Abstract

Wiedenbach's Theory of Nursing as the helping art was the framework for this quasi-experimental study. This study sought to determine the effects of a follow-up encounter by a Geriatric Nurse Clinician on return visits to the emergency department by elderly clients. A nonprobability quota sampling consisted of elders, 65 to 92 years of age with chronic health problems, who utilized the emergency department of a 474-bed urban hospital. Thirty subjects were randomly assigned to three equal groups: Groups A and B received either a telephone call or a home visit, while Group C received no follow-up encounter. Demographic data were collected from medical records of subjects in all three groups. A researcher-developed 8-item questionnaire was used to assess needs and intervention on subjects in Groups A and B. Hospital and emergency department admission logs were monitored for return visits of all subjects 7 days post-discharge from the emergency department. Chi-square statistics were used to analyze data. The researcher hypothesized that the return rate of elderly clients to the emergency department would positively correlate to follow-up encounters by a Geriatric Nurse Clinician. Since X^(3, N = 30) = .58, p < .05, no statistically significant relationship in the rate of return visits and follow-up encounters among three groups were noted. However, additional findings revealed that the elders had a preference for the emergency room physician, and there was a lack of comprehensive histories and discharge planning for elders who utilized the emergency department. These conclusions indicate that the GNC may be a valuable asset in the emergency department to act as advocator primary health care provider, consultant for referrals, and researcher to improve the quality of health care for the elder. Recommendations include replication of the study with a larger sample using a time series design and implementation of a study which focuses on the significant others role to further validate Wiedenbach's (1964) theory.

Degree

Master of Science in Nursing (MSN)

Department

Graduate Nursing

Degree Date

8-1-1991

Publication Number

27924604

First Advisor

Dr. Mary Patricia Curtis

Second Advisor

B. J. Landis

Third Advisor

Peggi Seaman

Document Type

Thesis

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