A nurse-led model of care within an emergency department reduces representation rates for frail aged care residents

Abstract

BACKGROUND: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. METHODS: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). RESULTS: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. CONCLUSION:Significant improvements can be achieved by integration of an acute frail older person service into an ED.