The time is now: Care of the older person in emergency, providing an education resource for emergency clinicians

Erin Cranitch1,2, Ellen Burkett1,2, Tamara Ward1, Laura Hines1

1Clinical Excellence Queensland, 2Metro South Health


Australian Emergency Departments (EDs) are experiencing significant growth in older person presentations.  Older persons, defined as people sixty-five years and older, are more likely to present with complex histories, co-morbidities and pharmacological considerations.  Older people present with symptoms and deceptively different vital signs from their younger counterparts, that may correlate with serious pathology.  Often referred to as ‘atypical or non-specific’ these symptoms also confound diagnosis and timely treatment in ED.  There is an opportunity to educate ED Nurses about these differences.  A survey of national health department sites and a grey literature search, was unable to identify any other departments with a specific older person  module within current training packages for ED nurses.


The project aim was to develop a statewide education module on the unique care needs of older persons in the ED with content able to be utilised across the spectrum of novice to highly experienced senior nurses. This education will be a catalyst for improvement of clinical outcomes for this growing cohort.


A working group of Emergency and Gerontologic nursing, medical and allied health experts was formed to inform the development of content and learning activities with geriatric specific domains.  The domains encompass care of the older person in Emergency, common older person presentations and pharmacologic and psychosocial considerations of the older person.  The content also addressed important adult medico-legal issues relevant to the older person cohort in ED.


The module is being rolled out across Queensland EDs to coincide with a statewide Frail Older Persons program. Quality indicators will be measured via self-report of clinician knowledge and satisfaction of care provided to this vulnerable cohort.  The module will be incorporated into the statewide Emergency Transition Support Program during its next review and is available for nation-wide health departments via the Queensland Frail Older Persons website.  The content is suitable to be leveraged for other groups including medical officers and allied health clinicians.


Erin is an Emergency (ED) Nurse Practitioner (NP) and a Clinical Lead at the Healthcare Improvement Unit, Clinical Excellence Queensland.  With more than eleven years in ED including adult and paediatric tertiary centres and a founding member of two ED outreach teams for Residential Care Facility patients Erin has a special interest in vulnerable groups across the age continuum.  Erin has completed the Masters of Nursing Science, NP, Masters of Emergency Nursing and the International Paediatric Postgraduate Certificate.  Erin has the International Diploma of Humanitarian Assistance (IDHA) and is member of the IDHA 37 Alumni, New York. Erin is a health delegate on the Australian Medical Assistance Team and a sessional academic at Queensland University of Technology.