medRxiv (Cold Spring Harbor Laboratory),
Journal Year:
2024,
Volume and Issue:
unknown
Published: Nov. 6, 2024
Abstract
Background
Older
adults
constitute
a
considerable
number
of
attendances
at
emergency
departments
(EDs).
Whilst
many
require
hospital
admission,
greater
focus
now
is
on
admission
avoidance
with
older
being
subsequently
discharged
from
EDs.
Little
known,
however,
about
the
experiences
out
hours
(OOH)
when
specialist
person
support
services
are
unavailable.
Aim
To
explore
senior
health
care
professionals’
discharging
people
during
Method
A
qualitative
study
involving
individual
semi-structured
interviews
was
used
to
healthcare
professionals.
Fourteen
participants
in
total
responded
wide
geographical
spread.
Data
analysis
undertaken
using
Braun
and
Clarke’s
(2022)
six-step
framework
for
Thematic
Analysis.
Results
One
overarching
theme
identified
focusing
risks
safety
whilst
OOH
ED.
Three
sub-themes
included
“Should
they
stay,
or
should
go?”,
“Bright
lights
noise”,
“New
ways
working”,
which
an
ED,
delaying
discharge,
recommendations
future
practice.
Significant
differences
were
reported
between
office
discharge
Diversity
practice
assessments,
resources
available
also
evident
across
adverse
consequences
having
stay
prolonged
periods
Conclusions
There
have
been
welcome
developments
who
attend
However,
further
innovative
collaboration
decision
makers
needed
meet
needs
rapidly
ageing
population.
Safe,
equitable
effective
24/7
be
norm
all
every
ED
regardless
location.
Gaps
must
addressed
taking
cognisance
relevant
Emergency Medicine Journal,
Journal Year:
2023,
Volume and Issue:
40(4), P. 248 - 256
Published: Jan. 17, 2023
Care
for
older
patients
in
the
ED
is
an
increasingly
important
issue
with
ageing
society.
To
better
assess
quality
of
care
this
patient
group,
we
assessed
predictors
three
outcomes
related
to
care:
being
seen
and
discharged
within
4
hours
arrival;
admitted
from
hospital
reattending
30
days.
We
also
used
these
identify
better-performing
EDs.
Age and Ageing,
Journal Year:
2024,
Volume and Issue:
53(8)
Published: Aug. 1, 2024
Due
to
the
increasing
number
of
older
patients
in
emergency
departments
(EDs)
with
frailty,
cognitive
impairment
and
multimorbidity,
there
is
a
need
for
geriatric
expertise
EDs.
Journal of Emergency Nursing,
Journal Year:
2023,
Volume and Issue:
50(1), P. 22 - 35
Published: Oct. 6, 2023
Abstract
Background
Recognizing
frailty
and
providing
evidenced-based
management
in
busy
emergency
departments
is
challenging.
Understanding
the
knowledge
educational
needs
of
ED
staff
important
to
design
training
that
might
improve
patient
outcomes.
Objective
This
study
aimed
explore
staff,
use
screening
instruments
Irish
departments,
challenges
department.
Methods
A
multisite
survey
(different
specialties)
was
conducted
between
April
September
2021.
An
anonymous
online
distributed
via
email.
Free-text
sections
were
analyzed
using
content
analysis.
Results
In
total,
168
(nursing,
medical
allied
health)
participated,
representing
9
26
(35%).
Most
respondents
nurses
(n
=
78,
46%).
Less
than
half
had
received
identification
81,
48%).
One-fifth
doctors
(20%)
unsure
how
define
frailty.
Major
barriers
resource
deficits,
insufficient
diagnostic
pathways
from
lack
education
on
suitable
instruments.
Conclusions
surveyed
relied
clinical
judgment
rather
formal
identification.
high
proportion
reported
poor
low
confidence
recognizing
Dedicated
with
expertise,
bespoke
initiatives,
clearly
defined
may
help
address
issues
identified.
BMC Emergency Medicine,
Journal Year:
2023,
Volume and Issue:
23(1)
Published: Nov. 19, 2023
Abstract
Background
Although
outcome
goals
for
acute
healthcare
among
older
people
living
with
frailty
often
include
Health-Related
Quality
of
Life
(HRQoL)
and
other
patient-reported
measures
(PROMs),
current
quality
metrics
usually
focus
on
waiting
times
survival.
Lay
patient
review
have
identified
the
EuroQol
EQ-5D
as
a
candidate
measure
this
setting.
This
research
appraised
feasibility,
psychometric
performance,
respondents’
outcomes
in
Methods
People
aged
65
+
Clinical
Frailty
Scale
(CFS)
5–8
were
recruited
from
eight
UK
hospitals’
emergency
care
admissions
settings.
They
completed
five-level
EQ-VAS.
Feasibility
was
assessed
completion
completeness.
For
reliability,
response
distributions
internal
consistency
analysed.
Finally,
EQ-Index
values
compared
demographic
characteristics
service
construct
validity.
Results
The
232
participants
65–102.
38%
responded
departments
62%
wards.
Median
time
12
(IQR,
11)
minutes.
98%
responses
complete.
had
acceptable
distribution
(SD
1.1–1.3)
(Cronbach’s
alpha
0.69).
EQ-VAS
demonstrated
midpoint
pattern.
0.574
0.410)
related
positively
increasing
age
(
p
=
0.010)
negatively
CFS
<
0.001).
Participants
higher
more
frequent
problems
mobility,
self-care,
usual
activities.
Conclusions
Administration
feasible
these
properties,
while
appeared
problematic.
severe
also
poorer
HRQoL.
Journal of the American Geriatrics Society,
Journal Year:
2024,
Volume and Issue:
72(7), P. 2017 - 2026
Published: April 26, 2024
The
Geriatric
Emergency
Medicine
Specialist
(GEMS)
pilot
program
is
an
innovative
approach
that
utilizes
geriatric-trained
advanced
practice
providers
to
facilitate
geriatric
assessments
and
care
planning
for
older
adults
in
the
emergency
department
(ED).
objective
of
this
study
was
explore
effect
GEMS
on
use
observation
status
final
ED
disposition.
