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Welcome
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11 February 2012
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| [ Print-friendly version ] |
| Nursing intervention for older patients who are discharged home from Emergency Department |
| ISRCTN | ISRCTN08788893 |
| ClinicalTrials.gov identifier | |
| Public title | Nursing intervention for older patients who are discharged home from Emergency Department |
| Scientific title | Nursing intervention for older patients who are discharged home from Emergency Department: A randomised controlled trial |
| Acronym | N/A |
| Serial number at source | N/A |
| Study hypothesis |
The overall aim of the study is to investigate a model for structured nursing assessment and intervention for geriatric patients in the Emergency Department and the following months. The objectives are:
1. To examine the effect of identification of geriatric patients (>70 years) at risk of functional decline and readmission. 2. To examine the effect of nursing assessment and intervention given before discharge from Emergency Department and one and six months after. |
| Lay summary | |
| Ethics approval |
1. The Ethical Board of The Capital Region of Denmark approved on the 12th of December 2007 (ref: H-D-2007-0110)
2. The Danish Data Protection Agency approved on the 6th of November 2008 (ref: 2008-41-2768) |
| Study design | Randomised controlled parallel group trial |
| Countries of recruitment | Denmark |
| Disease/condition/study domain | Geriatric patients; functional decline |
| Participants - inclusion criteria |
1. Patients 70 years and older scoring more than 2 points (out of 6) when screened with Identification of Seniors at Risk 1 (ISAR 1) screening tool (McCusker 1998)
2. Discharged home from Medical Emergency Department and residents of Amager, Copenhagen 3. Able to decide on informed consent 4. Able to communicate in Danish |
| Participants - exclusion criteria |
1. Patients admitted to Medical Emergency Department from nursing home
2. Patients already included who are readmitted 3. Spouses to already included patients 4. Patients who do not wish to participate |
| Anticipated start date | 16/02/2009 |
| Anticipated end date | 01/08/2011 |
| Status of trial | Completed |
| Patient information material | No patient information available in web-format. |
| Target number of participants | 300 patients |
| Interventions |
Geriatric patients admitted to the Emergency Department are detected using ISAR 1 screening tool. After randomisation and at discharge and one and six months after the geriatric intervention nurse does the experimental intervention that consists of a brief, standardised geriatric nursing assessment using a ten point checklist of physical, mental, medical, and social problems. The focus is on unresolved problems, new or pre-existing, that required medical intervention, new or different home care or other services, or comprehensive geriatric assessment. After this a discharge plan/plan is worked out with relevant referrals to the outpatient clinic, community care, primary physician or arrangements with next-of-kin.
Patients in the control group received the usual Emergency Department services and consultations. They are not referred to the intervention nurse. |
| Primary outcome measure(s) |
1. Readmission to Emergency Department within one and six months, data collected from the Hospitals administrative database.
2. Admission to nursing home within one and six months, data collected from the Hospitals administrative database. 3. Death within one or six months, data collected from the Hospital administrative database. |
| Secondary outcome measure(s) |
1. Physical functional status at baseline, one, and six months, measured by
1.1. Chairstand test, total number of rise from a chair in 30 seconds (Jones CJ, Rikli RE, Beam WC, 1999) 1.2.Handgrip-strength using a Jamar dynamometer (Bohannon RW, Schaubert KL 2005) 1.3. Avlund’s Mobility-Tiredness Scale that counts activities managed without fatigue (Avlund K, Kreiner S, Schultz-Larsen K 1996). 2. Cognitive functional status at baseline, one, and six months, measured by mini-mental status examination that consists of 11 questions, maximum score (best performance)=30 (Folstein MF, Folstein SE, McHugh PR 1975). 3. Mental functional status at baseline, one, and six months, measured by Geriatric Depression Scale (0-1=not depressed,2- 5=risk of depression)(Bull 1988) 4. Health related quality of life at baseline, one, and six months, measured by 12-itim short-form Health Survey (SF 12) (Ware J Jr, Kosinski M, Keller SD 1996). 5. Amount of patient’s unresolved problems, data collected from intervention nurse records. 6. Amount of help at home from the community, data collected from the community health center utilisation database. |
| Sources of funding |
1. Amager Hospital (Denmark)
2. Danish Nurses’ Organization (Denmark) 3. The Lundbeck Foundation (Denmark) 4. The Tryg Foundation (Denmark) (ref: J.nr. 1072-09) 5. University of Southern Denmark, Institute of Clinical Research (Denmark) - Research Unit of Nursing |
| Trial website | |
| Publications | |
| Contact name | Mrs Elizabeth Rosted |
| Address |
University Hospital of Amager
Italiensvej 1 |
| City/town | Copenhagen |
| Zip/Postcode | 2300 |
| Country | Denmark |
| elizabeth.rosted@amh.regionh.dk | |
| Sponsor | University Hospital of Amager (Denmark) |
| Address | Italiensvej 1 |
| City/town | Copenhagen |
| Zip/Postcode | 2300 |
| Country | Denmark |
| amager.hospital@amh.regionh.dk | |
| Sponsor website: | http://www.amagerhospital.dk/ |
| Date applied | 14/01/2010 |
| Last edited | 17/02/2010 |
| Date ISRCTN assigned | 17/02/2010 |
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