Case finding and referral model for emergency department elders: A randomized clinical trial

Mion, Lorraine C.; Palmer, Robert M.; Meldon, Stephen W.; Bass, David M.; Singer, Mendel E.; Payne, Susan N.; Lewicki, Linda J.; Drew, Barbara L.; Connor, Jason T.; Campbell, James W.; Emerman, Charles L.

doi:10.1067/mem.2003.3

Cited by 172 publications

(279 citation statements)

References 38 publications

Supporting

Mentioning

259

Contrasting

Unclassified

Order By: Relevance

“…Left untreated, depression affects much more than just mood. It can impact physical health, impair memory and concentration and prevent affected individuals from enjoying life (Hustey & Meldon, 2002;Mion et al, 2003;Chang & Chueh, 2011). However, depression is not a normal or necessary part of ageing and it is very important to recognise early as possible (Ormala & Julkunen, 2012).…”

Section: Introductionmentioning

confidence: 99%

Undercover fear of elderly people in nursing homes: Death anxiety and depression

2017

View full text Add to dashboard Cite

Aim: To find out the level of death anxiety and depression level among Turkish elderly people. Methods: This research was carried out on 106 elderly people aged 60 years and older from three different nursing homes. Descriptive statistics, one-way ANOVA, t-test, Cronbach's alpha coefficient, and correlations were used for the analyses. Results: The 25.4% of elderly were between 65-69 years old, and included most of the elderly who were male (83%), single (92.5%) and retired (35.8%).The overall mean on depression was 14.43, and the death anxiety was 7.57. Mild depression was found in 69.8%, and no symptoms of depression were reported by 16% of the subjects. A positive correlation was found between total score of GDS and TDAS (r: 0.304, p<0.01). Conclusion: Healthcare professionals working with elderly people in nursing homes should be aware about death anxiety of the elderly.

show abstract

Section: Introductionmentioning

confidence: 99%

Undercover fear of elderly people in nursing homes: Death anxiety and depression

2017

View full text Add to dashboard Cite

show abstract

“…These interventions are resource-intensive and have had only intermittent success in decreasing hospitalizations, reducing ED visits, increasing primary care visits, and improving functional outcomes. [7][8][9][10][11][12][13][14] Several studies have found that comprehension of discharge instructions is a significant barrier to care compliance [15][16][17][18] and that many older patients discharged from the ED do not understand their discharge instructions, nor do they attend follow-up appointments. 18,19 Studies conducted in other patient populations have shown that telephone follow-up encourages compliance with discharge instructions and increases the likelihood of physician follow-up.…”

mentioning

confidence: 99%

A Randomized Trial Exploring the Effect of a Telephone Call Follow‐up on Care Plan Compliance Among Older Adults Discharged Home From the Emergency Department

Biese

LaMantia

Shofer

et al. 2014

Academic Emergency Medicine

120

View full text Add to dashboard Cite

Objectives: Older patients discharged from the emergency department (ED) have difficulty comprehending discharge plans and are at high risk of adverse outcomes. The authors investigated whether a postdischarge telephone call-mediated intervention by a nurse would improve discharge care plan adherence, specifically by expediting post-ED visit physician follow-up appointments and/or compliance with medication changes. The second objectives were to determine if this telephone call intervention would reduce return ED visits and/or hospitalizations within 35 days of the index ED visit and to determine potential cost savings of this intervention.Methods: This was a 10-week randomized, controlled trial among patients aged 65 and older discharged to home from an academic ED. At 1 to 3 days after each patient's index ED visit, a trained nurse called intervention group patients to review discharge instructions and assist with discharge plan compliance; placebo call group patients received a patient satisfaction survey call, while the control group patients were not called. Data collection calls occurred at 5 to 8 days and 30 to 35 days after the index ED visits for all three groups. Chi-square or Fisher's exact tests were performed for categorical data and the Kruskal-Wallis test examined group differences in time to follow-up.Results: A total of 120 patients completed the study. Patients were 60% female and 72% white, with a mean age of 75 years (standard deviation [SD] AE 7.58 years). Intervention patients were more likely to follow up with medical providers within 5 days of their ED visits than either the placebo or the control group patients (54, 20, and 37%, respectively; p = 0.04). All groups performed well in medication acquisition and comprehension of medication indications and dosage. There were no differences in return visits to the ED or hospital within 35 days of the index ED visit for intervention patients, compared to placebo or control group patients (22, 33, and 27%, respectively; p = 0.41). An economic analysis showed an estimated 70% chance that this intervention would reduce total costs. Conclusions:Telephone call follow-up of older patients discharged from the ED resulted in expedited follow-up for patients with their primary care physicians. Further study is warranted to determine if

show abstract

“…The lack of difference observed in the present study is consistent with most previous RCTs. 2,3,[5][6][7][8] Although we attempted to distinguish between avoidable and nonavoidable ED revisits using two definitions from the literature, [23][24][25] we still found no evidence of study impact. The avoidability of visits is a subjective evaluation combining clinical indicators and patient-professional interactions during the ED visit and may not be recorded in the hospital chart, making it difficult to determine reliably whether preventive actions might have been possible or effective.…”

Section: Discussionmentioning

confidence: 81%

“…4 Three others did not significantly reduce ED revisits, [5][6][7] and one showed a nonsignificant trend toward an increase. 8 Based on the available literature, we developed a short-term intervention involving telephone follow-up.…”

Section: Ré Sumémentioning

confidence: 99%

Randomized controlled trial of a nursing intervention to reduce emergency department revisits

Cossette

Vadeboncœur

Frasure-Smith

et al. 2015

CJEM

View full text Add to dashboard Cite

Objective: To determine whether a nursing intervention delivered at emergency department (ED) discharge would reduce ED revisits. Method: A randomized study was conducted in the ED of a tertiary cardiac hospital in Montreal, Quebec. Between November 2006 and March 2010, 3,795 patients were assessed for eligibility based on two risk factors for ED revisits ($ 1 ED visit in the past year and $ 6 medications); 132 were randomized to the experimental group (EG) and 133 to the control group (CG). The intervention included one nurse-patient meeting before leaving the ED, with two additional telephone contacts over the next 2 weeks. The primary outcome was time to ED revisits within 30 days after discharge. Secondary outcomes included time to ED revisits over 90, 180, and 365 days and hospitalizations over 30, 90, 180, and 365 days. Results: A planned interim analysis that stopped the study with half of the planned sample showed that the time to ED revisits was similar in both groups at 30 days (p 5 0.81; revisits: 18.2% in EG, 19.6% in CG), 90 days (p 5 0.44), 180 days (p 5 0.98), and 365 days (p 5 0.75). The only difference identified was a lower hospitalization proportion at 180 days in the EG group (13.6% v. 24.1%; p 5 0.038). Conclusions: These findings are consistent with previous research showing that few ED-based interventions are successful in reducing ED returns. Factors other than those targeted by the intervention, including an improvement in usual care, may explain the findings. RÉ SUMÉObjectif: L'é tude visait à dé terminer si une intervention en soins infirmiers, appliqué e au moment du congé du service des urgences (SU) permettrait de ré duire le nombre de reconsultations à ce mê me service. , ce qui a mis fin à l'é tude, au moment où la moitié de la taille pré vue de l'é chantillon avait é té atteinte. La seule diffé rence observé e é tait une diminution de la proportion des hospitalisations au bout de 180 jours dans le GE (13.6% v. 24.1%; p 5 0.038). Conclusions: Les ré sultats vont dans le mê me sens que ceux d'autres é tudes, selon lesquels peu d'interventions ré alisé es au SU permettent de ré duire le nombre de reconsultations à ce mê me service. Des facteurs diffé rents de ceux ciblé s par l'intervention, notamment une amé lioration des soins courants, pourraient expliquer ces ré sultats.

show abstract

Case finding and referral model for emergency department elders: A randomized clinical trial

Cited by 172 publications

References 38 publications

Undercover fear of elderly people in nursing homes: Death anxiety and depression

Undercover fear of elderly people in nursing homes: Death anxiety and depression

A Randomized Trial Exploring the Effect of a Telephone Call Follow‐up on Care Plan Compliance Among Older Adults Discharged Home From the Emergency Department

Randomized controlled trial of a nursing intervention to reduce emergency department revisits

Contact Info

Product

Resources

About