Background: Frequent ED users are generally over the age of 65 years, Medicare beneficiaries, sicker and have more health issues than non-frequent users. Elderly patients suffer a 20% mortality rate upon admission and a 30% decrease in activities of daily living (ADL) after discharge. Transitional care programs (TCP) decrease ED visits and readmission rates, improves ADLs, and increases event-free survival.
Purpose: To evaluate the need of an ED TCP in the ED. Aims are to assess ED providers’, nurses’ and managers’ perceptions of elderly frequent ED users’ discharge needs, resources, and potential role of a TCP.
Methods: Conducted within one community based ED in Tucson, Arizona. Survey content determined by a review of the literature focused upon elderly transitional care. Recruitment of nurses, providers, and managers following verbal consent. Inclusion criteria: willingness to participate in a 10-minute survey and work two shifts a month minimum within the ED. The survey is comprised of 19 questions focused on patient needs, current resources and the role of a TCP. Surveys were followed by a 5-minute post-survey session to review questions regarding content. Questions structured using a Likert scale format and categorical answers. Data analyzed using descriptive statistics. A needs assessment (NA) executive summary was presented to the ED staff and management.
Results: One hundred providers, nurses, and managers completed the survey of which 79% were female, 73% registered nurses, 14% physicians, and 10% advanced practice providers. The majority of respondents believed elderly patients are discharged unsafely, additional resources were needed, more time was spend caring for elderly patients, and TCPs were a viable supportive option. “What is a transitional care team (TCT)?” was the most asked question during question and answer session.
Implications: This NA revealed providers’, nurses’, and managers’ perceptions of elderly frequent ED user needs and the role of a TCP. Concerns identified are consistent with the literature. This NA provided information about ED staff perceptions of elderly frequent users and addressed transitional care while laying the groundwork for the potential future implementation of a TCP initiated in the ED.
| Identifer | oai:union.ndltd.org:arizona.edu/oai:arizona.openrepository.com:10150/626348 |
| Date | January 2017 |
| Creators | Stickney, Remington Bigelow, Stickney, Remington Bigelow |
| Contributors | Daly, Patricia, Daly, Patricia, Phillips, Linda, Martin-Plank, Lori |
| Publisher | The University of Arizona. |
| Source Sets | University of Arizona |
| Language | en_US |
| Detected Language | English |
| Type | text, Electronic Dissertation |
| Rights | Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. |
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