Understanding why aged care residents are transferred to the ED

Grant ID: EMSS-379R29-2018

Project Summary

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.


Outcomes

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.


Dissemination

Publications:

- Gurung, A., Broadbent, M., Bakon, S., Hocking, J., Glenwright, A., Shaw, C., Tweddell, S. and Clark, S., 2020. Understanding registered nurse decisionā€making, communication and care delivery between emergency departments and residential aged care facilities: A research protocol. Australasian Journal on Ageing, 39(3), pp.277-282.

- Gurung, A., Romeo, M., Clark, S., Hocking, J., Dhollande, S. and Broadbent, M., 2022. The enigma: Decisionā€making to transfer residents to the emergency department; communication and care delivery between emergency department staff and residential aged care facilities' nurses. Australasian Journal on Ageing.


SHARE

Amount Awarded
$55,206


Program


Grant Scheme


Status
Complete


Principal Investigator:
Dr Sean Clark


Co Investigators:
A/Prof Marc Broadbent
Dr Apil Gurung
Ms Shannon Bakon


Associate Investigators:
Ms Christine Shaw
Dr Julia Hocking
Ms Michelle Romeo
Ms Amanda Glenwright
Dr Sheryl Tweddell


Institution


Collaborating Institutions


CONTACT US +61 7 3720 5700 info@emfoundation.org.au Suite 1B, Terraces, 19 Lang Parade, Milton Qld 4064