The association between ward staffing levels, mortality and hospital readmission in older hospitalised adults, according to presence of cognitive impairment: a retrospective cohort study.

Background: Lower nurse staffing levels are associated with increased hospital mortality. Older patients with cognitive impairments (CI) have higher mortality rates than similar patients without CI and may be additionally vulnerable to low staffing.

Objectives: To explore associations between registered nurse (RN) and nursing assistant (NA) staffing levels, mortality and readmission in older patients admitted to general medical/surgical wards.

Wessex Acute Frailty Audit: applying quality improvement methodology to design and implement a regional frailty audit using a collaborative, multiprofessional approach.

Introduction: An acute hospital stay increases the risk of negative outcomes for those living with frailty. This paper describes the application of quality improvement methodology to design and implement a regional audit to gain an understanding of care provision.

Methods: Small scale tests of change (Plan-Do-Study-Act cycles) were used to design the audit structure and questions.

Cognitive impairment is independently associated with mortality, extended hospital stays and early readmission of older people with emergency hospital admissions: A retrospective cohort study.

Background: Older adults admitted to hospital are often cognitively impaired. It is not clear whether the presence of cognitive impairment conveys an additional risk for poor hospital outcomes in this patient population.

Objectives: To determine whether cognitive impairment in hospitalised older adults is independently associated with poor outcomes.

Development of stroke care in Ghana.

The burden of stroke in the developing world is huge and growing. In Ghana, located in West Africa, stroke is in the top five causes of death. Disability resulting from stroke creates many challenges to healthcare staff, patients, their families and the wider society.

The Winchester falls project: a randomised controlled trial of secondary prevention of falls in older people.

Background: the mortality and morbidity of falls in older people is significant, with recurrent fallers being at an increased risk. The most effective way to reduce falls in this group is not clear.

Objective: to determine the effectiveness of two interventions, one based in primary care and the other in secondary care, at preventing further falls in recurrent fallers.

Where now with Do Not Attempt Resuscitation decisions?

Geriatricians are often asked to make decisions about withholding cardiopulmonary resuscitation. This seems to be becoming more difficult and more controversial. There has been increased public concern about this subject recently and a recognition within the profession of the need for more openness and transparency in decision making.