Negative health outcomes and adverse events in older people attending emergency departments: A systematic review

For the last 25 years, there have been mounting concerns that ED's fast-paced environment is not suitable to meet the care needs of the ever-increasing older population. This paper reviews the research-based literature regarding negative health outcomes and adverse events experienced by older patients in the emergency department (ED). Electronic databases were searched for relevant English references. Search terms included: 'older person'; 'emergency department'; 'health outcome'; and 'adverse event'. The literature outlines a number of negative health outcomes and adverse events in older ED patients, including outcomes related to changes in health status, administrative outcomes suggesting negative health outcomes, and adverse events potentially associated with suboptimal ED practice. Further research is needed on the extent to which these apparent outcomes and events are avoidable. There are potential gains to be made in quality of geriatric emergency care by establishing evidence-based care that attends to the identified adverse events to achieve desirable health outcomes in this vulnerable ED population. (C) 2011 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.