Date of Award

Spring 5-22-2021

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Karen Sue Hoyt, PhD, DNP, Post-MSN FNP, BSN


The purpose of this evidence-based project (EBP) is to improve the emergency department (E.D.) staff adherence in completing the Identifying Seniors at Risk (ISAR) screening tool. The specific aim is to improve electronic health record (EHR) data collection to enhance the identification of older adults that are frequent utilizers of the E.D. at a local community hospital in Southern California. Based upon the most recent National Hospital Ambulatory Medical Care Survey, patients ages 65 and older make up 32% of all E.D. admissions. These patients also represent 50% of the moderate to severely ill patients seen in the E.D. and make up a significant portion of acute care costs. The John Hopkins Evidenced Based practice model was used to conduct this EBP project. A 15-minute ISAR training module intervention was administered to each staff where the rationale for the ISAR tool was explained, and a case analysis quiz was then administered. Each staff member signed on and agreed to implement the new practice change regarding using the ISAR screening tool after they scored 80% on the correct usage of the ISAR screening tool. The data was analyzed using Excel and Intellectus Statistics software. Analysis between the pre-and post-intervention group revealed a 70% ISAR screening tool completion rate just short of the 80% goal, which was a significant improvement compared to the prior average of 30%. A Chi-square test verified this with a p=0.002. The findings from this EBP project will be utilized for a part 2 project to evaluate rates of identification of at-risk older adults arriving in the E.D.

Keywords: Geriatrics, Screening, Identifying Seniors at Risk tool (ISAR tool)

Creative Commons License

Creative Commons Attribution-Share Alike 4.0 License
This work is licensed under a Creative Commons Attribution-Share Alike 4.0 License.