Abstract
Abstract Background Studies show that patients with Parkinson’s Disease (PD) are more often admitted to acute hospitals and have increased Length-of-Stay (LoS) compared to age-matched controls associated with higher morbidity and mortality. This review was undertaken as the outcomes of patients with PD have not been evaluated in this level 4 hospital. Previous work locally has shown a lack of knowledge regarding the inpatient management of PD. Methods Data was collected from a retrospective chart review (115 admissions coded with PD in 2019). 10 patients were selected from medical, surgical, and orthopaedic admissions respectively (36 admissions). Charts were reviewed recording demographics, LoS, Emergency Department (ED) management, complications, outcomes, and readmission rates. Data was collected, stored, and analysed using Microsoft Excel. Results Median age of patients was 80 years. 44% were female. Median length of stay was 15.5 days. PD was documented in 97% of patients in ED, of whom 11% of patients received their PD medications in ED. 78% of patients had a history of falls, but only 20% had lying and standing blood pressure recorded. 38% had delirium as an inpatient. 42% of patients were made nil by mouth (NPO) during their stay, 87% of these secondary to peri-procedural fasting. Medications were held in 71% of procedures. Only 69% of discharge summaries were readily available. 6 patients (20%) were readmitted within 3 months. Conclusion This review highlights several areas for improvement in the management of inpatients with PD in a level four hospital. Initial interventions include education sessions for healthcare staff and review of ED pathways. PD medication management will also be reviewed. Accessible electric discharge summaries are also a key area for improvement. We aim to assess patients with PD experience of their inpatient journey as the next step in our quality improvement project. We will reaudit in 6 months.
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