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. 2023 Sep;55(3):404-412.
doi: 10.1177/08445621221144667. Epub 2023 Jan 11.

The Association Between Frailty and a Nurse-Identified Need for Comprehensive Geriatric Assessment Referral from the Emergency Department

Fabrice I Mowbray  1 , Brittany Ellis  2 , Connie Schumacher  3 , George Heckman  4 , Kerstin de Wit  5   6 , Ryan P Strum  1 , Aaron Jones  1 , Rebecca H Correia  1 , Eric Mercier  7   8 , Andrew P Costa  1
Affiliations

The Association Between Frailty and a Nurse-Identified Need for Comprehensive Geriatric Assessment Referral from the Emergency Department

Fabrice I Mowbray et al. Can J Nurs Res. 2023 Sep.

Abstract

Background: Emergency nurses commonly conduct geriatric assessments in the emergency department (ED). However, little is known about what geriatric syndromes or clinical presentations prompt a nurse to document an identified need for comprehensive geriatric assessment (CGA).

Objectives: To examine the association between geriatric syndromes, like frailty, and a nurse-identified need for a CGA following emergency care.

Methods: We conducted a secondary analysis of a multi-province Canadian cohort from the InterRAI Multinational Cohort Study. We collected data at ED registration from patients 75 years of age and older (n = 2,274) from eight ED sites across Canada between November 2009 and April 2012. Geriatric syndromes were assessed by trained emergency nurses using the interRAI ED Contact Assessment; and we retrospectively calculated the ED frailty index. We employed binary logistic regression to determine the adjusted associations between geriatric syndromes and a nurse-identified need for a CGA.

Results: Approximately one-quarter (28%) of older adults were identified to need a CGA following emergency care. A 0.1 unit increase in the ED frailty index increased the likelihood of a nurse identify a need for CGA (RD: 6.6; 95% CI = 5.5-7.9). Most geriatric syndromes increased the probability of a nurse documenting the need for a CGA.

Conclusion: When assessed by emergency nurses, the identified need for CGA is strongly linked to the presence of geriatric syndromes, including frailty. We provide face validity for the continued use of emergency nurses for screening and assessing older ED patients.

Keywords: comprehensive geriatric assessment; emergency nursing; frailty; geriatric syndromes.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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