A nurse-led model of care within an emergency department reduces representation rates for frail aged care residents
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Hospital Emergency Departments (EDs) experience high presentation rates from older adults residing in Aged Care Facilities (ACFs), yet very few intervention studies have addressed the care needs of this population group. We designed and implemented a nurse-led model of care for older adults from ACFs, and determined its impact on patient outcomes.
This 12-month pre–post intervention study was conducted during 2013–2014, with follow-up during 2015–2016. Participants included all older adults presenting from ACFs to the ED of Mater Hospital Brisbane (MHB), Australia. Frailty status was determined using the Clinical Frailty Scale (CFS).
All participants were frail (n = 1130), with 19% severely frail, 55% very-severely frail, and 26% terminally ill. The intervention resulted in several improvements in patient outcomes, including significant reductions in ward admissions and 28-day representation rates.
Significant improvements can be achieved by integration of an acute frail older person service into an ED.
KeywordsEmergency department Frailty Aged care facilities Model of care Aged
In 2014, The Mater Hospital Brisbane funded one fulltime nursing position (SM) to implement the Mater Aged Care in an Emergency (MACIAE) study. ED is funded by an Australian National Health and Medical Research Council (NHMRC) Early Career Fellowship (#1112672).
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
The study was granted an exemption from the requirements for full Mater Health Services Human Research Ethics Committee (MHS HREC) review (HREC Ref No: HREC/15/MHS/44) as an audit of practice in accordance with the definition of research by the National Statement on Ethical Conduct of Human Research (2014).
Due to the pragmatic approach, a waiver of obtaining patient consent was approved by the ethics committee.
- 4.Preston L, Chambers D, Campbell F et al (2018) Health Services and Delivery Research. What evidence is there for the identification and management of frail older people in the emergency department? A systematic mapping review. NIHR Journals Library, Southampton (UK)Google Scholar
- 11.Australian Insititute of Health and Welfare. Older Australia at a glance Australia 2018. https://www.aihw.gov.au/reports/older-people/older-australia-at-a-glance/contents/health-and-aged-care-service-use/aged-care. Accessed 8 Aug 2018