Objective:To identify and develop innovative measures in effectively caring for the elderly cancer patients in spite of the increase of acuity and census in the emergency center (EC).
Design: 1 month of data was reviewed restropectively. A 3 month pilot study was done. The effectiveness of the pilot study was evaluated at the end of the pilot study
Materials and Methods: Data were gathered and reviewed to identify the major chief complaints, age, length of stay, peak hours, and measures to improve the flow of the EC. The results of a 3 month pilot study, utilizing a gerontological nurse practitioner to provide care to the patients, was evaluated and compared with previous existing data.
Results: About 27% of the patients visiting the EC are geriatric oncology patients. Their medical needs could be classified as urgent (66%), emergent (1%), or non-urgent (33%). Common complaints were fever (33%), pain (15%), respiratory (10%), fluid and electrolyte imbalance (10%), weakness (7%), bowel/bladder problem (4%), and cardio/vascular related complaints (13%). The results of the pilot study indicated the patient's length of stay had decreased by 46 minutes. The satisfaction level had increased with results of 66% good and 33% excellent. Since then, the EC has been utilizing the nurse practitioner more in providing care to the emergency center patients.
Conclusion: Geriatric oncology patients have many needs. Innovative measures can help in decreasing the length of stay and increase their satisfaction in the EC. Since the utilizaiton of nurse practitioner in our oncology EC is a success, we would recommend this system to others.
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