Preventable complications in hospitals

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Hospital hallway with person in scrubs walking away from the camera

There is growing evidence that hospitals are not safe places for people with dementia.

For example, a recent report from the Australian Institute of Health and Welfare, commissioned by Alzheimer’s Australia with support from the J.O. & J.R. Wicking Trust, found that almost half of people with dementia in hospitals are not identified as such, and that people with dementia end up in hospital for longer than people without, at an additional cost of 35% to the healthcare system.

New Australian research published last week has now shown that people with dementia in hospital have higher rates of potentially preventable complications, including urinary tract infections, pressure ulcers, pneumonia and delirium.

The study looked at data collected by NSW public hospitals in 2006 and 2007 as part of the NHMRC-funded Hospital Dementia Services Project. The researchers looked at patient records from 440,000 overnight hospital stays during the period involving people aged 50 and over. Just over 10% of these hospital stays (44,500) involved a person with dementia.

Comparing those with and without dementia on rates of 12 preventable complications, the researchers found that people with dementia experienced higher rates of complications in 7 of the 12 categories, even after statistically controlling for a range of other factors.

“Even though Australia has one of the best health systems, things can still go wrong in hospital, particularly for vulnerable people like those with dementia. This research shows that people with dementia in NSW had higher rates of complications in hospital - sometimes 2 or 3 times the rates than people without dementia in the same age groups.

These complications can cause suffering and distress for people with dementia (as well as their carers and staff), and has an impact on health care costs. It is clear that we need to better understand what happens to people with dementia while they are in hospital, the extent to which these complications are preventable, and by what means. We know that kinds of hospital working environments (university-educated nurse staffing levels per patient, for example) can make a big contribution to differences in the rates of these complications. This work highlights opportunities to reduce these complications for people with dementia.” - said lead researcher Kasia Bail, Assistant Professor in nursing at the University of Canberra.