In response to the proliferation of geriatric EDs geared specifically to patients ages 65 and older, the Emergency Nurses Association, American College of Emergency Physicians, American Geriatrics Society and Society for Academic Emergency Medicine have issued a comprehensive set of geriatric ED guidelines covering everything from staffing to education to handling common problems of aging, such as falls, delirium and dementia.
Geriatric emergency departments first appeared in 2008, but this is the first time there has been a standardized template for how they should be set up and how care for older patients should be delivered, Alex Rosenau, DO, FACEP, president of ACEP, said in a news release.
It is important that the special needs of these vulnerable patients are met appropriately in the emergency setting. As of 2010, there were 40 million people in this age group, and many of them will be emergency patients at some point.
The groups developed the guidelines over a two-year period to address the challenge to the American healthcare system and EDs that the population explosion among seniors presents. Widespread adoption of the guidelines is expected to more effectively allocate healthcare resources and improve patient care.
Similar programs designed for other age groups (pediatrics) or specific diseases (myocardial infarction, stroke, trauma) have improved care both in individual EDs and systemwide, resulting in better, more cost-effective care and better patient outcomes, according to the news release.
The optimal geriatric emergency departments will help keep functionally independent seniors functionally independent, said Mark Rosenberg, DO, FACEP, geriatric emergency medicine chief at St. Josephs Healthcare System in Paterson, N.J., and chairman of ACEPs Geriatric Emergency Department Guidelines Task Force, said in the news release.
Geriatric emergency patients represent 43% of hospital admissions, according to the news release. On average, geriatric patients stay longer in the ED, use more resources and are significantly more likely to require social services.
Our advice to healthcare systems with limited resources is to make the entire emergency department a geriatric emergency department, Rosenberg said. If the ER is designed for the most frail and vulnerable, it will work for the strongest patients as well.
The guidelines cover staffing; follow-up care; education; quality improvement; equipment and supplies; policies, procedures and protocols; the use of urinary catheters; medication management; fall assessment; delirium and dementia; and palliative care: www.acep.org/geriEDguidelines.