C Brymer1, P Cavanagh, E Denomy, K Wells, C Cook. 1. Division of Geriatric Medicine, The University of Western Ontario, London, Ontario, Canada. cbrymer@julian.uwo.ca
Abstract
OBJECTIVE: In a previous study, emergency nurses gave a high priority to the educational topics of geriatric depression, physical assessment of the elderly, and mental status testing. Our objective was to measure the impact of a 1-day workshop for emergency nurses that addressed these educational needs. METHODS: The workshop consisted of case-based didactic sessions addressing (1) physical assessment of the elderly, (2) delirium, depression, and dementia, and (3) a practical approach to mental status testing in the elderly. The educational program was evaluated using 2 methods: (1) before, and 1 month after, the workshop, participants rated their own practice patterns; and (2) during the course of 2 years, changes in the number of referrals for geriatric assessment and home care from a large emergency department in the study area were monitored. RESULTS: Of 101 ED nurses who attended the 1-day workshop, 51 completed both preworkshop and postworkshop questionnaires (response rate, 50.5%). the most significant self-reported changes in practice 1 month after the workshop were improved screening for depression and altered mental status in older adults (P <.0001 and P <.01, respectively). Other positive changes were noted for inquiring about unplanned weight loss and assistance received at home. A steady increase in the number of referrals for geriatric assessment and home care was noted from the emergency department being monitored. DISCUSSION: Targeted geriatric educational programs can make an impact on the practice of emergency nurses when they are part of an overall, coordinated approach to improving assessment and discharge planning for elderly patients in emergency departments. Mechanisms for reinforcing learning several months after educational events may prove critical to the long-term success of such initiatives.
OBJECTIVE: In a previous study, emergency nurses gave a high priority to the educational topics of geriatric depression, physical assessment of the elderly, and mental status testing. Our objective was to measure the impact of a 1-day workshop for emergency nurses that addressed these educational needs. METHODS: The workshop consisted of case-based didactic sessions addressing (1) physical assessment of the elderly, (2) delirium, depression, and dementia, and (3) a practical approach to mental status testing in the elderly. The educational program was evaluated using 2 methods: (1) before, and 1 month after, the workshop, participants rated their own practice patterns; and (2) during the course of 2 years, changes in the number of referrals for geriatric assessment and home care from a large emergency department in the study area were monitored. RESULTS: Of 101 ED nurses who attended the 1-day workshop, 51 completed both preworkshop and postworkshop questionnaires (response rate, 50.5%). the most significant self-reported changes in practice 1 month after the workshop were improved screening for depression and altered mental status in older adults (P <.0001 and P <.01, respectively). Other positive changes were noted for inquiring about unplanned weight loss and assistance received at home. A steady increase in the number of referrals for geriatric assessment and home care was noted from the emergency department being monitored. DISCUSSION: Targeted geriatric educational programs can make an impact on the practice of emergency nurses when they are part of an overall, coordinated approach to improving assessment and discharge planning for elderly patients in emergency departments. Mechanisms for reinforcing learning several months after educational events may prove critical to the long-term success of such initiatives.
Authors: Christopher R Carpenter; Nada Hammouda; Elizabeth A Linton; Michelle Doering; Ugochi K Ohuabunwa; Kelly J Ko; William W Hung; Manish N Shah; Lee A Lindquist; Kevin Biese; Daniel Wei; Libby Hoy; Lori Nerbonne; Ula Hwang; Scott M Dresden Journal: Acad Emerg Med Date: 2020-12-12 Impact factor: 5.221