Recommended Citation
Strebig D, Koplitz A, Ludy H. Stay home: Nurses spur decline in emergency visit returns. Value Informed Nursing Practice poster presentation at Empowering Nursing Excellence: Recognizing the Value and Impact of Nurses, Advocate Health Midwest Region Nursing Research & Professional Development Conference 2023; November 15, 2023; virtual.
Presentation Notes
*Recipient of "People's Choice Award" for Value Informed Nursing Practice category. Value Informed Nursing Practice poster presentation at Empowering Nursing Excellence: Recognizing the Value and Impact of Nurses, Advocate Health Midwest Region Nursing Research & Professional Development Conference 2023; November 15, 2023; virtual.
Abstract
Background
Approximately 21 million older adults visit the emergency department. Thus, development of patient-centered approaches to care delivery of older adults in this setting are critically important in preventing recidivism. Embedding evidence-based practice into nursing workflow allows nurses to screen, assess, intervene, and refer patients to social services and physical therapy prior to leaving the emergency department. Nurse communication provides actionable information to create the plan of care.
Purpose
A small community hospital utilizes the Identification of Seniors at Risk screening tool to collaboratively initiate a patient-centered approach to care delivery that prevents repeat emergency department visits for older adults (65 years or older).
Implementation
Older adults comprised 34.9% of emergency department visits. To identify older adults who are at risk for adverse outcomes, nurses utilized a six-point screening tool. A score ≥ 2 was considered at risk and prompted nurses to document comments in the medical record that consolidated screening, assessment, and interview findings. Comments provided nursing insight to achieve broader clinical and psycho-social understanding of the patient that drove care delivery. This information was used by social services and physical therapy to prioritize workflows and ensure patients received tailored resources, education, treatment, and referrals that maximized their discharge disposition to home.
Outcomes
On average, screenings for older adults were completed for 86.6% of emergency department visits. This remained consistent, but efforts on improving nursing comment documentation showed improvement in comment completion rate from 34.8% to 52.2%. Increased comment completion rates were directly correlated to a reduction in 30-day return to emergency department visit rate from 25.2% to 17.9%.
Implications for Practice
Nurse-driven screening of older adults in the emergency department trigger interprofessional evaluations that result in reduced return rates. Small hospitals must seek creative partnerships to bring the care delivery system directly to the patient, allowing them to remain in their communities.
Document Type
Poster
Publication Date
11-15-2023
Stay home: Nurses spur decline in emergency visit returns
Background
Approximately 21 million older adults visit the emergency department. Thus, development of patient-centered approaches to care delivery of older adults in this setting are critically important in preventing recidivism. Embedding evidence-based practice into nursing workflow allows nurses to screen, assess, intervene, and refer patients to social services and physical therapy prior to leaving the emergency department. Nurse communication provides actionable information to create the plan of care.
Purpose
A small community hospital utilizes the Identification of Seniors at Risk screening tool to collaboratively initiate a patient-centered approach to care delivery that prevents repeat emergency department visits for older adults (65 years or older).
Implementation
Older adults comprised 34.9% of emergency department visits. To identify older adults who are at risk for adverse outcomes, nurses utilized a six-point screening tool. A score ≥ 2 was considered at risk and prompted nurses to document comments in the medical record that consolidated screening, assessment, and interview findings. Comments provided nursing insight to achieve broader clinical and psycho-social understanding of the patient that drove care delivery. This information was used by social services and physical therapy to prioritize workflows and ensure patients received tailored resources, education, treatment, and referrals that maximized their discharge disposition to home.
Outcomes
On average, screenings for older adults were completed for 86.6% of emergency department visits. This remained consistent, but efforts on improving nursing comment documentation showed improvement in comment completion rate from 34.8% to 52.2%. Increased comment completion rates were directly correlated to a reduction in 30-day return to emergency department visit rate from 25.2% to 17.9%.
Implications for Practice
Nurse-driven screening of older adults in the emergency department trigger interprofessional evaluations that result in reduced return rates. Small hospitals must seek creative partnerships to bring the care delivery system directly to the patient, allowing them to remain in their communities.
Affiliations
Aurora Medical Center Washington County