Prevention of hospital-acquired geriatric syndromes: applying lessons learned from infection control.

Abstract

Geriatric syndromes are multifactorial health conditions occurring in persons rendered vulnerable by age and multiple organ systems impairments.1 Many geriatric syndromes, including pressure ulcers, falls, delirium, and functional decline occur with high frequency in hospitalized patients, causing significant morbidity, mortality, and resource utilization.2 Hospital-acquired geriatric syndromes received heightened attention from the Centers for Medicare and Medicaid Services (CMS) following an August 2007 rulemaking that included stage 3 or 4 pressure ulcers and injurious falls as two of the eight “reasonably” preventable adverse events—referred to as hospital-acquired conditions (HACs)—targeted for reduction through the use of financial penalties levied on hospitals.3 Review of the initial HACs list revealed three categories: serious preventable events, hospital-acquired infections, and geriatric syndromes. 3 In subsequent rulemakings, additional events were added. 4 (Table 1)