Older Adult Care in the Emergency Department: Identifying Strategies that Foster Best Practice

Abstract

<h4></h4> <p>The goals of this study were to obtain a profile of older adults who are treated in the emergency department, examine their length of stay and contributing factors, and determine nurses’ knowledge and perception of care provided to older adults. The records of 206 older adults were reviewed. Emergency department nurses completed the Geriatric Institutional Assessment Profile, which measures knowledge of older adult care. The majority of older patients were community-dwelling women who required urgent care. The most common reason for the emergency department visit was a fall. Mean time older adults spent in the emergency department was longer than 5 hours, and nearly half were admitted to the hospital. Nurses scored lowest in pressure ulcer prevention and appropriate urinary catheter usage. Emergency department nurses are challenged to combine gerontological knowledge that focuses on basic care of older adults with their knowledge and skills in dealing with emergency situations.</p>

An outcomes evaluation of an Australian Hospital in the Nursing Home admission avoidance programme

“…The ED has been identified as a site that can provide a unique opportunity for conducting an initial screen and collaboration with community agencies (such as aged care facilities) for older adults (Mion et al 2001, Caplan et al 2004. Previous research conducted at this and other (US and Italian) sites identified that older adults in general wait approximately 5-6 hours in the ED before being admitted or discharged (Robinson & Mercer 2007, Crilly et al 2008, Salvi et al 2008. Older adults from ACFs have longer waits (average six hours) in the ED before being admitted or discharged (Crilly et al 2008).…”

Stage 2 Pressure Ulcer Healing in Nursing Homes

“…One study evaluated care in the ED and concluded that nurses scored lower on PrU prevention than on other types of care provided. 23 This suggests that policy focus on nursing home improvements of PrU outcomes needs to expand to hospital treatment.…”

Portuguese nurses' knowledge of and attitudes toward hospitalized older adults

“…Several studies demonstrated an overall Cronbach's Alpha coefficient ranging between 0.60 and 0.65 (42)(43)(44)(45). The GNKA subscale has been used in several published studies (16,(46)(47)(48).…”

“…Several studies indicate that these events are associated with increased morbidity and unfavorable outcomes (12,13). The lack of RN knowledge about these syndromes may act as barriers to using evidence-based geriatric nursing protocols for best practice in clinical practice which could contribute to the older adult's risk for adverse events (14)(15)(16)(17)(18). This can significantly influence RNs practice related to geriatric syndromes, such as the use of restraints (19)(20)(21), the management of pressure ulcers (22,23), urinary incontinence -UI (24)(25)(26)(27)(28), and sleep disturbances (29).…”