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Posted: September 30th, 2024
Nurse Practitioner to Improve Outcomes for Geriatric Patients Paper.
Emergency care is one of the key areas of concern when it comes to geriatric patients. This is particularly important because elderly patients are more vulnerable to the risks of hospitalization and hospital readmission due to their age. On the one hand, elderly patients are more vulnerable to the risks of hospitalization and hospital readmission due to their age. This increased vulnerability stems from a combination of factors, including age-related physiological changes and a higher prevalence of chronic conditions. On the other hand, the emergency care delivered to this group of patients should be readjusted and tailored to their unique health and wellness needs. Elderly individuals often require a more comprehensive and holistic approach to care compared to younger patients. Elderly individuals admitted to emergency departments (EDs) typically require more comprehensive and holistic approaches to care than their younger counterparts. However, ED physicians are not always positioned to address the peculiar health needs of older adults. The issue to be considered in this project is the quality of emergency care provided to the elderly and the role of an adult-gerontology nurse practitioner in improving outcomes for the geriatric patients admitted to the ED.
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The issue of emergency care for geriatric patients is significant for several reasons. Firstly, the aging population is placing a growing strain on healthcare systems worldwide. To begin with, due to changing population demographics, the number of elderly patients admitted to EDs continues to increase. This trend is projected to continue in the coming decades, further exacerbating the challenges faced by emergency departments. According to McCabe and Kennelly (2015), “patients aged 65 years and over account for approximately 20% of emergency department (ED) presentations. It is projected that this figure will rise substantially in the coming decades” (p. 45). By 2030, every fourth Medicare beneficiary will be 85 years and older, and it is likely that older patients will make up to 70 percent of all emergency readmissions in the healthcare system (McCabe & Kennelly, 2015). The situation is further aggravated by the growing number of elderly people with chronic conditions and related comorbidities, which contribute to the burden of emergency care in the U.S. As such, ED nurses must be ready to manage the growing number of geriatric patients who are admitted to emergency care.
Furthermore, elderly clients who arrive to EDs typically require more complex and sophisticated care, as compared with their younger counterparts. This complexity stems from the increased prevalence of chronic conditions and age-related physiological changes in older adults. They utilize proportionally more services in EDs, as compared with other age groups (Boltz et al., 2013; Ellis, Marshall, & Ritchie, 2014). This increased utilization places a significant strain on ED resources and staff. Whenever a geriatric patient is admitted to an ED, he or she will stay longer, require more diagnostic tests, and experience higher hospital admission rates than younger patients (Boltz et al., 2013). These factors contribute to the higher costs associated with caring for geriatric patients in the ED. Older adults brought to EDs are usually sicker than younger patients, which is why they have higher rates of hospital readmissions due to more frequent exacerbations of chronic conditions or the development of new comorbidities (Ellis et al., 2014). This cycle of readmissions further increases the burden on the healthcare system. The costs of managing geriatric patients in the ED are also higher than those of younger patients (Ellis et al., 2014), and even when adequate care is provided, these clients are still likely to have poorer health outcomes as compared with patients from other age groups.
Finally, the growing number of older patients necessitates the development of new models of care. This includes exploring alternative staffing models and care delivery strategies that are better suited to the needs of geriatric patients. Here, Hwang et al. (2013) speak of the need to redesign emergency service settings in ways that would improve the quality of geriatric emergency care. They argue that current systems and models of emergency care often fail to meet the unique needs of older adults. Hwang et al. (2013) even used the term “geriatricizing” EDs, implying that the current systems and models of emergency care fail to meet the health needs of geriatric patients. Therefore, it is important to revisit the relevance of including an adult-gerontology advanced nurse practitioner instead of an ED physician to close the existing gaps in care and ensure smooth provision of high-quality emergency assistance to geriatric clients.
The goal of the proposed project is to improve the quality and accessibility of the nursing care provided to geriatric patients in EDs. This will be achieved by evaluating the feasibility of replacing ED physicians with adult-gerontology nurse practitioners to provide emergency care to elderly clients. More specifically, the aim of the project is to evaluate the feasibility of replacing ED physicians with adult-gerontology nurse practitioners to provide emergency care to elderly clients. It is expected that an adult-gerontology nurse practitioner working in an ED will be better positioned to streamline the delivery of holistic care to geriatric patients.
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The following PICOT question will need to be answered: “In patients 65 years of age or older (P), how does employing an adult Gerontology Nurse Practitioner in an emergency department (I) compared to an emergency department physician(C) influence their health outcomes and readmission (O) after the emergency department visit (T)?” This question will guide the research and analysis of the project. In other words, the project is intended to compare the quality of care provided by an adult Gerontology Nurse Practitioner to the care delivered by an ED physician. The selected issue will have far-reaching implications for the cost and outcomes of geriatric care.
The costs of healthcare in the U.S. continue to escalate, as more seniors seek emergency nursing assistance across hospital facilities. This trend is driven by several factors, including an aging population, rising chronic disease rates, and increasing healthcare costs. The growing demand for these services is further supplemented by the unprecedented complexity of the testing and diagnostic procedures required for this group of patients (Hwang et al., 2013). This complexity adds to the financial burden on the healthcare system. Adult gerontology nurse practitioners can be better positioned than ED physicians to identify the needs of elderly clients and organize the care process in ways that minimize its costs and enhance health outcomes. For example, they may be able to avoid unnecessary tests and procedures, which can significantly reduce healthcare expenditures. For instance, they may avoid ordering unnecessary tests. Likewise, these specialists may have the education and training needed to speed up the provision of quality care, thus reducing the risks of complications and hospital readmissions in the future. This can lead to significant cost savings for the healthcare system.
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Overall, new models of care have the potential to improve the quality of nursing assistance provided to geriatric patients in emergency departments. These models can also optimize the costs of such care while ensuring better health outcomes for elderly clients. They can also optimize the costs of such care while ensuring better health outcomes for elderly clients. More research is needed to see if an adult-gerontology nurse practitioner can provide better services to geriatric patients admitted to EDs, as compared with ED physicians. This research will help to inform policy decisions and improve the quality of care for this vulnerable population.
References.
de Leede-Brunsveld, S. F. M., Bleijenberg, N., Verhoef, J., Holtkamp, C., & Van Vught, J. A. H. (2023). Nurse practitioners in community health care: a rapid scoping review of their role, tasks, responsibilities, and implementation in Northwest Europe. Health & Social Care in the Community, 2023(1), 6678458.
Boltz, M., Capezuti, E., & Fulmer, T. T. (Eds.). (2024). Evidence-based geriatric nursing protocols for best practice. Springer Publishing Company.
Bogan, C. J., & Reifsnider, E. (2024). Home-Based Care as a New Medical Model: An Opportunity for Nurse Practitioners. The Journal for Nurse Practitioners, 20(4), 104941.
Turi, E., McMenamin, A., Kueakomoldej, S., Kurtzman, E., & Poghosyan, L. (2023). The effectiveness of nurse practitioner care for patients with mental health conditions in primary care settings: A systematic review. Nursing Outlook, 71(4), 101995.
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