Acute XXXX treatment for older adults hospitalized with @entity173 : current nursing practices and perceived barriers.

@entity1 @entity173 @entity6882 @entity158 @entity1443
This article examines acute @entity158 management practices for @entity1 65 years of age and older who were hospitalized during 1999 for @entity173 . Data were collected from the medical records of @entity1 (N = 709) admitted to 12 hospitals in the Midwest and from questionnaires on @entity158 practices completed by nurses (N = 172) caring for these @entity1 . The major variables examined were (1). pharmacological and nonpharmacological treatments for acute @entity158 in hospitalized elders, (2). nurses' perceived stage of adoption for avoiding @entity6882 use and for administering analgesics around-the-clock, and (3). nurses' perceived barriers to optimal treatment of acute @entity158 in elders. @entity1443 was the most frequently administered analgesic, but administered doses were far less than the maximum daily recommended dose. More than one third (39%) of the nurses reported that they always avoided the use of @entity6882 , and over half reporting avoiding its use sometimes. However, the majority of @entity1 (56.8%) received at least one dose of @entity6882 , even though evidence suggests that other analgesic agents are more appropriate for treatment of acute @entity158 in elders. Only 27% of @entity1 received @entity1 -controlled analgesia, and only 22.3% of @entity1 received around-the-clock administration during the first 24 hours after admission of analgesics that had been ordered on a prn basis. The majority of nurses were aware that around-the-clock administration of analgesics was preferable, but only 33.7% were persuaded (believed) that this method should be used. Intramuscular injection was used for 52.2% of @entity1 , even though this route is not recommended for older adults. The most frequently used nonpharmacological intervention was repositioning, followed by use of pressure relief devices and cold application. Nurses reported difficulty contacting physicians and difficulty communicating with them about type and/or dose of analgesics as the greatest barriers to @entity158 management. Findings from this multi-site study show that active and focused "translation" interventions are needed to promote adoption of evidence-based acute @entity158 management practices by health care providers.
