First Advisor

Mary Jo Coast

Second Advisor

Cullen, Patricia L.


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access


Executive Summary

Elder Abuse Screening and Identification for Emergency Department Nurses

The Elder Abuse Screening and Identification for Emergency Department Nurses was an educational intervention. The education and training module was intended to improve the, skills and attitudes of emergency department nurses. The goal was to improve future screening and identification of elder patients presenting to the department for a healthcare encounter who may be victims of elder abuse.


The problem being addressed is a clinical practice issue that has multi-faceted contributing factors. Clinical practitioners receive little to no education and training on the topic of elder abuse, with exception of the fact that as licensed professionals mandated reporting is a known requirement. A knowledge deficit of emergency room nurses’ knowledge on elder abuse identification, screening, reporting and referral had been identified as an area for advancing education. Elder abuse is identified in one out of fourteen cases annually. The nursing and clinical literature is severely lacking in information of the clinical manifestations of elder abuse that can clearly be differentiated from age related changes and co-morbidities. The underreporting of elder abuse cases identified in healthcare settings, can be improved with by advancing knowledge, skills and attitudes of healthcare professionals. Emergency department nurses are key to improving identification and improved care and discharge planning as they are first responders, first line triage and are instrumental to establishing the care plan and process for patients presenting for a care encounter.


The purpose of this evidence-based practice project was to improve the clinical identification by emergency department nurses in elder abuse identification by increasing the knowledge, skills and attitudes through the completion of an educational program authored by this forensic nurse specialist, DNP candidate. This project was a quality improvement initiative.


The goal was to design an educational intervention that focused and emphasized the clinical manifestations of elder abuse to improve the care of seniors presenting to the emergency department. The construct of the curriculum presented in the intervention addressed the three themes critical to understanding the scope, physiologic manifestations and the procedural aspects of care for a victim of elder abuse. increasing the knowledge and skill of the nurses in the identification and screening for elder abuse that may present as a symptom of a medical diagnosis, a co-morbid condition or as symptoms commonly associated with the aging process.


The objectives of this project included: 1) Identify the demographics and descriptive profile of the emergency department nurses participating in the study. 2) Identify the emergency department nurses’ knowledge on clinical identification of elder abuse and associated response, referral, reporting and documentation and 3) Evaluate the effectiveness of the elder abuse educational module used in the project.


Identifying the change in knowledge of emergency department nurses on the topic of clinical identification of elder abuse prior to and immediately following completion of an educational intervention was planned. The content development and delivery of the education was disseminated via the on-line learning technology platform used by the hospital where the intervention took place. The project consisted of collecting demographic (descriptive of the project participants), followed by a pre-test on knowledge of elder abuse. The one-hour educational program to emergency department nurses aimed at increasing their knowledge on clinical identification of elder abuse was given and followed by a post-test survey. The effectiveness of the educational intervention was measured by using a pre-and post-test survey score difference analysis.

Outcomes and Results

The objectives of the project were met. Objective one achieved a descriptive profile of the nurses that participated in the intervention. Objective two and three were met and showed at the pretest that the knowledge level to be below the benchmark of 80% or 12 correct responses. The aggregate mean score of the pretest (M= 9.11, SD= 2.21) were below the 80% benchmark. The post- test aggregate mean scores met and slightly exceeded the benchmark (M= 12.53, SD 1.59). The mean scores on the post-test showed improved knowledge of the content as the result of the intervention. A statistically significant improvement in mean knowledge scores was noted in the post-intervention assessment, suggesting that the educational intervention was successful in increasing nurses’ knowledge on the topic.

Date of Award

Summer 2017

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

Rights Statement

All content in this Collection is owned by and subject to the exclusive control of Regis University and the authors of the materials. It is available only for research purposes and may not be used in violation of copyright laws or for unlawful purposes. The materials may not be downloaded in whole or in part without permission of the copyright holder or as otherwise authorized in the “fair use” standards of the U.S. copyright laws and regulations.