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 and 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: 154-169. doi:10.1097/TME.0b013e31828c7f4a


Author Schnitker, Linda
Martin-Khan, Melinda
Beattie, Elizabeth
Gray, Len
Title What is the evidence to guide best practice for the management of older people with cognitive impairment presenting to emergency departments? a systematic review
Journal name Advanced Emergency Nursing Journal   Check publisher's open access policy
ISSN 1931-4485
1931-4493
Publication date 2013
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1097/TME.0b013e31828c7f4a
Open Access Status DOI
Volume 35
Issue 2
Start page 154
End page 169
Total pages 16
Place of publication Philadelphia, PA United States
Publisher Lippincott Williams and Wilkins
Collection year 2014
Language eng
Subject 2711 Emergency Medicine
2907 Emergency
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. Copyright
Keyword Aged
Cognition disorders
Emergency service
Evidence based practice
Hospital
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: UQ Centre for Clinical Research Publications
Official 2014 Collection
School of Medicine Publications
 
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