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      Impact of Hospital Design on Acutely Unwell Patients with Dementia

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          Abstract

          Increasing emphasis on patient privacy and satisfaction has seen more 100% single-room hospitals opened across the UK. Few studies have addressed the impact of these new hospital designs (single rooms) on clinical outcomes specifically for acutely unwell frail patients with dementia. The objective of this study was to profile and compare the clinical outcomes of acutely unwell patients with dementia admitted to two different hospital environments. This prospective observation study was conducted for 100 dementia patients admitted at Ysbyty Ystrad Fawr (hospital with 100% single rooms) and Royal Gwent Hospital (traditional multi-bed wards) under the same University Health Board. The length of stay (LoS) was significantly longer for patients admitted to single rooms. The clinical profile of the patients was similar in both hospitals and has no association with LoS. There was no significant difference in terms of incidence of inpatient falls, fall-related injury, discharge to a new care home, 30-day readmission, or mortality. The single room environment appears to influence LoS, as previously reported; however, following the introduction of quality improvement initiatives to prevent inpatient falls, single rooms do not appear to be associated with higher inpatient fall incidence. We propose more research to understand the relationship between single rooms and LoS.

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          The Barthel ADL Index: A standard measure of physical disability?

          There is no agreed single measure of physical disability for use either clinically or in research. It is argued that acceptance of a single standard measure of activities of daily living (ADL) might increase awareness of disability, improve clinical management of disabled patients, and might even increase acceptance of published research. The Barthel ADL Index is proposed as the standard index for clinical and research purposes. Its validity, reliability, sensitivity, and utility are discussed. The Barthel Index is as good as any other single simple index, and should be adopted as the standard against which future indices are compared. The temptation to use variations on the standard Barthel Index should be resisted.
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            An extended activities of daily living scale for stroke patients

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              The Barthel ADL Index: a standard measure of physical disability?

              There is no agreed single measure of physical disability for use either clinically or in research. It is argued that acceptance of a single standard measure of activities of daily living (ADL) might increase awareness of disability, improve clinical management of disabled patients, and might even increase acceptance of published research. The Barthel ADL Index is proposed as the standard index for clinical and research purposes. Its validity, reliability, sensitivity, and utility are discussed. The Barthel Index is as good as any other single simple index, and should be adopted as the standard against which future indices are compared. The temptation to use variations on the standard Barthel Index should be resisted.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Geriatrics (Basel)
                Geriatrics (Basel)
                geriatrics
                Geriatrics
                MDPI
                2308-3417
                12 January 2017
                March 2017
                : 2
                : 1
                : 4
                Affiliations
                [1 ]Medical student, School of Medicine, Cardiff University, Cardiff CF10 3AT, UK; YoungC9@ 123456cardiff.ac.uk
                [2 ]Consultant Clinical Scientist, Department of Dermatology, Aneurin Bevan University Health Board, Newport NP20 4SZ, UK; Chris.Edwards3@ 123456wales.nhs.uk
                [3 ]Consultant Geriatrician, Department of Geriatric Medicine, Ysbyty Ystrad Fawr, Aneurin Bevan University Health Board, Wales CF82 7EP, UK
                Author notes
                [* ]Correspondence: inder.singh@ 123456wales.nhs.uk ; Tel.: +44-144-380-2234; Fax: +44-144-380-2431
                Article
                geriatrics-02-00004
                10.3390/geriatrics2010004
                6371082
                31011015
                6a71f9ca-69b9-4b67-a684-061e30625427
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 02 December 2016
                : 09 January 2017
                Categories
                Article

                dementia,single rooms,multi-bedded wards,older people,falls,clinical outcomes

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