The Association Between Frailty and a Nurse-Identified Need for Comprehensive Geriatric Assessment Referral from the Emergency Department

TitleThe Association Between Frailty and a Nurse-Identified Need for Comprehensive Geriatric Assessment Referral from the Emergency Department
Publication TypeJournal Article
Year of Publication2023
AuthorsMowbray FI, Ellis B, Schumacher C, Heckman G, de Wit K, Strum RP, Jones A, Correia RH, Mercier E, Costa AP
JournalCanadian Journal of Nursing Research
Volume55
Issue3
Pagination08445621221144667
ISBN Number0844-5621
Accession Number36632010
KeywordsComprehensive geriatric assessment, Emergency nursing, Frailty, Geriatric syndromes
Abstract

BackgroundEmergency nurses commonly conduct geriatric assessments in the emergency department (ED). However, little is known about what geriatric syndromes or clinical presentations prompt a nurse to document an identified need for comprehensive geriatric assessment (CGA).ObjectivesTo examine the association between geriatric syndromes, like frailty, and a nurse-identified need for a CGA following emergency care.MethodsWe conducted a secondary analysis of a multi-province Canadian cohort from the InterRAI Multinational Cohort Study. We collected data at ED registration from patients 75 years of age and older (n = 2,274) from eight ED sites across Canada between November 2009 and April 2012. Geriatric syndromes were assessed by trained emergency nurses using the interRAI ED Contact Assessment; and we retrospectively calculated the ED frailty index. We employed binary logistic regression to determine the adjusted associations between geriatric syndromes and a nurse-identified need for a CGA.ResultsApproximately one-quarter (28%) of older adults were identified to need a CGA following emergency care. A 0.1 unit increase in the ED frailty index increased the likelihood of a nurse identify a need for CGA (RD: 6.6; 95% CI = 5.5–7.9). Most geriatric syndromes increased the probability of a nurse documenting the need for a CGA.ConclusionWhen assessed by emergency nurses, the identified need for CGA is strongly linked to the presence of geriatric syndromes, including frailty. We provide face validity for the continued use of emergency nurses for screening and assessing older ED patients.

DOI10.1177/08445621221144667
Link

https://journals.sagepub.com/doi/10.1177/08445621221144667