在时间紧迫的急诊部环境下安全照护老年患者-hongkongcollegeof.pdfVIP

Hong Kong Journal of Emergency Medicine Managing older patients safely in the time critical environment of an emergency department JA Lowt hian, C Brand, A L Barker, N A ndrianopoulos, C Smit h, C Batey, PDeV Smit , HH New nham, P Hunter, PA Cameron Demand for emergency department (ED) serv ices is increasing worldwide. The fastest growth in ED presentations is by patients aged 65 years, currently representing 18% of all attendances. Older patients present with more complex clinical conditions and multiple co-morbidities. This means they are likely to spend more time in ED, are more likely to be admitted to hospital, and are more likely to re-attend. The Safe Elderly Emergency Discharge (SEED) project aims to determine whether current models of emergency care ensure safe discharge and facilitate optimal health outcomes for older patients; and develop a tailored evidence- based care framework applicable to Australian and international settings. Risk screening for unsafe discharge will be conducted on patients aged 65 years discharged home from ED. Patients will be followed for 6 months post-ED presentation to monitor health outcomes and map their care journey. Demographic, clinical, and functional characteristics will be collected. The primary outcome is unsafe discharge, defined as unplanned re-presentation/admission within 30 days of the index presentation. Secondary outcomes include unplanned ED re-presentation/hospital admission within 6 months; patient experience; change in functional status; functional decline; health service utilisation; and death within 6 months. The effectiveness of the ED discharge risk screening tools for predicting unsafe discharge will be evaluated at 30 days and 6 months. SEED will determine the risk factors for unplanned ED re-presentation/hospital admission at 30 days for patients aged