Older Patients in the Emergency Department: What Are the Risks?

Nolan, Margaret R

doi:10.3928/00989134-20091103-01

Cited by 17 publications

(7 citation statements)

References 25 publications

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“…(8) EDs should be better designed to accommodate older people in terms of environment and type of care and services provided (Considine et al, 2010). Alternative triage and waiting processes could enhance the patient journey and be better suited to the needs of elderly patients (Considine et al, 2010;Nolan, 2009). Additionally, communication aids should be provided to older people when they are in ED (Nolan, 2009).…”

Section: Methodsmentioning

confidence: 99%

“…Alternative triage and waiting processes could enhance the patient journey and be better suited to the needs of elderly patients (Considine et al, 2010;Nolan, 2009). Additionally, communication aids should be provided to older people when they are in ED (Nolan, 2009). (9) Interdisciplinary teams with geriatricians and aged care nurse practitioners/nurse consultants should be deployed in ED for assessments/ evaluations (Nolan, 2009).…”

Section: Methodsmentioning

confidence: 99%

“…Additionally, communication aids should be provided to older people when they are in ED (Nolan, 2009). (9) Interdisciplinary teams with geriatricians and aged care nurse practitioners/nurse consultants should be deployed in ED for assessments/ evaluations (Nolan, 2009). Alternatively it may be useful to enhance the geriatric knowledge of existing ED nurses (Robinson & Mercer, 2007).…”

Section: Methodsmentioning

confidence: 99%

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Referrals to hospital emergency departments from residential aged care facilities: Stuck in a time warp

O’Connell

Hawkins²,

Considine³

et al. 2013

Contemporary Nurse

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This research aimed to describe the number and type of residents admitted to emergency departments (EDs) over 2 years; and to explore nurses' perceptions of the reasons why residential aged care facility (RACF) residents are referred to EDs. The research objective was addressed in a retrospective exploratory study using data on admissions to EDs from RACFs (N = 3,094) at the participating organisation over a 2-year period, and interview data on seven RACF and four ED nurses' perceptions of the issues involved. Most residents presenting at EDs required urgent medical attention. Major themes identified by RACF and ED nurses included issues related to staff competency, availability of general practitioners, lack of equipment in RACFs, residents and family members requesting referrals, communication difficulties, and poor attitudes towards RACF staff. There is a need to use strategies to detect residents whose conditions are deteriorating and treat them promptly in RACFs.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Referrals to hospital emergency departments from residential aged care facilities: Stuck in a time warp

O’Connell

Hawkins²,

Considine³

et al. 2013

Contemporary Nurse

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“…The upward trend in ED utilization is particularly problematic because older adults receive more diagnostic testing that could be harmful and may even be unnecessary while in the emergency department, compared to their younger counterparts. 9 Studies show that there is a significant increase in the use of resources when older adults visit the emergency department. This includes doubling of intensive care services, increased number of imaging tests, electro cardio gram, and cardiac monitoring as well as inappropriate medication for older adults.…”

Section: Introduction and Review Of Literaturementioning

confidence: 99%

ED Utilization and Self-Reported Symptoms in Community-Dwelling Older Adults

Dermody¹,

Sawyer²,

Kennedy³

et al. 2017

Journal of Emergency Nursing

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Background The rise in emergency department (ED) utilization among older adults is a nursing concern, because emergency nurses are uniquely positioned to positively impact the care of older adults. Symptoms have been associated with ED utilization, however, it remains unclear if symptoms are the primary reason for ED utilization. Purpose Describe the self-reported symptoms of community-dwelling older adults prior to accessing the emergency department. Examine the differences in self-reported symptoms among those who utilized the emergency department, and those who did not. Procedures A prospective longitudinal design was used. The sample included 403 community-dwelling older adults 75 years and older. Baseline in-home interviews were conducted followed by monthly telephone interviews over 15 months. Main Findings Commonly reported symptoms at baseline included pain, feeling tired, and having shortness of breath. In univariate analysis, pain, shortness of breath, fair/poor well-being, and feeling tired were significantly correlated with ED utilization. In multivariable models, problems with balance, and fair/poor well-being were significantly associated with ED utilization. Conclusions Several symptoms were common among this cohort of older adults. However, there were no significant differences in the types of symptoms reported by older adults who utilized the emergency department compared to those who did not use the emergency department. Based on these findings, symptoms among community-dwelling older adults may not be the primary reason for ED utilization.

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“…Such environments can contribute to errors in ED care (Campbell 2009) and lead to hightened risk in older adults. For example, the noisy, crowded and constantly lit environment of the ED can increase an older adults’ vulnerability to preventable incidences, which places them at greater risk for injury (Sparks 2008, Nolan 2009).…”

Section: Introductionmentioning

confidence: 99%