Providing care for older adults in the Emergency Department: expert clinical recommendations from the European Task Force on Geriatric Emergency Medicine
Authors:
Vojtěch Mezera
Authors place of work:
Geriatrické centrum, Pardubická nemocnice
Published in the journal:
Geriatrie a Gerontologie 2022, 11, č. 1: 7-14
Category:
Recommendation
Summary
Despite the rapidly expanding knowledge in the field of Geriatric Emergency Medicine in Europe, widespread implementation of change is still lacking. Many opportunities in everyday clinical care are missed to improve care for this susceptible and growing patient group.
The aim was to develop pragmatic clinical Geriatric Emergency Medicine guidelines based on expert consensus, to be disseminated across Europe.
Using a modified Delphi procedure a prioritized list of topics related to Geriatric Emergency Medicine was created. Next, a multi-disciplinary group of nurses, geriatricians and emergency physicians performed a review of recent guidelines and literature to create recommendations. These recommendations were voted upon by a group of experts and placed on visually attractive posters.
Setting and participants: A group of multi-disciplinary experts in the field of Geriatric Emergency Medicine in Europe.
The expert group identified the following eight subject areas to develop targeted guidelines on: Comprehensive Geriatric Assessment in the Emergency Department (ED), age/frailty adjusted risk stratification, delirium and cognitive impairment, family involvement, ED environment, silver trauma, end of life care in the acute setting.
Eight posters with guidelines on the most important topics in Geriatric Emergency Medicine are now available through https: //posters. geriemeurope. eu/. Pragmatic guidelines for Geriatric Emergency Medicine in Europe were created and are ready for dissemination across Europe.
Keywords:
geriatrics – acute care – frailty – emergency medicine – guidelines – geriatric emergency medicine
Zdroje
1. Aminzadeh F, Dalziel WB. Older adults in the emergency department: a systematic review of patterns of use, adverse outcomes, and effectiveness of interventions. Ann Emerg Med 2002; 39(3): 238–247.
2. Gruneir A, Silver MJ, Rochon PA. Emergency department use by older adults: a literature review on trends, appropriateness, and consequences of unmet health care needs. Med Care Res Rev 2011; 68(2): 131–155.
3. Schnitker LM-KM, Beattie E, Gray L. Negative health outcomes and adverse events in older people attending emergency departments: A systematic review. Australas Emerg Nurs 2011; 14(3): 141–162.
4. Heeren P, Hendrikx A, Ceyssens J, et al. Structure and processes of emergency observation units with a geriatric focus: a scoping review. BMC Geriatr 2021; 21(1): 95.
5. La Grouw Y, Bannink D, van Hout H. Care Professionals Manage the Future, Frail Older Persons the Past. Explaining Why Frailty Management in Primary Care Doesn’t Always Work. Front Med (Lausanne) 2020; 7: 489.
6. Dent E, Martin FC, Bergman H, et al. Management of frailty: opportunities, challenges, and future directions. Lancet 2019; 394(10206): 1376–1386.
7. Hesselink G, Sir O, Ozturk E, et al. Effects of a geriatric education program for emergency physicians: a mixed-methods study. Health Educ Res 2020; 35(3): 216–227.
8. Mooijaart SP, Lucke JA, Brabrand M, et al. Geriatric emergency medicine: time for a new approach on a European level. Eur J Emerg Med 2019; 26(2): 75–76.
9. Bellou A, Conroy SP, Graham CA. The European curriculum for geriatric emergency medicine. Eur J Emerg Med 2016; 23(4): 239.
10. Gladman JR, Conroy SP, Ranhoff AH, Gordon AL. New horizons in the implementation and research of comprehensive geriatric assessment: knowing, doing and the ‹know-do› gap. Age Ageing 2016; 45(2): 194-200.
11. McCusker J, Minh Vu TT, Veillette N, et al. Elder-Friendly Emergency Department: Development and Validation of a Quality Assessment Tool. J Am Geriatr Soc 2017.
12. British Geriatrics Society. Quality Care For Older People With Urgent & Emergency Care Needs - ‹Silver Book›2012.
13. Sinek S. Start with why. London, United Kingdom: Penguin Books 2009.
14. American College of Emergency P, American Geriatrics S, Emergency Nurses A, Society for Academic Emergency M, Geriatric Emergency Department Guidelines Task F. Geriatric emergency department guidelines. Ann Emerg Med 2014; 63(5): e7–25.
15. Lo AX, Biese K, Carpenter CR. Defining Quality and Outcome in Geriatric Emergency Care. Ann Emerg Med 2017; 70(1): 107–9.
16. Terrell KM, Hustey FM, Hwang U, et al. Quality indicators for geriatric emergency care. Academic emergency medicine: official journal of the Society for Academic Emergency Medicine 2009; 16(5): 441–449.
17. British Geriatrics Society. Emergency Care 2021. Available from: www. bgs. org. uk/topics/emergency- care
18. Schuster S, Singler K, Lim S, et al. Quality indicators for a geriatric emergency care (GeriQ-ED) - an evidence-based delphi consensus approach to improve the care of geriatric patients in the emergency department. Scand J Trauma Resusc Emerg Med 2020; 28(1): 68.
19. Carpenter CB, Conroy S. Silver Book II: British Geriatrics Society 2021: 22.
20. Nickel CB, Conroy S. Geriatric Emergency Medicine: Springer International Publishing 2018.
21. Delirium: prevention, diagnosis and management. National Institute for Health and Care Excellence: Clinical Guidelines. London 2019.
22. Dawood M. End of life care in the emergency department. Emerg Med J 2020; 37(5): 273–278.
23. Carpenter CR, Cameron A, Ganz DA, Liu S. Older Adult Falls in Emergency Medicine: 2019 Update. Clin Geriatr Med 2019; 35(2): 205–219.
24. Hanning J, Walker KJ, Horrigan D, et al. Review article: Goals-of-care discussions for adult patients nearing end of life in emergency departments: A systematic review. Emerg Med Australas 2019; 31(4): 525–532.
25. Preston L, van Oppen JD, Conroy SP, et al. Improving outcomes for older people in the emergency department: a review of reviews. Emerg Med J 2020.
26. Turner J, Coster J, Chambers D, et al. What evidence is there on the effectiveness of different models of delivering urgent care? A rapid review. Health Services and Delivery Research. Southampton (UK) 2015.
27. Crede SH, O’Keeffe C, Mason S, et al. What is the evidence for the management of patients along the pathway from the emergency department to acute admission to reduce unplanned attendance and admission? An evidence synthesis. BMC Health Serv Res 2017; 17(1): 355.
28. European Resuscitation Council. ERC guidelines 2021. Available from: https: //cprguidelines. eu.
29. Ringer T, Dougherty M, McQuown C, et al. White Paper-Geriatric Emergency Medicine Education: Current State, Challenges, and Recommendations to Enhance the Emergency Care of Older Adults. AEM Educ Train 2018; 2(Suppl 1): S5–S16.
Štítky
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- Providing care for older adults in the Emergency Department: expert clinical recommendations from the European Task Force on Geriatric Emergency Medicine