Impact of nurse-delivered geriatric intervention in the emergency department: A systematic review.

Abstract

Canada's aging population is a growing challenge for emergency departments (EDs), as older adults require complex, resource-intensive care. Traditional ED models focus on single, acute conditions and often fail to address older patients' multifaceted needs, leading to functional decline, misdiagnosis, and readmission. Nurses are well suited to lead geriatric-focused interventions. This systematic review examined 33 studies since 2014, evaluating nurse-delivered ED care for adults ≥65 years across seven intervention types: multidisciplinary teams, geriatric screening, geriatric assessment, nurse geriatric specialists, ED pathway/process change, and discharge planning. Multidisciplinary teams, nurse geriatric specialists, geriatric screening, and geriatric assessments were associated with improved inpatient admission rates, functional decline, and discharge rates. Combining nurse geriatric specialists with multidisciplinary teams yielded the most consistent benefits. Improvements in ED revisits and hospital length of stay were less consistent, especially in higher-quality studies. Evidence quality was modest, but findings support nurse-delivered strategies in improving care for older adults in the ED. Future research should focus on high-quality, multi-site evaluations to inform practice.