Integrating informal caregivers into the rehabilitation of hospitalized adults in a geriatric rehabilitation department: a best practice implementation project

OBJECTIVES: The aim of this project was to improve collaboration between health care professionals and informal caregivers in a rehabilitation program for hospitalized older adults in a tertiary geriatric department in Switzerland through the implementation of best practice recommendations. INTRODUCTION: Informal caregivers are key partners for health care providers when an older patient is hospitalized. Their lack of inclusion in the rehabilitation process may limit the quality of care for the patient after discharge. METHODS: The project used the JBI audit and feedback method and tools to implement best practice recommendations into practice. Nine audit criteria were developed based on a JBI evidence summary. A baseline audit was conducted, followed by a multicomponent implementation strategy, designed with the collaboration of informal caregiver partners. A follow-up audit was completed to determine improvements in practice. RESULTS: Baseline data showed results below 50% compliance for five of the nine criteria, indicating the need for significant improvement. Analysis of the results highlighted nurse-related and organizational barriers. The follow-up results achieved improvements in eight criteria, with an increase of 50% or more for three criteria. Three other criteria did not meet the need of informal caregivers; therefore, their results demonstrated low improvement. CONCLUSIONS: Careful preparation of nurses through targeted education, clinical training, and discussions achieved positive results, in line with best practice recommendations. The involvement of informal caregivers to design the multicomponent implementation strategy was also a successful partnership. This was used to scale up evidence-based recommendations to other units in the geriatric rehabilitation department. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A657.