Abstract
Background: Older adults living in the Long Term Care facilities are frail and have complex care needs. Holistic assessment of resident’s health status is the key to delivering optimal care. Comprehensive Geriatric Assessment (CGA) is the validated gold standard tool to identify care needs for frail older people in order to develop a coordinated and integrated plan for treatment and long-term follow-up. There was no designated CGA available for the Pre-admission to Community Nursing Units (CNUs) only a Common Summary Assessment Report (CSAR). Therefore, the care needs are not clearly identified prior to being accepted in the care home.
Purpose/Aim: The author aimed to present the Nursing Home Pre-Admission Comprehensive Geriatric Assessment (CGA) form developed in collaboration with the Integrated Care Team for Older Persons. The form captures the complex needs of frail older people entering nursing homes to ensure the care home has the scope to meet their needs. The form streamlines the assessment process, allowing multidisciplinary teams to address all important medical needs and functional issues in a focused and standardized fashion enabling comprehensive and dedicated clinical thinking to be applied to the resident’s care.
Methodology: The pre-admission assessment form was initiated in collaboration with all members of the multidisciplinary team (MDT) across the Integrated Care Programme for Older Persons (ICPOP) service in Community Healthcare Organisation-Dublin North City and County (CHO-DNCC), using the CGA from the community ICPOP. This was modified to support the preadmission assessment of the older person in the Nursing Home (NH). Engagement from the NS’s stakeholders was paramount. The document was amended gradually after multiple meetings with ICPOP and NH teams. The final version of the CGA was validated for use in July 2023 and then implemented into practice across the Community Nursing units (CNUs) in CHO- DNCC.
Outcome/Result: Preliminary data demonstrated that the pre-admission assessment tool is fit for purpose and accepted by the CNU staff as all information describes the individual’s clinical baseline health status prior their admission, enabling timely and informed clinical decision-making in caring for the frail older individual. The pre-admission assessment form is the best intervention to provide collaboration and integration working in practice and has the potential to greatly improve the quality of care and promote overall good health for older people in the nursing home. The staff became better understood the different care needs of the care home population.
Conclusion: The Pre-admission Assessment From is a designated Assessment tool for the Nursing Home in which a holistic view of the resident’s medical, functional, and social issues is taken. CGA is therefore a structured approach to creating a unified view of many different parts of a resident’s clinical assessment providing all information required to plan and deliver the optimal, coordinated, patient-centred care for the frail older adult who lives in a care home. The Pre-admission CGA form is transferable to other agencies if requested.