Nursing Assessment and Intervention to Geriatric Patients Discharged from Emergency Departments

Elizabeth Emilie Rosted, Ingrid Poulsen, Carsten Hendriksen, Lis Wagner

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    Background: Geriatric patients recently discharged
    from hospital are at risk of unplanned readmissions
    and admission to nursing home. When discharged
    directly from Emergency Department (ED) the risk
    increases, as time pressure often requires focus on
    the presenting problem, although 80% of geriatric
    patients have complex and often unresolved caring
    Objective: To investigate a structured nursing
    intervention’s impact on geriatric patients’
    unresolved problems and their use of help from the
    community health centre.
    Method: We conducted a prospective descriptive
    study of selected geriatric patients with nursing
    intervention at discharge and 1 and 6 months
    follow-up. Included were geriatric patients 70+
    years discharged to their home October 2006-June
    2008. Intervention: After detecting the geriatric
    patients planned to be discharged, the geriatric
    nurse in the ED did a brief standardised nursing
    assessment developed by McCusker et al.
    comprising a checklist of physical, mental, medical
    and social problems. Focus was on unresolved
    problems that required medical intervention,
    new/different home care services or comprehensive
    geriatric assessment. After assessment the nurse
    made relevant referrals to geriatric outpatient
    clinic, community health centre, primary physician
    or arrangements with next-of-kin.
    Findings: 150 geriatric patients participated, mean
    age 81.7 (70-99). At discharge they had in mean 2
    (0-9) unresolved problems, after 1 month 0.8 (0-5),
    and after 6 months 0.5 (0-4). Before baseline ED
    visit 85 % of the patients received home care
    services, 1 and 6 months after discharge it was 96
    %. Relevance to clinical practice: Structured
    nursing assessment and intervention in the ED
    could be a way of discovering geriatric patients’
    unresolved problems and preventing further
    functional decline and readmission. To confirm the
    effect a randomized controlled trial including 270
    patients is carried out as part of my PhD study at
    University of Southern Denmark. Data is collected
    from Copenhagen University Hospital Amager.
    TitelNinth Asia/Oceania Regional Congress of Gerontology and Geriatric 2011 : Aging well together: regional perspectives
    Publikationsdatookt. 2011
    StatusUdgivet - okt. 2011

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