To read more about or view the complete Geriatric Emergency Department Guidelines please visit: https://www.acep.org/geriedguidelines/
In order to facilitate elderly care in the Emergency department, the guidelines strongly encourage the implementation of some policies, procedures and protocols. The following list is mostly suggestions and is non-exhaustive:
- Triage and initial evaluation: involve the family/friends as much as possible (gathering of valid informations)
- Early screening for high-risk elderly (Use a tool, for example the ISAR)
- Protocol for suspicion of elder abuse
- Delirium protocol (assessment with the CAM)
- Restraint policy (with detailed non pharmacological method of agitation management)
- DNR (information about level of care previously discussed available)
- Palliative care protocol
- Urinary catheter placement guidelines
- Falls education and reference guide
- Wound assessment and care
- Transition of care protocol (for example, a check list)
- Medication reconciliation guidelines (for example education about the BEERS criteria)
For more information or samples, click on each items.
A note on developing protocols
Here are a few tips before engaging into the protocol “Asterix mansion”:
- Develop them in team (nurses, physician, pharmacist, OT, PT, GEM nurse)
- Evaluate, modify, re-evaluate
- Make it accessible (intranet, paper copies well identified)
- Educate health professionals users
- Monitor their uses
The key word here: creativity!
That is what I like about geriatric emergency medicine. The issues are so obvious and big, any project or idea could turn out to be a GREAT solution.
References and Resources
- The Geri-ED Guidelines – Policies, Procedures and Protocols section.