Nurse-led ED support for Residential Aged Care Facility staff: An evaluation study

• We evaluated a nurse-led telephone service to Residential Aged Care Facilities.
• Presentations and admissions of older people to the ED from the RACFs reduced.
• Staff in RACFs and ED reported high levels of satisfaction with the model.
• There is need for greater cross-sectoral partnership, shared procedures and inclusive policy.

ObjectivesTo evaluate the impact of a nurse-led telephone support service to Residential Aged Care Facilities (RACFs) on a range of measures relating to the transfer of acutely unwell residents to the Emergency Department (ED) of a large tertiary referral hospital in New South Wales, Australia over a 9 month period.MethodsA pre- and post-intervention design determined the impact of the telephone service, associated clinical guidelines and education. Data from 4 intervention RACFs using the nurse-led telephone service were compared with 8 control RACFs. Data included the older patient's triage category, presenting problem(s), transfer rates from RACFs, ED admissions, and overall hospital length of stay. Interviews and focus groups with staff from RACFs and EDs were conducted to ascertain their experiences.ResultsReduced presentations of older people to the ED from the 4 pilot RACFs occurred. High levels of satisfaction among staff in RACFs were reported.