Rosted, Elizabeth Emilie4; Poulsen, Ingrid2; Hendriksen, Carsten3; Wagner, Lis4
1 Syddansk Forskningscenter for Klinisk Sygepleje (SFKS), Department of Clinical Research, Det Sundhedsvidenskabelige Fakultet, SDU2 Research Unit of Nursing, Institute of Clinical3 Institut for Folkesundhedsvidenskab4 Syddansk Forskningscenter for Klinisk Sygepleje (SFKS), Department of Clinical Research, Det Sundhedsvidenskabelige Fakultet, SDU
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 needs. 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 2 164 (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.
Ninth Asia/oceania Regional Congress of Gerontology and Geriatric 2011: Aging Well Together: Regional Perspectives, 2011