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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...

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Autores principales: Leaker, Hannah, Fox, Loralee, Holroyd-Leduc, Jayna
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
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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.
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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
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