Posted: September 30th, 2024

Nurse Practitioner to Improve Outcomes for Geriatric Patients Essay

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 demographic often presents unique challenges that require specialized attention. On the one hand, elderly patients are more vulnerable to the risks of hospitalization and hospital readmission due to their age. These vulnerabilities necessitate a reevaluation of current care practices. 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. Tailoring care can significantly improve patient outcomes and satisfaction. Elderly individuals admitted to emergency departments (EDs) typically require more comprehensive and holistic approaches to care than their younger counterparts. This comprehensive approach can help address the multifaceted health issues they face. However, ED physicians are not always positioned to address the peculiar health needs of older adults. This gap in care highlights the need for specialized roles within the ED. 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.

The issue of emergency care for geriatric patients is significant for several reasons. Understanding these reasons is crucial for developing effective interventions. To begin with, due to changing population demographics, the number of elderly patients admitted to EDs continues to increase. This trend underscores the urgency of adapting healthcare systems to meet growing demands. 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). These projections indicate a pressing need for strategic planning in healthcare. 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). This demographic shift will have significant implications for resource allocation. 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. Addressing these comorbidities requires a coordinated and multidisciplinary approach. As such, ED nurses must be ready to manage the growing number of geriatric patients who are admitted to emergency care. Preparing nurses with specialized training can enhance their ability to provide effective care.

Furthermore, elderly clients who arrive to EDs typically require more complex and sophisticated care, as compared with their younger counterparts. This complexity often results in longer stays and more intensive resource use. They utilize proportionally more services in EDs, as compared with other age groups (Boltz et al., 2013; Ellis, Marshall, & Ritchie, 2014). This increased utilization highlights the need for efficient care models. 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 overall strain on emergency services. 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 readmission can be mitigated with targeted interventions. 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. Improving outcomes requires a focus on both prevention and treatment.

Finally, the growing number of older patients necessitates the development of new models of care. Innovative care models can better address the specific needs of this population. 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. Redesigning these settings can lead to more efficient and effective care delivery. 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. This concept emphasizes the importance of specialized care environments. 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. This role could be pivotal in transforming geriatric emergency care.

The goal of the proposed project is to improve the quality and accessibility of the nursing care provided to geriatric patients in EDs. Achieving this goal will require collaboration across various healthcare disciplines. 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. This evaluation will provide insights into the potential benefits and challenges of such a change. 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. Streamlining care can lead to improved patient outcomes and satisfaction.

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 evaluation process. 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. This comparison will help identify the most effective care model. The selected issue will have far-reaching implications for the cost and outcomes of geriatric care. Addressing this issue could lead to significant improvements in healthcare delivery.

The costs of healthcare in the U.S. continue to escalate, as more seniors seek emergency nursing assistance across hospital facilities. This trend highlights the need for cost-effective care solutions. 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). Addressing this complexity requires innovative approaches to care delivery. 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. Their specialized training equips them to handle the unique challenges of geriatric care. For instance, they may avoid ordering unnecessary tests. This approach can lead to more efficient use of resources. 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. Reducing readmissions can significantly improve patient outcomes and reduce costs.

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 lead to more personalized and effective care. They can also optimize the costs of such care while ensuring better health outcomes for elderly clients. Cost optimization is crucial for the sustainability of healthcare systems. 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 inform future healthcare policies and practices.

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.