Baumbusch Jennifer, Shaw Maureen
University of British Columbia, School of Nursing, Vancouver, British Columbia, Canada.
J Emerg Nurs. 2011 Jul;37(4):321-7; quiz 426. doi: 10.1016/j.jen.2010.04.013. Epub 2010 Jun 1.
Older adults account for up to 14.5% of ED visits. Presentation of older adults can differ from younger adults. Emergency visits by older adults that are characterized by comorbidity, cognitive and functional impairment, and complex social issues. In addition, older adults present with subtle, atypical symptoms making diagnosis and discharge more challenging. The purpose of this study was to describe an innovative geriatric emergency nurse role that has been implemented to address the unique needs of older adults in the emergency department.
This was an exploratory, descriptive study. The study sample was comprised of two groups: Geriatric Emergency Nurses (N=5) and key informants (N=15). The study was based at a tertiary hospital in Vancouver, Canada. Data was collected using semi-structured interviews. Data were analyzed using thematic analysis.
The findings are organized into three sections: defining the role and its functions; a collaborative relationship: fitting in to the larger emergency department; and recommendations for future role development.
Findings from the study have led to further considerations about the role in relation to communication about older patients both within the emergency department and with community stakeholders. We also discuss the importance of this role in relation to the continuum of care and recognizing the central role of the emergency department as a place for intervention. Lastly, we consider the need for further integration of gerontological knowledge and expertise within the emergency department beyond a specialized role.
老年人占急诊就诊人数的比例高达14.5%。老年人的临床表现可能与年轻人不同。老年人的急诊就诊具有合并症、认知和功能障碍以及复杂社会问题等特点。此外，老年人表现出的症状较为隐匿、不典型，这使得诊断和出院决策更具挑战性。本研究的目的是描述一种创新的老年急诊护士角色，该角色已被实施以满足急诊科老年人的独特需求。
这是一项探索性描述性研究。研究样本包括两组：老年急诊护士（N = 5）和关键信息提供者（N = 15）。该研究以加拿大温哥华的一家三级医院为基础。通过半结构化访谈收集数据。使用主题分析法对数据进行分析。
研究结果分为三个部分：定义角色及其功能；合作关系：融入更大的急诊科；以及对未来角色发展的建议。
该研究结果引发了对该角色在急诊科内部以及与社区利益相关者就老年患者沟通方面的进一步思考。我们还讨论了该角色在连续护理方面的重要性，以及认识到急诊科作为干预场所的核心作用。最后，我们考虑了除专门角色外，在急诊科进一步整合老年医学知识和专业技能的必要性。
