Each year, one in four nursing home residents are transferred to an emergency room by ambulance. Most times, transfers are necessary, but can have a harmful effect on older adults.
In nursing homes, residents are used to regular routines and familiar faces, but in the emergency room, they lose that familiarity and personal care. When they return to the nursing home, they experience bedsores, feelings of distress and reduced cognitive function.
Thanks to Kaitlyn Tate, a 2016 nursing graduate, research is helping to reduce unnecessary transfers. Kaitlyn conducted 12 interviews with 20 health-care aides as part of a larger study.
The study, ‘EXamining Aged Care Transitions,’ looked at how key people decided to transfer residents and the factors influencing their decision to transfer. Focus groups and interviews were conducted with nurses (RNs and LPNs), managers, directors, health-care aides, who work most closely with those involved in the decision making process like family members, EMS urgent response and hospital managers.
Kaitlyn led the data collection, analysis and dissemination for health-care aides’ perceptions on avoidable transfers. She was actively involved in the data collection and analysis for the larger study. These findings informed survey development and implementation to determine the perceptions of factors influencing avoidable transfers.
This research led to the development and validation of the following. Transfers are avoidable if:
The research team held a symposium in the fall of 2016 to bring important stakeholders in older persons care together and created a dissemination video, of which Kaitlyn was a contributor and narrator.
“Our goal is to determine ways to support decision making so we can minimize the number of avoidable transitions, says Kaitlyn. “This in turn will also help minimize undue strain on nursing home residents.”
Clinical agencies have expressed interest in the results and have asked to use them to help reduce their incidents of avoidable transfers. Kaitlyn continues her research work in older persons transitions, and is currently coordinating a review and evaluation of quality indicators for older persons transitions in care.
Kaitlyn is applying her research in her practice as an emergency room nurse at the Westview Health Centre in Stony Plain. “I was able to apply my skills and knowledge from research to better communicate with emergency medical services staff and provide informed assessments and recommendations when older persons were transferred from long-term care,” says Kaitlyn.
The study ‘EXamining Aged Care Transitions’ was funded by Covenant Health, Network of Excellence in Seniors' Health and Wellness, and conducted through CLEAR (Connecting Leadership Education Research) Outcomes with the University of Alberta. Publication is currently in progress.