Postimplementation of NICHE, unit leadership, and
nursing staff recognized that recommendations from the
geriatricians were often not acted upon because there
was a lack of understanding of the importance of geriatric
considerations and it was not part of the daily care.
Orthostatic blood pressures were often ordered by geriatricians,
but were not completed, leading to a delay in
care. Education was developed on orthostatic blood pressures,
and a process was developed to improve compliance
with orthostatic blood pressures in geriatric trauma
patients. On the TTU, orthostatic vital signs are completed
upon the first time out of bed and daily for all patients
aged 65 years and more admitted after a fall. Nurses are
prepared to review orthostatic vital signs during Collaborative
Rounds, so appropriate interventions can be initiated.
As a result, trauma providers and geriatricians can
make medication adjustments if necessary