Older adults (OA) are at risk for potential hazards of hospitalization, these include: immobility, delirium, medication side effects, malnutrition, pressure ulcers, procedures, peri- and postoperative periods, and hospital-acquired infections and more. Discuss in detail three potential hazards for this population while in the hospital and identify potential prevention strategies for each hazard. Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook.
Introduction
Hospitalization can pose a range of potential hazards for older adults, who are particularly vulnerable due to age-related physiological changes and pre-existing health conditions. This paper will discuss three potential hazards that older adults may encounter during hospitalization: delirium, medication side effects, and pressure ulcers. For each hazard, potential prevention strategies will be identified to mitigate these risks.
Delirium in Older Adults During Hospitalization
Delirium, characterized by acute cognitive impairment and disturbance in attention, is a common complication in older adults during hospitalization (Inouye, Westendorp, & Saczynski, 2014). It is estimated that approximately one-third of older adults admitted to hospitals experience delirium (Leslie et al., 2015). Delirium can lead to prolonged hospital stays, increased mortality rates, functional decline, and higher healthcare costs (Leslie et al., 2015).
There are several potential preventive strategies for delirium in older adults. Firstly, the identification of individuals at risk for delirium is crucial. Risk factors such as advanced age, pre-existing cognitive impairment, functional decline, sensory impairments, and polypharmacy should be assessed upon admission to identify those at higher risk (Inouye et al., 2014). Implementing comprehensive geriatric assessments can help identify these risk factors.
Secondly, providing a suitable environment that promotes orientation and cognitive stimulation can prevent delirium. This includes ensuring adequate lighting, reducing noise levels, and encouraging social interaction and engagement (Inouye et al., 2014). Nurses can play a critical role in promoting a therapeutic environment by maintaining a consistent daily routine for the patient and offering reassurance and explanations for any changes to reduce confusion.
Lastly, optimizing sleep and maintaining the patient’s normal sleep-wake cycle can also prevent delirium. Sleep disruption can contribute to the development of delirium, so strategies to improve sleep quality should be considered, such as minimizing nighttime disruptions, implementing non-pharmacological approaches like relaxation techniques, and providing a comfortable and quiet environment (Leslie et al., 2015).
Medication Side Effects in Older Adults During Hospitalization
Older adults are more susceptible to adverse drug reactions due to age-related changes in pharmacokinetics and increased prevalence of multiple chronic conditions (Turnheim, 2004). Medication side effects can lead to morbidity, hospital readmissions, and increased healthcare costs. Minimizing medication-related risks is vital for hospitalized older adults.
One strategy to prevent medication side effects is to utilize a comprehensive medication review upon admission. A thorough assessment of the patient’s medication list, including prescription and over-the-counter drugs, can identify potential interactions, duplications, or inappropriate medication use (Moser & Riegel, 2008). Collaborative efforts among healthcare professionals, including pharmacists, can facilitate this review process.
Additionally, healthcare providers should prioritize patient education regarding their medications. Older adults must be informed about the purpose, dosage, potential side effects, and management strategies of their prescribed medications (Moser & Riegel, 2008). Ensuring clear communication and providing patient-centered educational materials can enhance medication adherence and reduce the risk of adverse events.
Furthermore, healthcare providers should consider age-related physiological changes when prescribing medications. Adjustments in medication dosages, particularly for drugs with a narrow therapeutic index, should be made to ensure safety and efficacy in older adults (Turnheim, 2004). Regular monitoring for medication-related adverse events should also be implemented throughout the hospital stay to promptly identify and manage any side effects.
Pressure Ulcers in Older Adults During Hospitalization
Pressure ulcers, also known as bedsores or decubitus ulcers, are a significant hazard for older adults during hospitalization. Prolonged immobility, decreased sensory perception, incontinence, poor nutrition, and compromised skin integrity increase the risk of pressure ulcers (Moore & Cowman, 2014). Pressure ulcers can lead to pain, infection, delayed wound healing, and increased healthcare costs.
To prevent pressure ulcers, healthcare providers should conduct a comprehensive nursing assessment upon admission. Assessing the patient’s risk factors, such as age, mobility, nutrition, and skin condition, can aid in identifying those who require specialized preventive interventions (Moore & Cowman, 2014). Nutritional assessment and management are crucial to optimize tissue repair and prevent tissue breakdown.
Moreover, implementing preventive measures such as frequent repositioning, maintaining adequate hydration, and using pressure-reducing devices like pressure-relieving mattresses or cushions can significantly reduce the occurrence of pressure ulcers (Reddy, Gill, & Rochon, 2018). Nurses should prioritize patient mobility and implement regular turning and repositioning schedules to redistribute pressure points.
Additionally, healthcare providers should educate older adults and their caregivers on skin care techniques. Strategies to protect and optimize skin integrity, such as regular moisturizing, avoiding excessive sun exposure, and using appropriate skin barrier products, should be emphasized (Moore & Cowman, 2014). Ensuring proper skin hygiene and cleanliness is essential to prevent infection.
Conclusion
Hospitalization presents potential hazards for older adults, including delirium, medication side effects, and pressure ulcers. However, adopting preventive strategies can mitigate these risks. Healthcare professionals should prioritize risk assessment and implement individualized interventions to prevent delirium, minimize medication-related risks, and reduce the incidence of pressure ulcers. By incorporating these preventive measures into practice, the well-being and outcomes of hospitalized older adults can be significantly improved.