Cargando…
The Impact of Geriatric Emergency Management Nurses on the Care of Frail Older Patients in the Emergency Department: a Systematic Review
BACKGROUND: Frail older adults are high users of emergency departments (EDs). Many Canadian EDs have hired Geriatric Emergency Management (GEM) nurses in an effort to improve care to older adults. METHODS: We conducted a systematic review to determine the impact of GEM nurses on care provided to fra...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Canadian Geriatrics Society
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458600/ https://www.ncbi.nlm.nih.gov/pubmed/32904804 http://dx.doi.org/10.5770/cgj.23.408 |
_version_ | 1783576231490355200 |
---|---|
author | Leaker, Hannah Fox, Loralee Holroyd-Leduc, Jayna |
author_facet | Leaker, Hannah Fox, Loralee Holroyd-Leduc, Jayna |
author_sort | Leaker, Hannah |
collection | PubMed |
description | BACKGROUND: Frail older adults are high users of emergency departments (EDs). Many Canadian EDs have hired Geriatric Emergency Management (GEM) nurses in an effort to improve care to older adults. METHODS: We conducted a systematic review to determine the impact of GEM nurses on care provided to frail older adults. We searched MEDLINE, Embase, CINAHL, and Cochrane databases. A grey literature search was also conducted. Inclusion criteria were English-language, evaluation of GEM nurse or geriatric-trained nurse assessments of older adults (age ≥ 65 years) within the ED, and reported clinical and/or health system outcomes. The PRISMA statement was followed, and article quality was assessed using GRADE. RESULTS: 5,115 citations and 191 full text articles were screened; 8 articles from 7 different studies were included. Study quality varied between very low to high. Five included studies analyzed the effect of GEM nurses on ED revisits, with most finding they decreased revisits. Four included studies analyzed the effect of GEM nurses on hospital admissions/readmissions, demonstrating variable impact. One study looked at the cost-effectiveness and found the cost to be negligible. The impact on patient-specific outcomes was less clear. CONCLUSIONS: GEM nurses may be an effective option to help in the management of frail older adults in the ED. |
format | Online Article Text |
id | pubmed-7458600 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Canadian Geriatrics Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-74586002020-09-04 The Impact of Geriatric Emergency Management Nurses on the Care of Frail Older Patients in the Emergency Department: a Systematic Review Leaker, Hannah Fox, Loralee Holroyd-Leduc, Jayna Can Geriatr J Narrative/Systemic Review BACKGROUND: Frail older adults are high users of emergency departments (EDs). Many Canadian EDs have hired Geriatric Emergency Management (GEM) nurses in an effort to improve care to older adults. METHODS: We conducted a systematic review to determine the impact of GEM nurses on care provided to frail older adults. We searched MEDLINE, Embase, CINAHL, and Cochrane databases. A grey literature search was also conducted. Inclusion criteria were English-language, evaluation of GEM nurse or geriatric-trained nurse assessments of older adults (age ≥ 65 years) within the ED, and reported clinical and/or health system outcomes. The PRISMA statement was followed, and article quality was assessed using GRADE. RESULTS: 5,115 citations and 191 full text articles were screened; 8 articles from 7 different studies were included. Study quality varied between very low to high. Five included studies analyzed the effect of GEM nurses on ED revisits, with most finding they decreased revisits. Four included studies analyzed the effect of GEM nurses on hospital admissions/readmissions, demonstrating variable impact. One study looked at the cost-effectiveness and found the cost to be negligible. The impact on patient-specific outcomes was less clear. CONCLUSIONS: GEM nurses may be an effective option to help in the management of frail older adults in the ED. Canadian Geriatrics Society 2020-09-01 /pmc/articles/PMC7458600/ /pubmed/32904804 http://dx.doi.org/10.5770/cgj.23.408 Text en © 2020 Author(s). Published by the Canadian Geriatrics Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No-Derivative license (http://creativecommons.org/licenses/by-nc-nd/2.5/ca/), which permits unrestricted non-commercial use and distribution, provided the original work is properly cited. |
spellingShingle | Narrative/Systemic Review Leaker, Hannah Fox, Loralee Holroyd-Leduc, Jayna The Impact of Geriatric Emergency Management Nurses on the Care of Frail Older Patients in the Emergency Department: a Systematic Review |
title | The Impact of Geriatric Emergency Management Nurses on the Care of Frail Older Patients in the Emergency Department: a Systematic Review |
title_full | The Impact of Geriatric Emergency Management Nurses on the Care of Frail Older Patients in the Emergency Department: a Systematic Review |
title_fullStr | The Impact of Geriatric Emergency Management Nurses on the Care of Frail Older Patients in the Emergency Department: a Systematic Review |
title_full_unstemmed | The Impact of Geriatric Emergency Management Nurses on the Care of Frail Older Patients in the Emergency Department: a Systematic Review |
title_short | The Impact of Geriatric Emergency Management Nurses on the Care of Frail Older Patients in the Emergency Department: a Systematic Review |
title_sort | impact of geriatric emergency management nurses on the care of frail older patients in the emergency department: a systematic review |
topic | Narrative/Systemic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458600/ https://www.ncbi.nlm.nih.gov/pubmed/32904804 http://dx.doi.org/10.5770/cgj.23.408 |
work_keys_str_mv | AT leakerhannah theimpactofgeriatricemergencymanagementnursesonthecareoffrailolderpatientsintheemergencydepartmentasystematicreview AT foxloralee theimpactofgeriatricemergencymanagementnursesonthecareoffrailolderpatientsintheemergencydepartmentasystematicreview AT holroydleducjayna theimpactofgeriatricemergencymanagementnursesonthecareoffrailolderpatientsintheemergencydepartmentasystematicreview AT leakerhannah impactofgeriatricemergencymanagementnursesonthecareoffrailolderpatientsintheemergencydepartmentasystematicreview AT foxloralee impactofgeriatricemergencymanagementnursesonthecareoffrailolderpatientsintheemergencydepartmentasystematicreview AT holroydleducjayna impactofgeriatricemergencymanagementnursesonthecareoffrailolderpatientsintheemergencydepartmentasystematicreview |