Descriptive Study of Emergency Room Visits From Nursing Home Residents for Behavioral Problems at the Nancy University Hospital: Place of the Advanced Practice Nurse

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.

Study Overview

• Status: Completed
• Conditions: Behavioral Disorders
• Intervention / Treatment: Other: Observation

• Study Type: Observational
• Enrollment (Actual): 4000

Contacts and Locations

Study Locations

• France
  • Nancy, France, 54000
    • CHRU de Nancy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 75 years and older (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• 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

Description

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

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Retrospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Nursing home residents with behavioural problems; Nursing home residents from Grand Nancy aged 75 and over referred to emergency departments for disorientation, agitation, dementia or behavioural problems during the study period	Other: Observation; Observation
Nursing home residents with other problems; Nursing home residents from Grand Nancy aged 75 and over referred to emergency departments for other reasons	Other: Observation; Observation

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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	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	through study completion, an average of 6 months

Secondary Outcome Measures

Outcome Measure	Time Frame
Age of the patients	through study completion, an average of 6 months
Gender of the patients	through study completion, an average of 6 months
Presence of previous medical cognitive disorder	through study completion, an average of 6 months
Name of nursing home of origin	through study completion, an average of 6 months
Length of stay at emergency room	through study completion, an average of 6 months
Referral after visit at emergency room	through study completion, an average of 6 months
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	through study completion, an average of 6 months
Presence of intervention of geriatric mobile team	through study completion, an average of 6 months

Collaborators and Investigators

• Sponsor: Central Hospital, Nancy, France
• Collaborators: Marie MANGEOT- Nurse; Mahmut GUNDESLI MD

Study record dates

Study Major Dates

• Study Start (Actual): April 14, 2021
• Primary Completion (Actual): June 30, 2021
• Study Completion (Actual): June 30, 2021

Study Registration Dates

• First Submitted: March 26, 2021
• First Submitted That Met QC Criteria: April 13, 2021
• First Posted (Actual): April 15, 2021

Study Record Updates

• Last Update Posted (Actual): November 18, 2021
• Last Update Submitted That Met QC Criteria: November 17, 2021
• Last Verified: November 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Pathologic Processes; Disease Attributes; Emergencies; Problem Behavior
• Other Study ID Numbers: 2021PI027

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No