Nurse-Administered Screening Tools for Detecting Elder Abuse in Emergency Departments: A Scoping Review.
Mohamed El Hussein, Dawson Sheehan
PMID 39618121WHAT IT FOUND
No nurse-administered screening tool is the gold standard for detecting elder abuse in emergency departments.
The ED Senior AID tool showed the strongest validation data, but most tools rely on subjective judgement, lack reliability testing, or were not designed specifically for nurses.
Key findings
01The scoping review identified six unique screening tools intended for or adaptable to emergency department nurses, but found no gold standard for elder abuse detection.
02The ED Senior AID tool demonstrated a sensitivity of 94.1% and specificity of 84.3% in a multicenter validation of 916 patients, though confidence intervals were wide.
03Most identified tools rely on nurse clinical judgement rather than a standardized score, which creates risk for bias and inconsistency in detection.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only ten studies met inclusion criteria, indicating a significant gap in current research. The review included literature from the past 25 years, which may mix outdated screening practices with modern ones. Nine of the ten studies were conducted in the USA, limiting generalizability to other healthcare systems. Only English-language articles were included, potentially missing culturally specific abuse presentations. No quality appraisal of the included studies was performed, as is typical for scoping reviews, so the methodological strength of the evidence is unverified. Many tools had wide confidence intervals around their sensitivity and specificity, suggesting uncertainty in their accuracy.
Declared interests
No specific conflicts of interest or funding sources are detailed in the provided text.
The easy way to misread this
Do not assume the ED Senior AID tool or any other identified instrument is a definitive diagnostic test. The review highlights that most tools rely on subjective nurse judgement rather than objective scores, and validation data is limited, often with wide confidence intervals, meaning a negative screen does not rule out abuse.