusishwa na udhaifu. Kwa watu wenye udhaifu, hata tukio dogo kama maambukizi linaweza kusababisha mabadiliko makubwa katika hali ya afya: kutoka kujitegemea hadi kutegemea, kutoka kuhamahama hadi kutohamahama, kutoka kuanguka hadi kuanguka, kutoka kuamka hadi kupotea (Clegg, 2013), na kwa hivyo, udhaifu umeonyeshwa kuwa kiashiria cha nguvu na cha kujitegemea cha ziara za dharura na kulazwa hospitalini (McNellen et al., 2013), kuingizwa tena hospitalini (Pugh et al., 2014). Uhamisho wa ghafla wa hospitali katika hali ya dharura unaweza kuwa na wasiwasi na usumbufu kwa wazee dhaifu, familia zao na watunzaji. Mapokezi haya kuunda kuongezeka kwa mahitaji ya vitanda vya hospitali kali na kusababisha gharama kubwa kwa huduma ya afya ya Ireland. Kwa hivyo, mada hii ina umuhimu kwa watunga sera, madaktari na wafanyakazi wa uuguzi ambao wanahitaji kuelewa sababu za hatari za udhaifu ili kuwawezesha kutekeleza programu za kugundua mapema, kuzuia na usimamizi. Kwa kuongeza ufahamu na uelewa wa udhaifu, tunaweza kuboresha matokeo kwa watu wazima hawa wazee na kupunguza mahitaji ya huduma ya afya.Methodolojia: Inapendekezwa kwamba mbinu iliyotumika kwa utekelezaji wa alama ya kitaifa ya onyo la mapema itatumika kwa kuzindua programu ya elimu ya udhaifu. Hii inajumuisha: - Kutoa mpango wa mafunzo kwa kundi la waalimu wa kitaifa (N = kukubaliana) ambao watatoa: - Kutoa programu za elimu za mitaa - Kudumisha hifadhidata ya wafanyakazi waliozoezwa ndani ya nchi - Kuongoza kikundi cha utawala wa mitaa - Kuanzisha Kikundi cha Usimamizi cha Kitaifa (kwa pamoja na) TILDA (Longitudinal Study on Aging) ni utafiti wa kisasa wa utafiti wa afya na rasilimali za kipekee katika Kituo cha TILDA cha TILDA cha TILDA katika Chuo cha Trinity. Mtaalamu wa utafiti wa TILDA, ambaye ni mtaalamu wa utafiti wa TILDA, atawasilisha muhtasari wa mifano ya nadharia inayounga mkono udhaifu na mafunzo katika zana muhimu za tathmini ya udhaifu. Wauguzi ni sehemu muhimu ya mbinu za ushirikiano kwa ajili ya huduma kwa ajili ya wagonjwa na udhaifu. Mafunzo haya yatahimiza wauguzi kuwa wanachama wa proactive katika utambulisho wa mapema na tathmini ya udhaifu, kuhakikisha usimamizi mzuri ili kuboresha matokeo kwa watu wazima hawa walio hatarini. udhaifu, elimu, elimu ya kitaalamu, tilda Jinsi ya kutaja: Lang D, Hoey C, O<unk>Shea D, Whitty H. Programu ya Kitaifa ya Elimu ya Udhaifu. Jarida la Kimataifa la Utunzaji wa Pamoja. 2017 (k) (a) (b) (a) (b) (a) (b) (b) (c) (c) (d) (e) (e) (e) (e) (e) (e) (e) (e) (e) (e) (e) (e) (e) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) (f) "Kama ilivyoelezwa katika taarifa ya DOI (http: www.doi.org 10.53343.ijic.org) iliyochapishwa tarehe 17 Oktoba 2017: ""Kuna uwezekano mkubwa kwamba."