[Alusti test as a premonitory variable of adverse health events in a nursing home. Two-years follow-up]. / Test Alusti como variable premonitoria de procesos adversos de salud en una residencia de mayores. Seguimiento a 2 años.

INTRODUCTION: Functional capacity is a good indicator of health, quality of life, and a good predictor of morbimortality. It is a priority to functionally assess the geriatric population through objective, precise, and simple instruments. The Alusti Test in its two versions, complete (TA) and abbreviated (TAA), is a scale that meets these criteria. OBJECTIVE: To determine the usefulness of the Alusti Test as a predictor of adverse health events: falls, hospitalizations, cognitive deterioration, and mortality in the elderly institutionalized population, with a two-year follow-up. MATERIAL AND METHODS: This observational study's sample included 176 persons admitted to a nursing home for 32months, with a mean age of 85.5years. The TA was performed on 138 and the TAA on 38. RESULTS: The ratio of falls is much higher in residents with mild dependence than in those with total dependence (P<.001). Hospitalizations increase as the results of the Alusti Test are more favorable. The risk of hospitalization in dependent patients is 50% lower (P<.001) than in those with preserved mobility. Cognitive impairment is similar in all the populations with some mild-moderate level of functional dependence and decreases in the population with preserved mobility. Categorization as total and mild/severe dependence is related to a 3-4times higher mortality at six months follow-up. CONCLUSIONS: A higher mild-moderate level of dependence on the AT correlates with a lower risk of falls, a lower rate of hospitalization, and a higher risk of mortality at six months.

The Alusti Test, a Functional Assessment Scale Applicable to the Geriatric Population.

INTRODUCTION: Decreases in functional ability generate dependence, limiting people's quality of life. Assessment tools are needed to evaluate functional abilities of the older adults that can objectively and accurately assess any type of user. Such proper or adapted tools are not always available. The aim of this study was to demonstrate the usefulness and universal application of the Alusti Test, a functional assessment scale, in the older population and to evaluate the sensitivity to change of the Alusti Test short version (Alusti-S) in a psychogeriatric hospitalized population. METHODS: Longitudinal study was conducted in a psychogeriatric clinic in Navarra, Spain. The study sample comprised 539 persons of 65 years and older hospitalized at a psychogeriatric clinic (mean age 82.8 ± 7.3 years). The sensitivity to change was assessed upon admission and discharge through the application of three tests: Barthel Index, Complete Alusti Test, and Alusti-S. RESULTS: We verified sensitivity to change, as illustrated by an improvement of 24.7%, 13.8%, and 16.0%, respectively. Due to the greater functional deterioration upon admission, the improvement margin in the three tests was higher in patients over 85 years of age and in women. CONCLUSION: We consider the Alusti Test an innovative functional assessment tool due to its simplicity, sensitivity, and suitability to universal application in psychogeriatric populations. Correlating recommended physical activity based on the functional ability of the person, based on the Alusti Test, is a pending task that could be of interest for the sake of efficient interventions.

Test Alusti: nueva escala de valoración del rendimiento físico para la población geriátrica / Alusti test: new scale for assessment of physical performance in the geriatric population

Introducción: La condición funcional física y psíquica son factores clave en la población anciana. Hay disponibles muchas herramientas de evaluación, pero no se pueden aplicar a la totalidad de la población geriátrica. Presentamos el test Alusti, cuyas 2versiones le permiten abarcar este amplio y complejo espectro de población. Material y métodos: Estudio prospectivo realizado con población institucionalizada, hospitalizada y comunitaria, desarrollado entre septiembre y diciembre del 2016. Se ha realizado el análisis comparativo con otros test: índice de Barthel (IB), velocidad de la marcha (VM), Timed «UP & GO» test (TUG), Short Physical Performance Battery (SPPB) y test Tinetti. Resultados: Se incluyeron 363 sujetos (edad media 83,25 años), con diferentes niveles de situación funcional y cognitiva. La aplicación del test resulta sencilla, rápida (entre 3 y 6min), con un 100% de aplicabilidad y usabilidad, con efecto suelo-techo amplio (0-100 puntos), con un coeficiente de correlación intraclase (CCI) que muestra alta fiabilidad interobservador (CCI = 0,99) y buena correlación en su versión completa con el IB (CCI = 0,86; intervalo de confianza [IC]: 0,82-0,88) y el test Tinetti (CCI = 0,76; IC 95%: 0,71-0,81) así como en la abreviada con IB (CCI = 0,71; IC 95%: 0,65-0,75) y con el test Tinetti (CCI = 0,90; IC 95%: 0,88-0,92). Permite medir la variación de la situación funcional, que en nuestra muestra ha generado un aumento del 10,9%, tras un periodo de hospitalización. Conclusiones: El test Alusti permite la evaluación del rendimiento físico en la totalidad de la población geriátrica. La mayor concordancia se produce con el test Tinetti, al que supera en aplicabilidad

Introduction: Physical and psychological functional conditions are key factors in the elderly population. Many evaluation tools are available, but they cannot be applied to the whole geriatric population. The use Alusti Test is presented. This test consists of 2versions, which enable it to encompass this wide and complex population spectrum. Materials and methods: A prospective study with the institutionalised, hospitalised, and community population, was conducted between September and December 2016. A comparative analysis was conducted using the Barthel Index (BI), Gait Speed Test (GST), Timed «Up & Go» Test (TUG), Short Physical Performance Battery (SPPB), and Tinetti Test. Results: A total of 363 subjects were enrolled (mean age: 83.25 years), with varying levels of functional and cognitive conditions. The test was simple and quick to apply (3-6min), 100% applicable and usable with broad floor and ceiling effects (0-100 points) with an intraclass correlation coefficient (ICC) that shows a high inter-observer reliability (ICC = 0.99), and a good correlation in its full version with BI (ICC = 0.86) (95% CI: 0.82-0.88), and the Tinetti test (ICC = 0.76; 95% CI: 0.71-0.81), as well as in the abbreviated version BI (ICC = 0.71; 95% CI: 0.65-0.75) and Tinetti Test (ICC = 0.90; 95% CI: 0.88-0.92). This allows the variation of the functional condition to be measured, which in our sample showed an increase of 10.9%, after a period of hospital admission. Conclusions: It is considered that Alusti test meets the requirements for physical performance assessment in the whole the geriatric population. The highest level of accuracy is given by the Tinetti test, which has greater applicability

[Alusti test: New scale for assessment of physical performance in the geriatric population]. / Test Alusti: nueva escala de valoración del rendimiento físico para la población geriátrica.

INTRODUCTION: Physical and psychological functional conditions are key factors in the elderly population. Many evaluation tools are available, but they cannot be applied to the whole geriatric population. The use Alusti Test is presented. This test consists of 2versions, which enable it to encompass this wide and complex population spectrum. MATERIALS AND METHODS: A prospective study with the institutionalised, hospitalised, and community population, was conducted between September and December 2016. A comparative analysis was conducted using the Barthel Index (BI), Gait Speed Test (GST), Timed «Up & Go¼ Test (TUG), Short Physical Performance Battery (SPPB), and Tinetti Test. RESULTS: A total of 363 subjects were enrolled (mean age: 83.25 years), with varying levels of functional and cognitive conditions. The test was simple and quick to apply (3-6min), 100% applicable and usable with broad floor and ceiling effects (0-100 points) with an intraclass correlation coefficient (ICC) that shows a high inter-observer reliability (ICC = 0.99), and a good correlation in its full version with BI (ICC = 0.86) (95% CI: 0.82-0.88), and the Tinetti test (ICC = 0.76; 95% CI: 0.71-0.81), as well as in the abbreviated version BI (ICC = 0.71; 95% CI: 0.65-0.75) and Tinetti Test (ICC = 0.90; 95% CI: 0.88-0.92). This allows the variation of the functional condition to be measured, which in our sample showed an increase of 10.9%, after a period of hospital admission. CONCLUSIONS: It is considered that Alusti test meets the requirements for physical performance assessment in the whole the geriatric population. The highest level of accuracy is given by the Tinetti test, which has greater applicability.

Evaluación e impacto del uso de las tecnologías de la información y comunicación para la gestión clínica y seguimiento compartido y consensuado de las úlceras por presión / Evaluation and impact on the use of information and communication technology in the clinical management and agreed shared monitoring of pressure ulcers

Objetivo. Afrontar el grave problema de las úlceras por presión (UPP) implica buscar nuevos métodos y estrategias de registro, valoración y una estandarización de los criterios de intervención. La aplicación de las nuevas tecnologías de la información y las comunicaciones (TIC) constituye alternativa prometedora, a la vez que surge la necesidad de realizar estudios que corroboren su impacto. En este escenario, se presenta una aplicación informática específica de gestión de UPP, y se plantea valorar su aceptabilidad, utilidad y aplicabilidad por parte de profesionales enfermeros de 3 residencias de mayores, durante un año. Material y métodos. Se diseña y evalúa una aplicación informática que permite, partiendo de una recogida de datos completa, y un exhaustivo tratamiento e interpretación: 1) la gestión y seguimiento de las UPP; 2) la valoración del riesgo de padecer UPP; 3) el cribado del estado nutricional y, 4) el intercambio de datos entre profesionales y niveles asistenciales. Esto, que podría constituir un nuevo enfoque basado en el uso de TIC, como herramienta de cuidado compartido y consenso, tiene por delante un importante recorrido en términos de evaluación, al que se pretende contribuir mediante este artículo. Resultados. Los 3 centros han participado con 69 residentes. Se han realizado 27 cribados del estado nutricional, 22 valoraciones del riesgo de UPP y 230 monitorizaciones de lesiones. Conclusiones. Los profesionales enfermeros consideran que el sistema es útil, de fácil uso, perciben que mejora el seguimiento del paciente, no así la interrelación profesional. Acelerarían los procesos y potenciarían la parte web (AU)

Objective. Tackling the huge problem of Pressure Ulcers (PU), involves looking for new recording methods and strategies, as well as the standardization of the assessment and intervention criteria. In this context, a specific software application for PU management has been developed and was used for assessing its acceptability, usefulness and applicability by professional nurses from three residential homes for the elderly over a period of one year. Material and methods. A software application is designed and evaluated. This software application allows health professionals to: Manage and monitor PUs.; to determine the risk of PUs; and perform a nutritional status screen, based on a comprehensive data collection, processing and interpretation. It also allows health professionals to exchange data between themselves and at different care levels, which could provide a new approach based on the use of ICT as a tool for an agreement to shared care. This approach has an important journey ahead in terms of its assessment, to which we attempt to contribute through this article. Results. Three centres and 69 residents are taking part in this project. During these processes, 27 nutritional status screens and 22 PU risk assessments, as well as the monitoring of 230 PUs have been performed. Conclusions. Nurses professionals think that the system is useful, easy to use, and perceive that it improves patient monitoring, but not relationship between professionals. Moreover, they would like to makethe web a more powerful part of the application and to speed up the procedures (AU)

[Evaluation and impact on the use of information and communication technology in the clinical management and agreed shared monitoring of pressure ulcers]. / Evaluación e impacto del uso de las tecnologías de la información y comunicación para la gestión clínica y seguimiento compartido y consensuado de las úlceras por presión.

OBJECTIVE: Tackling the huge problem of Pressure Ulcers (PU), involves looking for new recording methods and strategies, as well as the standardization of the assessment and intervention criteria. In this context, a specific software application for PU management has been developed and was used for assessing its acceptability, usefulness and applicability by professional nurses from three residential homes for the elderly over a period of one year. MATERIAL AND METHODS: A software application is designed and evaluated. This software application allows health professionals to: Manage and monitor PUs.; to determine the risk of PUs; and perform a nutritional status screen, based on a comprehensive data collection, processing and interpretation. It also allows health professionals to exchange data between themselves and at different care levels, which could provide a new approach based on the use of ICT as a tool for an agreement to shared care. This approach has an important journey ahead in terms of its assessment, to which we attempt to contribute through this article. RESULTS: Three centres and 69 residents are taking part in this project. During these processes, 27 nutritional status screens and 22 PU risk assessments, as well as the monitoring of 230 PUs have been performed. CONCLUSIONS: Nurses professionals think that the system is useful, easy to use, and perceive that it improves patient monitoring, but not relationship between professionals. Moreover, they would like to makethe web a more powerful part of the application and to speed up the procedures.