Impact of a nurse led multidisciplinary team on an acute medical admissions unit.
OBJECTIVE: To determine the impact of a nurse-led multi-disciplinary team on management of elderly patients with functional problems admitted to an acute medical admission unit. DESIGN: Data collection from the first 16 months of the team's operation. SETTING: A district general hospital, Scotland. SUBJECTS: All elderly patients with functional problems who were considered fit for immediate multi-disciplinary assessment. RESULTS: Over 1000 patients were assessed during the first 16 months. Twenty four per cent of these frail individuals were discharged directly home, of whom, almost half had some form of ongoing support. The remaining 76% were transferred for ongoing care to other wards in the Medical Directorate. Of this group, 49% moved to general medicine, 43% to geriatric assessment and 8% to the Stroke Unit. The team were perceived to improve the appropriateness of these transfers by enabling staff to review both the medical and functional needs of elderly patients when deciding on the best setting for ongoing care. CONCLUSIONS: Immediate multi-disciplinary assessment of elderly patients admitted to a medical admissions unit enables the early supported discharge of a proportion of elderly and enhances the ability of the hospital to place appropriately those patients requiring a longer stay.