Does the Intervention of an Advanced Practice Nurse for Nursing Home Residents Aged 75 and Over in the Grand Nancy Area Make it Possible to Reduce the Use of the Emergency Service for These Residents?

November 22, 2022 updated by: BOURDAIRE Victoire, Central Hospital, Nancy, France

The rate of emergency room visits is high at the extremes of age, with patients aged 75 or over accounting for 12% of emergency room visits, and the time they spend there is significantly longer than that of younger patients.

Nursing Home residents represent 14% of these emergency room visits and only 5% of them on average are not hospitalised and return to their original Nursing Home.

A retrospective study of patients aged 75 and over referred to the emergency department of the Nancy Hospital by the Nursing Homes over a six-month period showed that nearly 30% of patients aged 75 and over referred by their Nursing Home were rehospitalized during the period studied, 1/3 for the same reason and 2/3 for other reasons.

The intervention of an Advanced Practice Nurse (IPA) attached to geriatric practice, among other things, as an interface between Nursing Home and the hospital therefore seems to have its place in improving the care pathway for the elderly.

The assessment by an Advanced geriatric Practice Nurse of residents of Nursing Home aged 75 and over in Grand Nancy area one week after a visit to the emergency room significantly reduces the number of new visits to the emergency room by these residents over a follow-up period of seven months, compared with residents of Nursing homes aged 75 and over (outside Grand Nancy area) who do not benefit from an assessment by an Advanced Practice Nurse.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Anticipated)

400

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

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 ,who consulted the emergency department of Nancy Hospital during the 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
  • Administratively present in the emergency department

Exclusion Criteria:

  • People under 75 years of age
  • Residing at home or in a senior residence
  • Referred by an inpatient department (rehabilitation department)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Nursing Home resident from Grand Nancy area with Advanced Practice Nurse intervention
Patients aged 75 years and over, resident in Nursing Home at the time of inclusion, and received at least once in the emergency room of the Nancy Hospital during the period concerned. Inclusion in the group with IPA intervention for Nursing Home residents of the Grand Nancy area where the Advanced Practice Nurse is authorised to intervene.
Other: Observation
Observation
Nursing Home resident outside Grand Nancy area without Advanced Practice Nurse intervention
Patients aged 75 years and over, resident in Nursing Home at the time of inclusion, and received at least once in the emergency room of the Nancy Hospital during the period concerned. Inclusion in the control group for Nursing Home residents outside the Grand Nancy area without the Advanced Practice Nurse intervention.
Other: Observation
Observation

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
RATE OF REHOSPITALISATION OVER THE ENTIRE FOLLOW-UP PERIOD IN THE 2 GROUPS OF PATIENTS WITH AND WITHOUT ADVANCED PRACTICE NURSE INTERVENTION
Time Frame: through study completion, an average of 7 months
through study completion, an average of 7 months

Secondary Outcome Measures

Outcome Measure
Time Frame
PROPORTION OF AVOIDABLE VISITS FOR A REASON SIMILAR TO THE REASON FOR INITIAL HOSPITALISATION
Time Frame: through study completion, an average of 7 months
through study completion, an average of 7 months
PROPORTION OF PATIENTS DIRECTLY ADMITTED TO THE NANCY HOSPITAL GERIATRIC UNIT
Time Frame: through study completion, an average of 7 months
through study completion, an average of 7 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Central Hospital, Nancy, France

Collaborators

Mahmut GUNDESLI MD
Manon DUPRE, internship

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Anticipated)

May 1, 2023

Primary Completion (Anticipated)

June 1, 2023

Study Completion (Anticipated)

June 1, 2023

Study Registration Dates

First Submitted

November 14, 2022

First Submitted That Met QC Criteria

November 22, 2022

First Posted (Actual)

November 25, 2022

Study Record Updates

Last Update Posted (Actual)

November 25, 2022

Last Update Submitted That Met QC Criteria

November 22, 2022

Last Verified

November 1, 2022

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2022PI165

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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