Dissertation
Screening and assessment of the older adult in the emergency department
University of the Sunshine Coast, Queensland
Doctor of Philosophy, University of the Sunshine Coast, Queensland
2021
DOI:
https://doi.org/10.25907/00086
Abstract
Background: The number of frail older adults with complex health conditions presenting to emergency departments (EDs) globally is increasing. In turn, EDs and the broader health system are being tasked to meet this challenging demand. However, older adults are not a homogenous group. Screening older adults who present to the ED who are at risk for frailty, will help identify those at greatest risk of iatrogenic and unforeseen complications such as re-presentation to the ED and those who may benefit from further geriatric assessment. For clarity within this thesis, ‘frailty risk screening’ or ‘frailty screening’ will refer to screening for the adverse events associated with frailty, rather than to identify individuals who may be frail. There are several frailty risk screening tools available, but many are too involved for the fast-paced ED environment. Those developed for use in the ED lack rigorous evaluation of their sensitivity and specificity.
Following frailty risk screening, the assessment of a frail older adult, in ED, requires a unique and different approach, compared to that undertaken for a younger adult. In geriatric practice the gold standard for this assessment is the comprehensive geriatric assessment (CGA). Again, this is a very detailed assessment and difficult to administer, in toto, in the busy, noisy ED environment. There has been little work undertaken to determine which aspects of such an assessment might be usefully undertaken in the ED; and may provide additional information to support complex decision-making. The frailty risk screening and assessment of the older adult is vital to efficient and effective care, yet is difficult to embed into the unique workflow of the ED. Given the time constraints placed on clinicians with decision-making responsibilities working in the ED, ED-specific screening and assessment processes are required to enhance ED clinical care and decision-making.
Details
- Title
- Screening and assessment of the older adult in the emergency department
- Authors
- Andrea Taylor
- Contributors
- Marc Broadbent (Principal Supervisor) - University of the Sunshine Coast, Queensland, School of Nursing, Midwifery and Paramedicine - LegacyApil Gurung (Co-Supervisor) - University of the Sunshine Coast, Queensland, Healthy Ageing Research Cluster
- Awarding institution
- University of the Sunshine Coast, Queensland
- Degree awarded
- Doctor of Philosophy
- Publisher
- University of the Sunshine Coast, Queensland
- DOI
- 10.25907/00086
- Organisation Unit
- School of Health - Nursing; University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy
- Language
- English
- Record Identifier
- 99569808902621
- Output Type
- Dissertation
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