Abstract
Introduction
The Centers for Disease Control and Prevention (CDC) reports 136.9 million ED visits
in 2015, of which 21.4 million (15.6%) were by patients who were 65 or older. This
US population demographic is expected to grow by 112% over the next 40 years, becoming
just below 25% of the total US population. Emergency nurses will play an increasingly
important part in the development of nursing care for geriatric patients. The purpose
of this study was to explore emergency nurses’ perception of their ability to care
for geriatric patients in the emergency setting.
Methods
This was a mixed-methods sequential design using quantitative survey data and qualitative
focus group data, which were analyzed separately and then given equal priority during
the data-interpretation phase.
Results
Less than 50% of survey respondents (N = 1,610) reported geriatric-specific screenings,
accommodations, and communication with outside agencies as “always available” in their
care settings. Qualitative analysis (N = 23) yielded the categories of Triage/Assessment,
Care in the Emergency Environment, Discharge Planning, and Facilitators and Barriers,
which generally reflected the trajectory of care for the older patient. The overarching
concern was keeping patients safe in both the community and in the emergency department.
Discussion
Emergency departments should develop integrated systems to facilitate appropriate
care of older patients. Identified barriers to improved care include a lack of integration
between emergency care and community care, deficits in geriatric-specific education,
inconsistent use of early screening for frailty, and lack of resources in the emergency
care environment to intervene appropriately.
Key words
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Biography
Lisa A. Wolf, Member, Pioneer Valley Chapter, is Director, Institute for Emergency Nursing Research, Emergency Nurses Association, Schaumburg, IL.
Biography
Altair M. Delao is Senior Associate, Institute for Emergency Nursing Research, Emergency Nurses Association, Schaumburg, IL.
Biography
Aaron J. Malsch, Member, Milwaukee Area Chapter, is Senior Services Program Coordinator, Advocate Aurora Health, Milwaukee WI.
Biography
Michael D. Moon, Member, San Antonio Chapter, is Associate Professor, University of the Incarnate Word, San Antonio, TX.
Biography
Adam Perry is Faculty Member, Geriatric Emergency Department Collaborative New York, NY.
Biography
Kathleen Evanovich Zavotsky, Member, West Central Jersey Chapter, is Assistant Vice President, The Center for Professional Development, Innovation and Research, Robert Wood Johnson Barnabas Health, Robert Wood Johnson University Hospital, New Brunswick, NJ.
Article info
Publication history
Published online: March 28, 2019
Footnotes
Earn Up to 7.5 Hours. See page 473.
This study was funded in part through the John A. Hartford Foundation and the West Heath Institute. Grant name: Developing a Geriatric Emergency Department Collaborative.
Identification
Copyright
© 2019 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
