What is the evidence to guide best practice for the management of older people with cognitive impairment presenting to emergency departments? A systematic review

Schnitker, Linda, Martin-Khan, Melinda, Beattie, Elizabeth, & Gray, Len (2013) What is the evidence to guide best practice for the management of older people with cognitive impairment presenting to emergency departments? A systematic review. Advanced Emergency Nursing Journal, 35(2), pp. 154-169.

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Abstract

The aim of this study was to conduct a systematic literature review of research-based studies to identify practices designed to meet the specific care needs of older cognitively impaired patients in emergency departments (ED). A systematic literature review of studies was completed using PRIMSA methodology. The search criteria included articles from both emergency and acute care settings. A total of 944 articles were screened, and a total of 43 articles were identified as eligible. The review found a number of intervention studies to improve quality of care for older persons with cognitive impairment carried out or commenced in emergency settings, including interventions to improve cognitive impairment recognition (n = 9) and clinical approaches to reduce falls (n = 1) and both delirium incidence and prevalence (n = 2). Relevant studies carried out in acute care settings regarding cognitive impairment recognition (n = 4) and primary and secondary prevention of delirium (n = 18) and intervention studies that reduced the prescription of deliriogenic drugs (n = 1), reduced behavioral symptoms and discomfort (n = 7), and improved nutritional intake (n = 1) in hospitalized older persons with dementia were also identified. There is limited research available that reports interventions that improve the quality of care of older ED patients with cognitive impairment. Although this review found evidence obtained from the acute care setting, additional research is needed to identify whether these interventions are beneficial in fast-paced emergency settings.

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ID Code: 66565
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: literature review, cognitive impairment, emergency department, aged, hospital, evidence-based practice
DOI: 10.1097/TME.0b013e31828c7f4a
ISSN: 1931-4485
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Emergency Medicine (110305)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Aged Care Nursing (111001)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Aged Health Care (111702)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Deposited On: 03 Feb 2014 01:04
Last Modified: 03 Feb 2014 22:47

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