In Australia, the existing model of emergency department care is struggling to cater for the needs of the older population. A large proportion of older patients arriving at emergency departments are from residential aged care facilities (RACFs). Nursing staff in RACFs often participate in decision making pertaining to transfer of residents to the emergency department, but very little research has been done on the decision making involved in this process.
The mixed methods study will engage with RACF nursing staff to understand their decision to transfer a resident, their perception of communication with the emergency department, and the services that influence the decision.
The study found that general practitioners, geriatric outreach teams, patient families and the presence of an advanced health directive may all influence the decision to transfer RACF patients to the hospital emergency department (ED).
However, RACF registered nurses predominantly relied upon facility policies, protocols and procedures as well as their own clinical judgement when deciding to transfer a resident to the ED. Inter-professional relationships between healthcare providers was also a key factor influencing the transfer process.
This provides objective data and detailed understanding of existing service provision, communication between facilities, and potential gaps in education and skills, thereby informing areas to target in health service reform for this vulnerable population.
Dr Sean Clark
Dr Marc Broadbent
Dr Apil Gurung
Ms Shannon Bakon
Ms Christine Shaw
Dr Julia Hocking
Ms Michelle Romeo
Ms Amanda Glenwright
Dr Sheryl Tweddell