An implementation science approach to geriatric screening in an emergency department.
Background: The Geriatric Emergency Department (ED) Guidelines recommend screening older adults during their ED visit for delirium, fall risk/safe mobility, and home safety needs. We used the Consolidated Framework for Implementation Research (CFIR) and the Expert Recommendations for Implementation...
| Publicado en: | Journal of the American Geriatrics Society Vol. 70; no. 1; pp. 178 - 188 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Wiley-Blackwell
Jan2022
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=154564702&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 154564702 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00028614 20Q jtl: Journal of the American Geriatrics Society issn: 00028614 maglogo: Y pubinfo: dt: Jan2022 vid: 70 iid: 1 pid: 480 pub: Wiley-Blackwell artinfo: ui: 154564702 10.1111/jgs.17481 ppf: 178 ppct: 10 formats: tig: atl: An implementation science approach to geriatric screening in an emergency department. aug: au: Southerland, Lauren T. Hunold, Katherine M. Van Fossen, Jenifer Caterino, Jeffrey M. Gulker, Peg Stephens, Julie A. Bischof, Jason J. Farrell, Erin Carpenter, Christopher R. Mion, Lorraine C. affil: Department of Emergency Medicine, The Ohio State University, Columbus Ohio,, USA Center for Biostatistics, Department of Biomedical Informatics, The Ohio State College of Medicine, Columbus Ohio,, USA Department of Emergency Medicine, Washington University at St. Louis, St. Louis Missouri,, USA College of Nursing, The Ohio State Wexner Medical Center, Columbus Ohio,, USA su: Evaluation of human services programs Health facilities Cross-sectional method Motivation (Psychology) Medical screening Organizational change Occupational adaptation Needs assessment Elder care Corporate culture Patient safety Diagnosis of delirium Hospital emergency services Academic medical centers Nurses' attitudes Equipment & supplies Home accident prevention Conceptual structures Medical protocols Scale analysis (Psychology) Descriptive statistics Accidental falls Physical mobility Nurse practitioners Emergency nursing Medical needs assessment Nursing interventions sug: subj: Evaluation of human services programs Health facilities Cross-sectional method Motivation (Psychology) Medical screening Organizational change Occupational adaptation Needs assessment Elder care Corporate culture Patient safety Continuing Care Retirement Communities All Other Outpatient Care Centers All Other Miscellaneous Ambulatory Health Care Services Diagnosis of delirium Hospital emergency services Academic medical centers Nurses' attitudes Equipment & supplies Home accident prevention Conceptual structures Medical protocols Scale analysis (Psychology) Descriptive statistics Accidental falls Physical mobility Nurse practitioners Emergency nursing Medical needs assessment Nursing interventions keyword: CFIR emergency department implementation screening tools CFIR emergency department implementation screening tools ab: Background: The Geriatric Emergency Department (ED) Guidelines recommend screening older adults during their ED visit for delirium, fall risk/safe mobility, and home safety needs. We used the Consolidated Framework for Implementation Research (CFIR) and the Expert Recommendations for Implementation Change (ERIC) tool for preimplementation planning. Methods: The cross‐sectional survey was conducted among ED nurses at an academic medical center. The survey was adapted from the CFIR Interview Guide Tool and consisted of 21 Likert scale questions based on four CFIR domains. Potential barriers identified by the survey were mapped to identify recommended implementation strategies using ERIC. Results: Forty‐six of 160 potential participants (29%) responded. Intervention Characteristics: Nurses felt geriatric screening should be standard practice for all EDs (76.1% agreed some/very much) and that there was good evidence (67.4% agreed some/very much). Outer setting: The national and regional practices such as the existence of guidelines or similar practices in other hospitals were unknown to many (20.0%). Nurses did agree some/very much (64.4%) that the intervention was good for the hospital/health system. Inner Setting: 67.4% felt more staff or infrastructure and 63.0% felt more equipment were needed for the intervention. When asked to pick from a list of potential barriers, the most commonly chosen were motivational (I often do not remember (n = 27, 58.7%) and It is not a priority (n = 14, 30.4%)). The identified barriers were mapped using the ERIC tool to rate potential implementation strategies. Strategies to target culture change were identifying champions, improve adaptability, facilitate the nurses performing the intervention, and increase demand for the intervention. Conclusion: CFIR domains and ERIC tools are applicable to an ED intervention for older adults. This preimplementation process could be replicated in other EDs considering implementing geriatric screening. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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