| Title |
Periodical |
Objectives |
Synthesis of results |
| 1. In-reach nursing services improve older patient outcomes and access to emergency care29. |
Australasian Journal On Ageing |
Identify the impact of basic care performed by the specialized nursing service on the clinical results of elderly patients from long-term care facilities treated at the emergency department, before and after the implementation of the service. |
The average length of stay in the emergency department decreased by 24 minutes and the hospitalization rate by 23%. The proportion of people who returned to the emergency department within six months decreased by 12%. The proportion of hospitalized patients discharged with a palliative care plan increased by 13%. There was a significant decrease in the average length of hospitalization, fewer hospitalizations of patients coming from long hospitalizations after the implementation of the primary care/follow-up service. |
| 2. Referrals to hospital emergency departments from residential aged care facilities: stuck in a time warp14. |
Contemporary Nurse |
Characterize elderly persons admitted to emergency services from long-term care facilities and to explore the perception of nurses of the reasons why these "residents" are referred to the emergency department. |
The main themes identified are related to professional competence, lack of equipment in nursing homes, relatives and residents requesting referrals, communication difficulties and poor team attitude. It is important to use strategies for the detection of residents with deteriorating conditions and to provide prompt care for the same. |
| 3. Respect in the care of older patients in acute hospitals30. |
Nursing Ethics |
To describe the experiences of elderly patients and their relatives in relation to the respect shown in the care offered at an acute care hospital. |
The concept of respect can be defined through the actions taken by nurses (kindness, patience when listening, trust, response to information needs, assistance with basic needs, pain relief, response to requests and time management), through the family (support, care and protection of the patient's interests) and by environmental factors (such as the valuation of the elderly by society, management of health organizations, the culture of nursing, the flow of information and patient accommodation)). |
| 4. Geriatric screening tools to select older adults susceptible for direct transfer from the emergency department to subacute intermediate-care hospitalization16. |
Journal of the American Medical Directors Association - JAMDA |
Evaluate whether easy, fast and inexpensive geriatric tracking tools predict a discharge outcome other than returning to the previous condition for patients admitted to a subacute/ intermediate care department. |
Among the geriatric screening tools, the ISAR - Identification of Seniors at Risk was used independently in the discharge of patients transferred from the emergency department to intermediate care. Predictive validity was poor. More research is needed on the selection of candidates for alternatives to conventional hospitalization. |
| 5. Impact of observation on disposition of elderly patients presenting to emergency departments with non-specific complaints18. |
Plos One |
Prospective study of the referral process of patients treated in the emergency department with nonspecific complaints. |
Planning for optimum referral of patients with nonspecific complaints improves after the observation period if it is strictly defined in relation to the hospitalization of patients with acute morbidities. |
| 6. Patient transfer forms enhance key information between nursing homes and emergency department20. |
Geriatric Nursing |
To assess the extent to which transfer forms facilitate communication between the employees of a long-term facility for the elderly and the emergency department based on the criteria proposed by Terrell and Miller. |
During the study period there were 306 patient transfers. Transfer forms were used in 157 cases. The results suggest that information considered valuable for the benefit of a patient in the emergency department has a greater chance of being acknowledged when using transfer forms. However, the availability of this information does not translate into observable differences in the case of time resolution and referrals. The forms reinforce the communication between the long-term institution and the emergency department. Essential information for emergency patient care is significantly increased with the use of the transfer form. |
| 7.Implementation and effectiveness of 'care navigation', coordinated management for people with complex chronic illness: rationale and methods of a randomised controlled trial31. |
Health Services Research - BMC |
Measure the impact of coordinated care interventions through the Care Navigation method on the use of health services and quality of life in elderly patients with chronic diseases over two years. |
This study of mixed methods informs the generality and sustainability of care coordination programs in Australia and internationally. The Care Navigation trial aims to develop these principles to provide a comprehensive program of coordinated care to improve health outcomes among patients with chronic disease. |
| 8. Dying cases in emergency places: Caring for the dying in emergency departments12. |
Social Science & Medicine |
Investigate end of life care in an emergency department. |
Evidence was found for the importance of the role of the nurse in modifying practices and improving the quality of end-of-life care through patient liaison, effective communication, and patient-centered care. |
| 9. During and beyond the triage encounter: Chronically ill elderly patients’ experiences throughout their emergency department attendances21. |
International Emergency Nursing |
Explore and describe the experiences of a group of chronically ill elderly patients cared for in the emergency department. |
The elderly perceived care in the emergency sector as a contradictory event. The initially receive fast and efficient care during triage, but then receive indifferent and inattentive behavior by the nurses. |
| 10. Emergency nurses’ perceptions of the role of confidence, self-efficacy and reflexivity in managing the cognitively impaired older person in pain32. |
Journal of Clinical Nursing |
To explore the practices of emergency nurses in the care of elderly people with cognitive deficits and long bone fracture pain to assess confidence and self-efficacy. |
Confidence, self-efficacy and reflexivity allowed the provision of appropriate, timely and compassionate care. Confidence and self-efficacy in nursing practices were based on clinical and reflexive experience and were crucial for the acquisition of skills and knowledge. |
| 11. Facilitators and barriers to safe emergency department transitions for community dwelling older people with dementia and their caregivers: A social ecological study33. |
International Journal of Nursing Studies |
Identify factors that facilitate or prevent safe care transitions for elderly people with dementia in two emergency sectors. |
Four categories were identified: under-triaged; waiting and worrying about what was wrong; time pressure with a lack of care for basic needs; and relationships and interactions leading to feeling ignored, forgotten and unimportant. These consequences arise from a triage system that does not recognize the atypical presentation of disease and illness. This results in a cascade of vulnerability in elderly people with dementia. |
| 12. Geriatric emergency nurses: addressing the needs of an aging population15. |
Journal Of Emergency Nursing |
Describe the innovative role of emergency nursing implemented to meet the needs of the elderly in the emergency department. |
Three themes emerged: defining the role and its functions; a collaborative relationship: tailoring the same to the emergency department and recommendations for future role development. |
| 13. Nurses’ experiences of caring for the older adult in the emergency department: A focused ethnography34. |
International Emergency Nursing |
Investigate the experiences of nurses caring for elderly persons in the emergency department. |
Three themes were identified: the culture of the emergency sector, care organized according to a pattern of priorities; the care of the elderly does not fit into this culture; managing the lack of adjustments between the elderly and the emergency sector, puts the elderly at risk of precarious care. |
| 14. Results of a national survey of Australian nurses’ practice caring for older people in an emergency department8. |
Journal of Clinical Nursing |
To report the practices of Australian nurses in the care of the elderly in the emergency department. |
Nurses use positive clinical practices and understand that patient-centered care can reduce adverse events and length of stay in the emergency department. It is important to improve language and tone in clinical practice. |
| 15. Screening for fall risks in the emergency department: a novel nursing-driven program9. |
Brief Research Report |
To describe the use of TUGT in evaluations carried out by geriatric nurses in the emergency department. |
The evaluation of gait with the Timed Up and Go Test (TUGT) was performed in 443 elderly people, of whom 368 had a positive result, i.e. it took more than 12 seconds to complete the three-meter walk. Interventions for positive outcomes included physical therapy (17.1%), outpatient visits with physical therapy (12.2%), and social work and consultation (44.0%). |
| 16. Undertriage in older emergency department patients - tilting against windmills17. |
Plos One |
To test whether a teaching intervention had a long-term sustainable effect on reducing undertriage rates in elderly patients. |
A total of 519 patients were evaluated before and 394 after the intervention. It was observed that the knowledge among nurses of triage was already high before the teaching intervention. The prevalence of undertriaged patients was 22.5% before the intervention and 24.2% one year after the intervention. The teaching intervention was not significant. Undertriage is not merely a matter of actual knowledge. |
