Frailty Focused Enhancements to Seniors’ Hospital Care (FrESH): a Mixed Methods Study Reporting the Efficacy of Specialized Education for Front-line Staff

Abstract

Background

Acute care hospital stays often lead to increased frailty and functional decline in older adults. Interventions such as specialized education for nurses can improve health outcomes and decrease lengths of stay for these patients. This study aimed to identify the facilitators and barriers to providing care to older adults in acute care, and the efficacy of specialized education for front-line staff.

Methods

A specialized education program for front-line staff, Frailty Focused Enhancements to Seniors’ Hospital Care (FrESH), was developed and delivered across five family medicine units in New Brunswick (NB). A mixed methods approach was used to assess the knowledge, attitudes, and experiences of staff caring for hospitalized older adults, and evaluate the impact of providing specialized education. Patient-level data on delirium, mobility, and medications pre- and post-specialized education intervention were collected and analyzed.

Results

Sixty-three front-line staff participated. Analysis of questionnaires demonstrated that staff had positive attitudes and beliefs about caring for older adults; however, knowledge of geriatric care principles was limited and remained unchanged. There was no significant change in patient-level measures post-intervention. Environmental constraints hindered staff from implementing best practices, leading to practical challenges to care delivery. While respondents expressed satisfaction with the education, their capacity to deliver the type of care presented in the education sessions was not achievable.

Conclusion

Staff identified the need for specialized education; however, there was no impact on care after participation. Results will inform changes to the specialized education programs target-ing care for hospitalized older adults in acute care.