Empowering Orthopedic Nurses’ and Nurse’s aides through a Multimodal Geriatric Mobile Team: a Mixed Methods Study

Background: Despite their proven effectiveness, geriatric perioperative units face organizational constraints that limit access to care. A mobile geriatric team can extend expertise to orthopedic wards, assessing older patients at nurses' and nurse’s aides' request. This study explored caregivers' perceptions of the geriatric mobile team and examines the quality of patient care before and after its intervention. Methods: This mixed-methods study used a convergent design. The mobile team provided direct geriatric expertise at the request of orthopedic caregivers and implemented an educational program to enhance their skills in geriatric care. Training included “aging simulation” workshops, error-awareness exercises (“room of errors” workshops), and courses on hospital-associated disability. Quantitative evaluation focused on post-operative care in four key areas: pain management, mobilization, nutritional screening, and continence care, along with adherence to the mobile team’s recommendations. Qualitative analysis involved focus groups with nurses and nurse’s aides to capture their experiences and perspectives. Results: Between December 2022 and April 2023, 38 patients were evaluated by the mobile team (mean age: 84 years ±6.1; 42% male). Patients were relatively independent (median ADL score: 6 [6–6]), with 24% experiencing neurocognitive disorders. The mobile team improved care appropriateness in over 70% of cases across all four domains. Nurses and nurse’s aides reported that the mobile team alleviated their feelings of isolation and lack of recognition by fostering horizontal communication and shared decision-making, reinforcing their role in patient-centered care. Conclusion: In orthopedic settings, a perioperative geriatric mobile team plays a critical role in supporting nurses as clinical care partners and nurse’s aides as frontline caregivers. By providing both hands-on assistance and targeted education, the team strengthens geriatric-centered care beyond specialized geriatric units, enhancing both professional confidence and patient outcomes. Trial and Protocol Registration: The study protocol is not registered as it was a retrospective study.