Streamlining care of older people in residential aged care: Nurse practitioner candidate and emergency department care coordination

Objective: Frail, older people are at increased risk of complications when the provision of healthcare requires they transfer out of their place of residence, particularly for those in residential aged care facilities (RACF) 1-4. Models of care that improve health outcomes for older persons and reduce potentially avoidable transfer to emergency departments (ED) are integral to managing an ageing population 5-13. The care coordination through emergency departments, residential aged care and primary health collaboration (CEDRiC) project coordinates care of the older person between: * A Nurse Practitioner Candidate (NPC) onsite in one RACF providing primary care in the facility aiming to reduce unnecessary transfer to hospital with onset of acute illness, and i) Advanced Practice Clinical Nurses in the local ED providing a Geriatric Emergency Department Intervention (GEDI). This presentation describes the impact of the CEDRiC project on outcomes for acutely unwell patients aged 70 years and older who presented to the ED. Design & Methods Quasi- experimental, pre-post design. Data collected included: i) patient level data from RACF and hospital databases, ii) direct observation of the NPC in the RACF. The Nursing Role Effectiveness model 14 was used to examine the NPC role within the CEDRiC project. Results Outcomes that improved for RACF residents following the implementation of the CEDRIC project included: reduction in the number of hospital transfers and reduced ED and hospital length of stay. The NPC demonstrated mostly independent and interdependent role functions most notably liaison with the GEDI team regarding transferring residents. Conclusion: Findings indicate that CEDRiC improves care outcomes for the older person in the RACF. Care coordination between the NPC and GEDI CNs in the local ED provide an added layer of communication that can streamline care for RACF residents transferred to the ED