Interventions

The results of the APOP screening
When a nurse performs the APOP screening, he/she directly fills in the patient's answers in the electronic patient file. As soon as the answers to all nine questions have been filled in, a result will appear on the nurse's screen. The result is whether or not the older patient has a higher chance of undesirable outcomes, compared to other ED patients, or whether there are memory disorders present.

Follow-up steps
If the patient has a higher chance of undesirable outcomes, caregivers can take this into account in their care for the patient. For example, they may pay extra attention to treating the patient on a bed instead of a gurney, and to the presence of a relative or informal caregiver of the patient. Doctors can take the high risk into consideration of possible examinations and treatments and discuss this with the patient.

Patients who have an increased risk of undesirable outcomes or cognitive disorders, according to the screening, but who return home after their ED visit, receive a phone call the next day by a nurse from the hospital. During this telephone conversation, the patient is asked whether he/she has any further questions regarding the visit to the ED, whether the given instructions are clear and whether the patient managed, for example, to obtain the new medication. The result of the screener is also automatically mentioned in the letter to the general practitioner.

For patients with an increased risk of undesirable outcomes who are immediately admitted to the hospital after their ED visit, it is important that this result of the APOP screening is transferred to the care providers who take over the care for the patient, so that they too take this into account. Nurses from the ED orally transfer the results to the nurses from the ward where the patient will be admitted. In addition, the Geriatric Consultation Team is called in by means of an automatic order, so that the patient is geriatrically assessed and treated further during hospitalization.