School of Nursing, Faculty of Life and Health Sciences, Ulster University, Londonderry, Northern Ireland.
Adv Emerg Nurs J. 2021;43(2):145-161. doi: 10.1097/TME.0000000000000350.
Older adults present to emergency medical services with a multitude of clinical and functional needs due to polypharmacy and multipathology. Older adults with mental health needs require additional time for the more comprehensive assessment required as a result of their underlying mental health condition. This article compares the time spent in emergency departments by older adults who have a mental health need with those who do not. Information on how they access prehospital and inhospital care is examined alongside key factors that impact on time spent in emergency departments. Data were collected from hospital records of older adults presenting at emergency departments in 3 large Health and Social Care Trusts in the United Kingdom using a retrospective, secondary, official personal information database source over 1 year. A total sample of 74,766 attendance records of older adults older than 65 years were examined. adults who presented with or had a mental health condition in their diagnosis or history, which made up a subsample of 1,818 people, were found to have significant differences in the time spent in emergency departments and some notable differences in trends and admission patterns. They wait longer than the older person without mental health needs, are more likely to breach the 4-hr waiting time target, are admitted in higher numbers, and rely heavily on the ambulance service. Health and social care systems and services need to undergo transformations to ensure that all people who access services are treated fairly and effectively.
老年人由于多种药物治疗和多种疾病而呈现出多种临床和功能需求,需要向急诊医疗服务机构就诊。有心理健康需求的老年人由于其潜在的心理健康状况,需要更多的时间进行更全面的评估。本文比较了有心理健康需求的老年人和没有心理健康需求的老年人在急诊部门花费的时间。还检查了他们如何获得院前和院内护理的信息,以及影响在急诊部门花费时间的关键因素。使用了英国 3 家大型卫生和社会保健信托机构的急诊部门就诊的老年人的医院记录中的数据,这是通过对过去 1 年的回顾性、二级、官方个人信息数据库来源进行的一项研究。共检查了 74766 名 65 岁以上老年人的就诊记录。有或有精神健康状况的诊断或病史的老年人构成了 1818 人的子样本,他们在急诊部门花费的时间存在显著差异,在趋势和入院模式方面也存在一些显著差异。他们比没有心理健康需求的老年人等待的时间更长,更有可能违反 4 小时等待时间的目标,入院人数更多,并且严重依赖救护车服务。卫生和社会保健系统和服务需要进行转型,以确保所有获得服务的人都得到公平有效的治疗。