Affiliation:
1. School of Nursing, Department of Life and Health Science Ulster University Coleraine UK
2. School of Nursing and Institute of Nursing and Health Research Ulster University Coleraine UK
Abstract
AbstractBackgroundFor many older people the emergency department (ED) is an important but sometimes difficult step in their healthcare journey. They often attend the ED with co and multi morbidities. Discharge home at evenings and weekends when post‐discharge support services are limited can result in a delay or failure to follow through on their discharge plan leading to adverse health outcomes and in some cases, readmission to ED.ObjectiveThe aim of this integrative review was to identify and appraise the support available to older people following discharge from the ED out of hours (OOH).MethodsFor this review, out of hours referred to those times after 17.30 until 08.00 a.m. on Mondays to Fridays, all hours on weekends and public holidays. Whittemore and Knafl's (Journal of Advanced Nursing, 2005;52:546), framework was used to guide all stages of the review process. Articles were retrieved following a rigorous search of published works using various databases, the grey literature and hand search of the reference lists of the studies included.ResultsIn total 31 articles were included in the review. These comprised systematic reviews, randomised control studies, cohort studies and surveys. Main themes identified included processes that enable support, support provision by health and social care professionals and telephone follow‐up. Results identified a significant dearth of out of hours discharge research and a strong recommendation for more concise and thorough research in this important area of care transition.ConclusionOlder person discharge home from the ED presents an associated risk as previous research has identified frequent readmission and periods of ill health and dependency. Out of hours discharge can be even more problematic when it may be difficult to arrange support services and ensure continuity of care. Further work in this area is required, taking cognisance of the findings and recommendations identified in this review.
Reference68 articles.
1. Frailty and adverse outcomes in older adults being discharged from the emergency department: A prospective cohort study
2. Telephone follow up for older people discharged from A&E
3. The Transition of Care Between Emergency Department and Primary Care: A Scoping Study
4. Do older people who self‐harm receive the hospital care they need?;Barr W.;Quality in Practice‐Policy, Practice and Research,2004
5. Berchet C. &Nader C.(2016).The organisation of out‐of‐hours primary care in OECD countries OECD Health Working Papers No. 89 OECD Publishing Paris.