Skip to main content
SpringerLink
Log in

Impact of season, weekends and bank holidays on emergency department transfers of nursing home residents

Irish Journal of Medical Science (1971 -) volume 185, pages 655–661 (2016)Cite this article

Abstract

Background

For urgent, unexpected clinical events, nursing home (NH) residents are transferred to the acute hospital emergency department (ED). A previous study showed that a third of transfers occurred during working hours.

Aims

Our aims were to profile a one-year NH transfers to the ED and to examine the re-presentation, patient-oriented outcome and the impact of season, weekends and bank holidays on NH transfers.

Methods

All NH transfers from a catchment to an ED over one year were identified using electronic patient record. Age, gender, reason for presentation, patient-oriented outcome and date and time of presentation were recorded. Representation and the interval between transfers were calculated. Number of transfers was calculated for season, weekdays/weekends and bank holidays. Student t test, Chi-square statistics and one-way ANOVA were used. Significance was set at 0.05.

Results

There were 802 transfers from 465 NH residents over a year; 501 (62.5 %) resulted in admissions, 189 (40.6 %) residents represent to the service and 80 episodes occurred within a fortnight of the last attendance. The highest transfers occurred in May (2.81 patients/day), during working hours and on Wednesdays and Thursdays (>2.5 transfers/day). ‘Unwell adult’ and ‘falls’ were the two commonest reasons for presentation.

Conclusions

Our study showed that NH transfers occurred mainly within working hours and during weekdays. Insights into the transfer pattern and the reasons for NH patients to utilise ED will facilitate improved design and operation of the department by creating care pathways for these patients.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Wang HE, Shah MN, Allman RM, Kilgore M (2011) Emergency department visits by nursing home residents in the United States. J Am Geriatr Soc 59(10):1864–1872

    Article  PubMed  PubMed Central  Google Scholar 

  2. Briggs R, Coughlan T, Collins R, O’Neill D, Kennelly SP (2013) Nursing home residents attending the emergency department: clinical characteristics and outcomes. QJM 106(9):803–808

    Article  CAS  PubMed  Google Scholar 

  3. National clinical programme for older people. January 2013

  4. Report of the National Acute Medicine by the Royal College of Physicians Ireland, The Irish Association of the directors of nursing and midwifery, Therapy Professions Committee, Quality and Clinical Care Directorate, Health Service Executive, 2010

  5. Health Information and Quality A-Z Nursing homes http://www.hiqa.ie/social-care/find-a-centre/nursing-homes/m

  6. Byrne C, Vartuli M, McCarthy F et al (2013) Older re-attender to emergency department and medicine for the older persons. Ir J Med Sci 182(Suppl 6):S241

    Google Scholar 

  7. Onder G, Carpenter I, Finne-Soveri H et al (2012) Assessment of nursing home residents in Europe: the services and health for elderly in long TERm care (SHELTER) study. BMC Health Serv Res 9(12):5

    Article  Google Scholar 

  8. Central statistics office (Ireland): Profile 2—older and younger, May 2012

  9. Nemec M, Koller MT, Nickel CH, Maile S, Winterhalder C, Karrer C, Laifer G, Bingisser R (2010) Patients presenting to the emergency department with non-specific complaints: the basel non-specific complaints (BANC) study. Acad Emerg Med 17(3):284–292

    Article  PubMed  Google Scholar 

  10. Ruger JP, Lewis LM, Richter CJ (2007) Identifying high-risk patients for triage and resource allocation in the ED. Am J Emerg Med 25:794–798

    Article  PubMed  Google Scholar 

  11. Dosa D (2005) Should I hospitalize my resident with nursing home-acquired pneumonia? J Am Med Dir Assoc 6(5):327–333

    Article  PubMed  Google Scholar 

  12. Romero-Ortuno R, O’Shea D, Silke B (2012) Predicting the in-patient outcomes of acute medical admissions from the nursing home: the experience of St James’s Hospital, Dublin, 2002-2010. Geriatr Gerontol Int. 12(4):703–713

    Article  PubMed  Google Scholar 

  13. Burkett E, Scott I (2015) CARE-PACT: a new paradigm of care for acutely unwell residents in aged care facilities. Aust Fam Physician 44(4):204–209

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mater Misericordiae University Hospital, North Circular Road, Dublin 7, Ireland

    C. W. Fan, T. Keating, E. Brazil, D. Power & J. Duggan

Authors
  1. C. W. Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Keating
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Brazil
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D. Power
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Duggan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. W. Fan.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 12 kb)

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fan, C.W., Keating, T., Brazil, E. et al. Impact of season, weekends and bank holidays on emergency department transfers of nursing home residents. Ir J Med Sci 185, 655–661 (2016). https://doi.org/10.1007/s11845-015-1332-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-015-1332-3

Keywords

search

Navigation