Clinical trial NCT04846608: Descriptive Study of Emergency Room Visits From Nursing Home Residents for Behavioral Problems at the Nancy University Hospital: Place of the Advanced Practice Nurse
Official title: Descriptive Study of Emergency Room Visits From Nursing Home Residents for Behavioral Problems at the Nancy University Hospital: Place of the Advanced Practice Nurse
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Behavioral Disorders
Lead sponsor: Central Hospital, Nancy, France
Sponsor class: OTHER
Collaborators: name: Marie MANGEOT- Nurse
name: Mahmut GUNDESLI MD
First posted: 2021-04-15
Enrollment: 4000
Sex: ALL
Minimum age (years): 75
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CONTROL
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All persons aged 75 and over, residents of nursing homes in the Nancy area, who consulted the emergency department during the 6 month study period

Brief summary: The demographic evolution of old age is a reality. After the age of 75, 2 out of 3 people living in institutions have neurocognitive disorders. Behavioural disorders such as physical aggression, agitation, hallucinations, sleep disorders, generate difficulties in the management of these patients and lead to unscheduled emergency hospitalizations. Non-pharmacological management of behavioral disorders is recommended as a first-line treatment because of its low risk and potential improvement (Haute Autorité de Santé 2009). However, this management is not simple and obvious to put in place, especially since not all elderly people with Behavioural disorders are in adapted structures. The advanced practice nurse specializing in geriatrics has a place in this care pathway. Because of her skills, she could "organize multi-professional care, set up analyses of practices within the nursing homes, train caregivers appropriately, and limit hospitalizations due to behavioral problems" (SALIEGE L. 2020). Advanced practice nursing is in its infancy in France, and everything remains to be done (International Council of Nurses- directive). The aim of the study is to identify the number of emergency room visits by people aged 75 and over for behavioral problems in nursing home during a 6 month-period.


Eligibility criteria: Inclusion Criteria:

* Person who has received full information on the organization of the research and has not objected to the use of this data
* Elderly men and women 75 years of age and older at the time of the emergency room visit
* Having for main residence one of the nursing homes of the Grand Nancy
* Administratively present in the emergency department
* Having been admitted to the emergency room for the following reasons:

  * Behavioural problems
  * Agitation
  * Dementia
  * Disorientation
  * Delirium

Exclusion Criteria:

* People under 75 years of age
* Residing at home or in a senior residence or in a nursing home outside Grand Nancy
* Referred by an inpatient department (rehabilitation department)
* Other reasons for emergency room use such as "depression" and "apathy

Primary outcomes:
measure: Number of passage of people aged 75 and over referred to emergency departments by nursing homes for disorientation, agitation, dementia or behavioural problems during the study period
timeFrame: through study completion, an average of 6 months
Secondary outcomes:
measure: Age of the patients
timeFrame: through study completion, an average of 6 months
measure: Gender of the patients
timeFrame: through study completion, an average of 6 months
measure: Presence of previous medical cognitive disorder
timeFrame: through study completion, an average of 6 months
measure: Name of nursing home of origin
timeFrame: through study completion, an average of 6 months
measure: Length of stay at emergency room
timeFrame: through study completion, an average of 6 months
measure: Referral after visit at emergency room
timeFrame: through study completion, an average of 6 months
measure: Number of iterative passage of people aged 75 and over referred to emergency departments by nursing homes for disorientation, agitation, dementia or behavioural problems during the study period
timeFrame: through study completion, an average of 6 months
measure: Presence of intervention of geriatric mobile team
timeFrame: through study completion, an average of 6 months
Other outcomes:
Locations:
city: Nancy
country: France
facility: CHRU de NANCY
Study officials:
References: