PDF(Pubmed)
Abstract：
UNASSIGNED: Nearly half of all persons living with dementia (PLwD) will visit the emergency department (ED) in any given year and ED visits by PLwD are associated with short-term adverse outcomes. Care partner engagement is critical in the care of PLwD, but little is known about their patterns of communication with ED clinicians.
UNASSIGNED: We performed a retrospective electronic health record (EHR) review of a random sampling of patients ≥ 65 years with a historical diagnosis code of dementia who visited an ED within a large regional health network between 1/2014 and 1/2022. ED notes within the EHRs were coded for documentation of care partner communication and presence of a care partner in the ED. Logistic regression was used to identify patient characteristics associated with the composite outcome of either care partner communication or care partner presence in the ED.
UNASSIGNED: A total of 460 patients were included. The median age was 83.0 years, 59.3% were female, 11.3% were Black, and 7.6% Hispanic. A care partner was documented in the ED for 22.4% of the visits and care partner communication documented for 43.9% of visits. 54.8% of patients had no documentation of care partner communication nor evidence of a care partner at the bedside. In multivariate logistic regression, increasing age (OR, (95% CI): 1.06 (1.04-1.09)), altered mental status (OR: 2.26 (1.01-5.05)), and weakness (OR: 3.38 (1.49-7.65)) significantly increased the probability of having care partner communication documented or a care partner at the bedside.
UNASSIGNED: More than half of PLwD in our sample did not have clinician documentation of communication with a care partner or a care partner in the ED. Further studies are needed to use these insights to improve communication with care partners of PLwD in the ED.
UNASSIGNED: We performed a retrospective electronic health record (EHR) review of a random sampling of patients ≥ 65 years with a historical diagnosis code of dementia who visited an ED within a large regional health network between 1/2014 and 1/2022. ED notes within the EHRs were coded for documentation of care partner communication and presence of a care partner in the ED. Logistic regression was used to identify patient characteristics associated with the composite outcome of either care partner communication or care partner presence in the ED.
UNASSIGNED: A total of 460 patients were included. The median age was 83.0 years, 59.3% were female, 11.3% were Black, and 7.6% Hispanic. A care partner was documented in the ED for 22.4% of the visits and care partner communication documented for 43.9% of visits. 54.8% of patients had no documentation of care partner communication nor evidence of a care partner at the bedside. In multivariate logistic regression, increasing age (OR, (95% CI): 1.06 (1.04-1.09)), altered mental status (OR: 2.26 (1.01-5.05)), and weakness (OR: 3.38 (1.49-7.65)) significantly increased the probability of having care partner communication documented or a care partner at the bedside.
UNASSIGNED: More than half of PLwD in our sample did not have clinician documentation of communication with a care partner or a care partner in the ED. Further studies are needed to use these insights to improve communication with care partners of PLwD in the ED.
摘要：
■在任何一年中，将近一半的痴呆症患者（PLwD）将访问急诊科（ED），而PLwD的ED访问与短期不良结果有关。护理伙伴参与在PLwD的护理中至关重要，但对他们与ED临床医生的沟通方式知之甚少。
■我们对2014年1月1日至2022年1月1日期间在大型区域卫生网络内就诊的年龄≥65岁、具有痴呆历史诊断代码的患者进行了回顾性电子健康记录(EHR)审查。EHR中的ED注释被编码为记录护理伙伴沟通和护理伙伴在ED中的存在。使用Logistic回归来确定与ED中护理伙伴沟通或护理伙伴存在的复合结局相关的患者特征。
■共纳入460例患者。中位年龄为83.0岁，59.3%是女性，11.3%是黑人，和7.6%的西班牙裔。在ED中记录了22.4％的就诊和43.9％的就诊记录了护理伙伴的沟通。54.8%的患者在床边没有护理伙伴沟通的记录，也没有护理伙伴的证据。在多变量逻辑回归中，年龄增加(或，（95%CI）：1.06（1.04-1.09）），精神状态改变（OR：2.26（1.01-5.05）），和虚弱（OR：3.38（1.49-7.65））显着增加了记录护理伴侣沟通或护理伴侣在床边的可能性。
我们样本中超过一半的PLwD没有与护理伙伴或ED中的护理伙伴进行沟通的临床医生文件。需要进一步的研究来使用这些见解来改善与ED中PLwD的护理伙伴的沟通。
■我们对2014年1月1日至2022年1月1日期间在大型区域卫生网络内就诊的年龄≥65岁、具有痴呆历史诊断代码的患者进行了回顾性电子健康记录(EHR)审查。EHR中的ED注释被编码为记录护理伙伴沟通和护理伙伴在ED中的存在。使用Logistic回归来确定与ED中护理伙伴沟通或护理伙伴存在的复合结局相关的患者特征。
■共纳入460例患者。中位年龄为83.0岁，59.3%是女性，11.3%是黑人，和7.6%的西班牙裔。在ED中记录了22.4％的就诊和43.9％的就诊记录了护理伙伴的沟通。54.8%的患者在床边没有护理伙伴沟通的记录，也没有护理伙伴的证据。在多变量逻辑回归中，年龄增加(或，（95%CI）：1.06（1.04-1.09）），精神状态改变（OR：2.26（1.01-5.05）），和虚弱（OR：3.38（1.49-7.65））显着增加了记录护理伴侣沟通或护理伴侣在床边的可能性。
我们样本中超过一半的PLwD没有与护理伙伴或ED中的护理伙伴进行沟通的临床医生文件。需要进一步的研究来使用这些见解来改善与ED中PLwD的护理伙伴的沟通。
