A new tool to asses risk of wandering in hospitalized patients

J Gerontol Nurs. 2014 Mar;40(3):28-33; quiz 34-5. doi: 10.3928/00989134-20140128-06. Epub 2014 Feb 5.

Abstract

This article describes the development and implementation of a wandering screening and intervention program based on identifying hospitalized patients with impaired cognition and mobility. A wandering screening tool developed by a multidisciplinary team was linked to appropriate levels of interventions available in the electronic health record. Advanced practice nurses (APNs) confirmed the accuracy of screening and interventions by bedside nurses for all patients who screened positive. Of 1,528 patients hospitalized during a 3-week period, 48 (3.1%) screened positive for wandering. At-risk patients were older (age ≥ 65) (66.7%), those admitted to surgical units (41.7%), Caucasian (89.6%), and men (58.3%). Thirteen (27.1%) had dementia and 45 (93.8%) had impaired cognition. Of those patients who screened positive for wandering, the APNs agreed with the bedside nurses' assessment in 79.2% of cases (38/48) about wandering risk and 89.5% (34/38 true positives) for the interventions. A two-item wandering screening tool and intervention was feasible for use by bedside nurses. Further studies are needed to determine whether this tool is effective in preventing wandering.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Confusion / diagnosis*
  • Confusion / epidemiology
  • Confusion / nursing
  • Female
  • Geriatric Assessment / methods
  • Geriatric Nursing / standards
  • Guidelines as Topic*
  • Hospitalization / statistics & numerical data
  • Hospitals, Teaching
  • Humans
  • Inpatients / statistics & numerical data
  • Male
  • Mass Screening / standards*
  • Nursing Assessment / methods
  • Patient Safety
  • Safety Management / standards*
  • Tertiary Care Centers
  • United States
  • Walking*
  • Wandering Behavior / psychology*
  • Wandering Behavior / statistics & numerical data