Grant Funding

Acute Care of Elders Unit

The Acute Care of Elders Unit, known as the ACE Unit, is one of only a few programs in the country specially designed for acutely ill persons in the rapidly growing population over 65.

THE UNIT

Modeled after a similar unit at the University Hospital of Cleveland, the ACE unit opened in 1994. The ACE unit has become a center of nursing excellence, providing quality care to the frail elderly admitted into the acute care setting.

The 31 bed unit is located on Cupp 5 east and has been decorated and furnished to suit the needs of the older adult. There are two negative pressure rooms for respiratory isolation and all rooms have the capacity for telemetry monitoring. Rooms are private with free television service. A dry erase board in each room is utilized to provide orientation to day and month. All signage throughout the unit is sized and located to be easily visible to both patients and visitors.

A spacious visitor and patient lounge is stocked with health education material specific to the older adult as well as providing information about local community services.

THE STAFF

What makes the ACE unit unique in the world of medical/surgical units lies in a team approach to providing multidisciplinary care for the old and oldest old.

Members of the multidisciplinary team located on the unit are:

Members of the team available by consult are:

In order to become a staff member on the ACE unit, the registered nurses and certified nursing assistants must successfully com­plete an in-house specialized gerontological education program.

Housestaff rotating onto the ACE unit receive an orientation and formalized daily instruction from the geriatrician attendings and fellows. Teaching rounds occur daily and formal multidisciplinary rounds are conducted twice weekly.

What happens when a patient leaves the hospital plays an important role in preventing premature readmission. For this reason there are two case managers who are dedicated to the ACE unit. On the first day of admission they begin the process of discharge planning. As indicated by the patient's disposition the case manager will arrange home care, hospice care, short-term placement in a SNF or specialty rehab hospital, or long term or short term nursing home placement. When a patient's condition makes it impossible for them to return home, the case manager will arrange nursing home placement.

There are occasions when a patient with a terminal illness nears the end of life and hospital hospice care is indicated. Hospice care will be provided on the ACE unit when death is imminent. If possible an empty room is made available for family members staying with the patient so they may sleep and shower.

Spirituality is recognized as an integral part of life for most older adults. Interdenominational pastoral care is available when requested by the family or patient. The hospital chaplain makes daily rounds on the ACE unit and volunteers from local places of worship visit several times a week in the evenings.

THE PATIENTS

Patients admitted to the ACE Unit should be 65 years of age or older and not in need of any specific specialty services such as            cardiology and oncology.

Once the patient arrives on the ACE unit admission assessments are completed by the nursing and medical staff and a plan of care is initiated.

Special emphasis is placed on assessment of: the presence of pain (using both verbal and non-verbal cues), mental status, skin integrity, elimination, diet and mobility. Fall risk screening is done on admission and every 24 hours until time of discharge. All new admissions receive an initial nutritional consult by a registered dietician within 24 hours with follow up as indicated.

Practice guidelines utilized in the provision of care for the elder population include:

• restraint reduction

• fall prevention

• wound care

• skin care

• dementia/delirium

Family members and friends are Welcome to visit at any time. An adult must supervise children.  Visitors for patients in respiratory or contact isolation should see the patient's nurse before entering the room.

For more information about the ACE Unit, call the Nurse Manager at (215) 662-8197.

ACE Unit
Presbyterian Medical Center
of the University of Pennsylvania Health System
Scheie, 3rd Floor
39th & Market Streets
Philadelphia, PA 19104-2699
Phone: (215) 662-8183
Fax: (215) 662-5268