Effect of the Geriatric Emergency Department Intervention on outcomes of care for residents of aged care facilities: A non-randomised trial.
advanced practice nursing
emergency care
emergency department
nursing home
outcome
Journal
Emergency medicine Australasia : EMA
ISSN: 1742-6723
Titre abrégé: Emerg Med Australas
Pays: Australia
ID NLM: 101199824
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
04
04
2019
revised:
17
09
2019
accepted:
23
10
2019
pubmed:
28
11
2019
medline:
19
8
2021
entrez:
28
11
2019
Statut:
ppublish
Résumé
As the population of Australia ages, EDs will experience an increasing frequency of presentations of older adults from residential aged care facilities (RACFs). These presentations are often complex and time consuming in the chaotic and potentially hazardous ED environment. The Geriatric Emergency Department Intervention (GEDI) model was developed to optimise the care of frail older adults, especially RACF residents, in the ED. The aim of the present study was to evaluate the effectiveness of the GEDI model on the primary outcomes of disposition (admission, discharge or death) and ED length of stay for residents of RACFs, presenting to an ED in regional Queensland, Australia. GEDI is a nurse-led, physician-championed, innovative model delivered by advanced practice nurses with expertise in gerontology. This quasi-experimental pragmatic study compared outcomes for RACF residents who presented to a regional Queensland ED during three time periods: pre-GEDI, interim GEDI and post-GEDI implementation of the GEDI model. Outcomes included disposition, ED length of stay, ED re-presentation and mortality. A significant increase in the likelihood of discharge from ED (hazard ratio 1.15, 95% confidence interval 1.05-1.26) and reductions in ED length of stay (hazard ratio 1.49, 95% confidence interval 1.24-1.78) were evident for RACF residents following the implementation of the GEDI intervention. There were no differences in mortality, ED re-presentation or in-hospital length of stay between the three time periods. There is a paucity of evidence to support the implementation of nurse-led teams in EDs designed to target older adults living in RACFs. The GEDI model was effective in reducing ED length of stay while increasing the likelihood of safe discharge for RACF residents.
Identifiants
pubmed: 31773885
doi: 10.1111/1742-6723.13415
doi:
Types de publication
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
422-429Subventions
Organisme : Department of Social Services, Australian Government
ID : Cedric-4-Z30R1E
Pays : International
Organisme : Emergency Medicine Foundation
ID : EMRS-61R29-2018
Pays : International
Organisme : Wishlist
ID : 2014-14
Pays : International
Informations de copyright
© 2019 Australasian College for Emergency Medicine.
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