Residents from residential aged care services (RACS) (i.e. nursing homes) many of whom are frail or disabled, are frequently transferred to ED for treatment of acute episodes of illness or injury. This review scoped the research related to the ways in which frailty or activities of daily living (ADL) measures are used for clinical purposes, either prior to the transfer of patients to ED or in ED themselves. A search for original studies up to June 2021 that included participants aged 65 years or over was conducted across four databases. Abstracts were first reviewed, leading to full text screening and article selection. Thirty-four studies were included in the scoping review. Most of the ADL and frailty assessments were conducted in residential aged care settings. In seven studies, ADL or frailty assessments in the aged care setting contributed to reduced transfer rates to ED. No results were found that associated the assessment of ADL or frailty with decisions related to treatment in the ED. A single ED study involved specialist emergency nursing in an ED as an intervention which included frailty assessment and led to decreased hospitalisation. This scoping review confirms an opportunity for further research into the ways frailty and ADL assessments are used for decision making in relation to the transfer of frail older people to ED, including how these assessments influence their treatment.

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评论文章：住院老年护理服务居民在急诊科转移中的日常生活活动和虚弱评估的作用：范围审查

来自住宅老年护理服务 (RACS)（即疗养院）的居民，其中许多体弱或残疾，经常被转移到急诊室治疗急性疾病或受伤事件。该综述将研究范围与将患者转移到 ED 之前或在 ED 本身中将虚弱或日常生活活动 (ADL) 措施用于临床目的的方式有关的研究。在四个数据库中搜索了截至 2021 年 6 月的原始研究，其中包括 65 岁或以上的参与者。首先审查摘要，然后进行全文筛选和文章选择。34 项研究被纳入范围审查。大多数 ADL 和虚弱评估是在住宅老年护理机构中进行的。在七项研究中，老年护理机构中的 ADL 或虚弱评估有助于降低向 ED 的转移率。没有发现将 ADL 或虚弱的评估与 ED 中与治疗相关的决定相关联的结果。一项单一的 ED 研究涉及 ED 中的专科急诊护理作为干预措施，其中包括虚弱评估并导致住院人数减少。该范围审查确认了进一步研究虚弱和 ADL 评估用于与将虚弱老年人转移到 ED 相关的决策的方式的机会，包括这些评估如何影响他们的治疗。一项单一的 ED 研究涉及 ED 中的专科急诊护理作为干预措施，其中包括虚弱评估并导致住院人数减少。该范围审查确认了进一步研究虚弱和 ADL 评估用于与将虚弱老年人转移到 ED 相关的决策的方式的机会，包括这些评估如何影响他们的治疗。一项单一的 ED 研究涉及 ED 中的专科急诊护理作为干预措施，其中包括虚弱评估并导致住院人数减少。该范围审查确认了进一步研究虚弱和 ADL 评估用于与将虚弱老年人转移到 ED 相关的决策的方式的机会，包括这些评估如何影响他们的治疗。