Zeitschrift für Gerontologie und Geriatrie
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The use of intravascular or intraluminal catheters is common in geriatric medicine. Blood stream infections due to intravascular catheterization, peritoneal catheters for dialysis, suprapubic or transurethral catheters, or percutaneous endoscopic gastrostomy are a major source of nosocomial infections. ⋯ The risk can be minimized by diligent checking of the indications, hygienic measures, using the correct materials, thorough follow-up, and education of the medical and nursing staff. Thus, it is possible to avoid individual suffering of patients and to reduce costs in the healthcare system.
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Comparative Study
Self- and proxy report for the assessment of pain in patients with and without cognitive impairment: experiences gained in a geriatric hospital.
Pain assessment is a complex procedure in patients with different degrees of cognitive impairment. The challenge is to determine whether self-reporting tools are adequate and to identify the cases in which proxy ratings are necessary. ⋯ In the majority of the cases, our approach enables reliable appropriate pain assessment without the strict prerequisite of an upstream cognitive assessment.
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Elderly hospitalized patients have a high risk for developing malnutrition. The causes for an impaired nutritional status in old age are various and the impact is far-reaching. Malnutrition is a comorbidity that is well treatable and various studies show the favorable effect of nutrition therapy on nutritional status and prognosis. In the past few years, several guidelines have been developed to improve nutritional management and to ensure standardized procedures to identify patients at nutritional risk who will benefit from nutrition therapy. However, it is still not clear to what extent nutrition management has been implemented in geriatric wards in Germany. ⋯ The use of validated screening instruments is clearly underrepresented and therapy algorithms are rarely implemented in German geriatric hospital units. There are a variety of nutrition interventions available, but it is unclear how patients at nutritional risk are identified. The data on the efficacy of nutrition therapy in elderly patients are very convincing and the integration of nutrition screening in the basic geriatric assessment seems sensible. The establishment of standardized procedures for nutrition intervention and therapy recommendations in the doctor's letter would be useful to ensure sustainability of nutrition therapy.