Study protocol for IMAGE: implementing multidisciplinary assessments for geriatric patients in an emergency department observation unit, a hybrid effectiveness/implementation study using the Consolidated Framework for Implementation Research

Table 1 Study intervention: nurses will perform three geriatric screening assessments that direct the need for geriatrician, pharmacist, PT, and case manager evaluations

Step 1: Assessment		Step 2: If assessment is positive
Delirium triage screen [39]	98% sensitive for ruling out delirium. Time 10 s.	1. Physician administers CAM ICU. If positive, geriatrics consult ordered.
Delirium triage screen [39]	98% sensitive for ruling out delirium. Time 10 s.	3. Delirium precautions.
Four-Stage Balance Test [40]	Balance test that improves identification of older adults in the ED at risk for fall. Time 40 s	1. Fall precautions.
		2. Physical therapy consult.
		3. Case manager home safety evaluation
		4. Geriatrics consult.
Identifying Seniors at Risk [41]	6 questions on ability to care for self, memory, and medication. Time 90 s	1. Pharmacy consult if ≥ 5 medications.
		2. Case management consult if score ≥ 2.
		3. Geriatrics consult if score ≥ 2.

ISSN: 2662-2211