Nurse-led Intervention Successful in Increasing Older Patients' Activity Levels

Nurse-led primary care interventions can lead to sustained increases in physical activity (PA) among older adults, according to a recent article published in PLOS Medicine by lead author Tess Harris of St George's University of London. Additionally, the participating patients indicated that they felt positively about the intervention, reports Medical Xpress.

Researchers enrolled nearly 300 people ages 60-75 in the trial, and randomly separated them by household, to receive either standard care or the nurse-led intervention. Primary care nurses delivered PA consultations over a three month-period to the intervention group, providing individualized activity plans and feedback on data recorded from pedometers and accelerometers worn by the patients.

At the three month mark, the intervention group reported that they took 1,037 more steps than the control group. Additionally, the intervention group spent 63 more minutes per week in PA sessions of 10 minutes or more. There was a sustained gap at the 12-month mark, although it decreased to 609 steps per day and 40 minutes per week.

The trial, funded by the National Institute for Health Research, suggests that this type of nurse-led intervention may be an effective way to increase PA in older adults, resulting in better health. However, the researchers said that additional trials are needed to discover what aspects of the intervention were most effective and how it would work in larger and more socio-economically diverse populations.


INQRI grantees Barbara Resnick and Sheryl Zimmerman also found success with an intervention designed to deliver Function Focused Care to residents in assisted living facilities. Their intervention was designed to maintain and improve function, PA, muscle strength, psychosocial outcomes (efficacy expectations and life satisfaction) and decrease adverse events (pain, falls and hospitalizations) among assisted living residents. Residents in intervention treatment sites demonstrated fewer declines in function and spent more time in moderate level physical activity at 4 months and more overall counts of activity at 12 months when compared to residents in control sites. There were also fewer transfers to the hospital among those in the treatment sites.

Interdisciplinary Study Indicates Poor Communication During Hospital to Nursing Home Transition Can Harm Patient Health

Transitional care has garnered significant attention since INQRI's own Mary Naylor conducted her ground-breaking research into the care older patients with multiple chronic conditions received during the transition from acute care to home or another care setting and developed the Transitional Care Model. Now, a study led by nurse researcher Barbara King and geriatrician Amy Kind reveals that the transition from hospital to nursing home is often difficult because of poor communication between staff at those institutions.

The study, published in the Journal of the American Geriatrics Society, reveals that nurses in skilled nursing facilities report that difficult transitions are the norm because they receive little information about their incoming patients. Adverse consequences that were a result of this poor communication included: increased risk of medication errors, delayed efforts to mobilize patients, and time wasted trying to obtain information that should have been shared. The nurses who participated in focus groups and surveys for this study reported that they felt their credibility and the credibility of the nursing home were undermined because of communications failures.

Several INQRI studies have examined the ways nurses can improve transitional care, including a study by Cynthia Corbett and Stephen Setter exploring the role of the home health care nurse in medication management; and a translational study by Nancy Hanrahan and Phyllis Solomon adapting the Transitional Care Model for people with serious mental illness in public managed care.

Read more about the King/Kind study here.