Geriatric nursing assessment and intervention in an emergency department: a pilot study
Version of Record online: 12 APR 2012
© 2012 Blackwell Publishing Ltd
International Journal of Older People Nursing
Special Issue: Acute care
Volume 7, Issue 2, pages 141–151, June 2012
How to Cite
Rosted, E., Wagner, L., Hendriksen, C. and Poulsen, I. (2012), Geriatric nursing assessment and intervention in an emergency department: a pilot study. International Journal of Older People Nursing, 7: 141–151. doi: 10.1111/j.1748-3743.2012.00323.x
- Issue online: 24 APR 2012
- Version of Record online: 12 APR 2012
- Submitted for publication: 15 June 2011 Accepted for publication: 13 February 2012
- emergency department;
- geriatric assessment;
- geriatric nursing;
- nursing assessment;
- nursing intervention
rosted e., wagner l., hendriksen c. & poulsen i. (2012) Geriatric nursing assessment and intervention in an emergency department: a pilot study. International Journal of Older People Nursing7, 141–151 doi: 10.1111/j.1748-3743.2012.00323.x
Aim. To describe and test a model for structured nursing assessment and intervention to older people discharged from emergency department (ED).
Background. Older people recently discharged from hospital are at high risk of readmission. This risk may increase when they are discharged straight home from an ED as time pressure requires staff to focus on the presenting problem although many have complex, unresolved, care needs.
Method. A prospective descriptive pilot study was conducted. Older people aged 70 and over and at risk of adverse health and functional outcome were included. Intervention: At discharge, and at 1 and 6 months follow-up, a brief standardised nursing assessment (ISAR 2) developed by McCusker et al. was carried out. The focus was on unresolved problems that required medical or nursing intervention, new or different home care services or comprehensive geriatric assessment. After assessment, the nurse made relevant referrals to the geriatric outpatient clinic, community health centre, general practitioner or made arrangements with next of kin.
Results. One hundred and fifty people participated, mean age was 81.7. At discharge, they had a mean of 1.9 unresolved problems, after 1 month 0.8, and after 6 months 0.4. Older people receiving home care services increased from 79% at discharge to 89% at 1 month and 90% at 6 months follow-up.
Conclusion. ISAR 2 works well in a Danish ED setting and intercepts older peoples’ problems. It seems that unresolved problems decrease when a nurse assesses and intervenes at discharge from ED, and at follow-up. However, a randomised controlled test should be carried out to confirm this.
Implications for practice. Nursing assessment and intervention should be implemented in the ED to reduce older peoples’ unrevealed problems.