| Interventions |
Exercise arm
TIDieR item 1: (brief name: provide the name or a phrase that describes the intervention): Acute Care for Elders unit. TIDieR item 2: (why: describe any rationale, theory or goal of the elements essential to the intervention): researchers hypothesised that Acute Care for Elders intervention will improve functional outcomes and the process of care in hospitalised older patients. TIDieR item 3: (what (materials): describe any physical or informational materials used in the intervention, including those provided to participants or used in intervention delivery or in training of intervention providers): full description of intervention provided in Landefeld and colleagues, 1995. The intervention included environmental changes with carpeting, handrails, large clocks and calendars, elevated toilet seats and door levers described. TIDieR item 4: (what (procedures): describe each of the procedures, activities or processes (or a combination) used in the intervention, including any enabling or support activities): physical and psychosocial function were assessed by the admitting nurse and daily interdisciplinary team rounds were conducted by the geriatrician medical director and geriatric clinical nurse specialist. Suggestions by the interdisciplinary team were recorded and communicated to the attending physician. Nursing care plans for fall risk assessment, mobility, self‐care, skin integrity, nutrition, continence, confusion, depression and anxiety, which had been modified for the intervention from those used routinely on usual care units, were implemented when appropriate. Medications of potential risk to older patients were identified by the medical director, who recommended alternative treatments, including non‐pharmacological interventions. TIDieR item 5: (who provided: for each category of intervention provider (e.g. psychologist, nursing assistant), describe their expertise, background and any specific training given): nursing staff did not move between the intervention and usual care units, attending and resident physicians provided care to both groups. No other information regarding training/expertise provided. TIDieR item 6: (how: describe the modes of delivery (such as face‐to‐face or by some other mechanism, such as Internet or telephone) of the intervention and whether it was provided individually or in a group): as item 4. TIDieR item 7: (where: describe the type(s) of location(s) where the intervention occurred, including any necessary infrastructure or relevant features): 34 bed Acute Care for Elders unit. Including a room for PT and a parlour for dining and visiting with family. TIDieR item 8: (when and how much: describe the number of times the intervention was delivered and over what period of time including the number of sessions, their schedule, and their duration, intensity or dose): not specified. TIDieR item 9: (tailoring: if the intervention was planned to be personalised, titrated or adapted, then describe what, why, when and how): as item 4. TIDieR item 10: (modifications: if the intervention was modified during the course of the study, describe the changes (what, why, when and how)): not specified. TIDieR item 11: (how well (planned): if intervention adherence or fidelity was assessed, describe how and by whom, and if any strategies were used to maintain or improve fidelity, describe them): not specified. TIDieR item 12: (how well (actual): if intervention adherence or fidelity was assessed, describe the extent to which the intervention was delivered as planned): significant differences favouring Acute Care for Elders unit in: adherence to care plans promoting independent function; time to discharge planning first being mentioned; number of referrals to the social workers, and delay to referral; days of ordered bed rest; number of referrals to PT and delay to consult; number of participants with physical constraints and time the constraints were used for; number of participants with prescriptions of high‐risk medication in first 24 hours. No differences in: number of participants who had an order of bed rest; number of participants with urinary catheters and time urinary catheters used for; number of participants with prescriptions of high‐risk medications in day prior to discharge.
Control arm
TIDieR item 1: usual care units. TIDieR item 2: not specified. TIDieR item 3: not specified. TIDieR item 4: nursing staff‐to‐participant ratios were similar on the intervention and usual care units. TIDieR item 5: same nursing ratios. TIDieR item 6: not specified. TIDieR item 7: usual care units. TIDieR item 8: not specified. TIDieR item 9: not specified. TIDieR item 10: not specified. TIDieR item 11: not specified. TIDieR item 12: not specified.
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