Recognition Of Frailty In Patients 75 Years And Older, Presenting To The Emergency Department Of A Level Three Hospital

Abstract Background Ireland is experiencing the challenges and opportunities with an ageing population. When these needs remain unmet, older patients with frailty may present to the emergency department. It is important to put processes in place to improve the management of older persons presenting to the Emergency Department. The variable indicative of placement risk is a tool to identify older people at risk of adverse health outcomes at the time of hospital admission. Determination of frailty status is useful to inform clinical decisions, as frailty scores can predict multiple adverse health-related outcomes following hospitalisation. The aim is for every patient to leave in a better condition, and to add value with every interaction. Methods A retrospective service evaluation, over a specified time period, ascertained provision prior to the implementation of frailty specific initiatives. 39 charts were selected for the clinical audit. The audit tool was devised utilising the NCAA 2023 guidelines. Reliability was assured through quality patient safety and support of clinical audit facilitation. Data collected and analysed utilising an excel audit tool. Results 100 percent of validated indicative placement risk is completed by nursing staff at triage. 92 percent of patients aged 75 years and older were triaged at 3. Cognition assessment was not standardized across assessment, with 26 percent of presentations with confusion observed, with collateral received on twenty eight percent. Overall, 34.8 percent of presentations had frailty recognition utilising agreed frailty terms. Conclusion The aim is to introduce clinical frailty assessment for all patients presenting aged seventy-five years and older. Delirium assessment is not standardized across assessment. The rapid clinical test for delirium (4AT) in line with national delirium assessment will be introduced. Frailty service is in position to support these changes. Ongoing education of Delirium and Frailty recognition for all Emergency department personal.