Adults age 65 and older make up at least 15% of emergency department visits, and they have longer lengths of emergency department stay, as well as poorer post-discharge outcomes, than the general population. At the same time, most nursing baccalaureate programs do not require coursework in geriatric care. Does this imply a gap between training and practice, or are emergency nurses equipped with the knowledge to work with older adults? The Journal of Emergency Nursing published an article that surveyed nurses at one large California hospital on geriatric knowledge and self-perception of nurse ability to work with older adults, which suggests that there may in fact be a knowledge gap.
The researchers administered and scored a questionnaire to nurses recruited at biweekly department meetings. Overall knowledge scores appeared low (mean score of 8.53 correct items out of a possible 15). Items ranged from questions about the proportion of the older adult population in the U.S. to items about symptoms in older adults. The highest score was 12 out of 15, which only one nurse attained. Scores of self-assessment were much higher with, for example, all respondents assessing themselves as “good” or “very good” at pain assessment. No information about item or scale statistical analysis was provided or comparison scores in other nursing samples —for example, nurses who had completed geriatric training.
The authors acknowledge that the specific findings are of limited generalizability, as it was conducted with a convenience sample at only one hospital. Further, there is no information on to what extent the nurses needed to be able to recall the questionnaire information to complete their duties. The topic that seemed most likely to lead to problems was in the end-of-life decision-making information, in which 74.2% of participants assessed themselves as “good” or “very good,” though none answered correctly an item about advanced directives and do-not-resuscitate (DNR) orders.
While it may not be appropriate to generalize too much based on this particular study, it points to important directions for future research and suggests the possibility that geriatric training in nursing programs may need to be emphasized in the coming years.
Roethler C, Adelman T, and Parsons V (2011). Assessing Emergency Nurses’ Geriatric Knowledge and Perceptions of their Geriatric Care. Journal of Emergency Nursing 37(2):132-137.