Irimia Ana Maria, Tennant Anna, Waldron Alexandria, Bashir Nahida
care of the older person, Musgrove Park Hospital, Taunton, England.
Nurs Older People. 2022 Apr 5;34(2):23-28. doi: 10.7748/nop.2022.e1381. Epub 2022 Feb 9.
A comprehensive geriatric assessment (CGA) is a holistic multidimensional review of older people living with frailty or at risk of frailty. In emergency surgical settings, CGAs can be used to identify medical issues and geriatric syndromes among older patients and consequently try to improve their post-operative outcomes. However, there is a lack of geriatrician input in hospitals beyond medical wards, which means that older people who need emergency surgery do not always undergo a CGA, with potential negative repercussions for their post-operative outcomes. One solution to this issue is to employ advanced nurse practitioners (ANPs) to deliver equivalent services. This article presents and discusses the results of an audit of an ANP-led CGA service for older people admitted to hospital for emergency surgery. The ANP reviewed 147 patients during the audit period and identified frailty in 37% and new medical issues in 89% of patients. Interventions initiated by the ANP based on the CGA included requests for additional investigations, referral to allied health professionals and discharge planning. The audit results suggest that ANPs can conduct CGAs in emergency surgical settings effectively.
全面老年评估（CGA）是对体弱或有体弱风险的老年人进行的全面多维评估。在急诊手术环境中，CGA可用于识别老年患者的医疗问题和老年综合征，从而努力改善他们的术后结局。然而，医院除医疗病房外，老年医学专家的参与不足，这意味着需要急诊手术的老年人并不总是接受CGA评估，这可能会对他们的术后结局产生负面影响。解决这个问题的一个办法是聘请高级执业护士（ANP）提供同等服务。本文介绍并讨论了一项针对因急诊手术入院的老年人由ANP主导的CGA服务的审计结果。在审计期间，ANP对147名患者进行了评估，发现37%的患者存在体弱，89%的患者有新的医疗问题。ANP根据CGA发起的干预措施包括要求进行额外检查、转诊至相关健康专业人员以及出院计划。审计结果表明，ANP可以在急诊手术环境中有效地进行CGA评估。
