Geriatric Nursing Commons^™

Keeping The Older Adult Steady With Steadi; A Fall Reduction Program, Payton Lawrence, Emily Hargrove, Rachel Collins, Aliya Leslie, Brittany Stricklin

Research Horizons Day Posters

No abstract provided.

An Actigraphy-Based Validation Study Of The Sleep Disorder Inventory In The Nursing Home, Gunnhild J. Hjetland, Inger Hilde Nordhus, Ståle Pallesen, Jeffrey Cummings, Rochelle E. Tractenberg, Eirunn Thun, Eirin Kolberg, Elisabeth Flo

School of Medicine Faculty Publications

Background: Disrupted sleep is common among nursing home patients with dementia and is associated with increased agitation, depression, and cognitive impairment. Detecting and treating sleep problems in this population are therefore of great importance, albeit challenging. Systematic observation and objective recordings of sleep are time-consuming and resource intensive and self-report is often unreliable. Commonly used proxy-rated scales contain few sleep items, which affects the reliability of the raters' reports. The present study aimed to adapt the proxy-rated Sleep Disorder Inventory (SDI) to a nursing home context and validate it against actigraphy. Methods: Cross-sectional study of 69 nursing home patients, 68% …

Ethical Considerations When Conducting Research With Older Adults, Karen Arrant

Journal of Interprofessional Practice and Collaboration

The ethical issue exists between the researcher’s passion for the study focus and the human rights of the participant. This manuscript provides a case study, an actual illustration, but names were changed to protect anonymity. Objectives include examining the researcher’s perspective and personal beliefs, identifying the process to recruit participants, the ethical manner to disseminate information, and identifying ethical principles during the study process.It is mandatory that minute attention is given to the details of caring for the safety and welfare of study participants.

End-Of-Life Care And The Use Of An Integrated Care Pathway, Marianne Brattgjerd, Rose Mari Olsen, Inger Jorun Danielsen

The Qualitative Report

Liverpool Care Pathway is an integrated care pathway (ICP) designed to ensure the provision of high-quality end-of-life care. However, the ICP has come under substantial criticism, suggesting that its use is related to poor care. This study explores nurses’ use of the ICP to dying patients in Norwegian nursing homes. We conducted a qualitative study using an abductive, mystery-focused method to analyze the experiences of 12 registered nurses. Our findings show that the nurses experienced the ICP as a very useful tool in end-of-life care, although they were actually working independently of the ICP in the provision of ongoing bedside …

Creating Restful Environments: Applying Evidenced-Based Interventions To Increase The Patients Perceptions Of Room Quietness At Night, Timothy Marks

West Chester University Doctoral Projects

Florence Nightingale first described the detrimental effects of noise on patients as an element nurses could control. Hospitalized patients who sleep in the hospital are at risk for poor periods of rest from unwanted noise in the care environment. This Doctor of Nursing Practice Project will assess interventions aimed at increasing the patient’s perception of quietness around the care environment at night for a pilot population. Swanson’s Theory of Caring will be utilized as a framework for the project. Outcomes of nursing interventions were reviewed for the improved patient perception of the care environment at night and resultant health outcomes. …

Screening For Palliative Care Services In An Assisted Living Facility, Maria Delia Crosby

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Palliative care services remain under-utilized, even as evidence suggests that early palliative care leads to positive health outcomes, reduced ED visits, and substantial cost savings. Barriers include a lack of knowledge of palliative care services in the community, and under-utilization of validated assessment tools, including a symptom checklist. Aims of this project: 1. To determine whether the integration of validated community-based palliative care screening tool in an assisted living setting will identify older adults with unmet palliative care needs. 2. To determine if tool implementation could lead to a referral for palliative care consultation.

Methods: A screening tool developed …

Evidence Based Treatment For Excessive Alcohol Consumption And Concurrent Hypertension, Kimberly Ann Ward

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose. Excessive alcohol consumption is a preventable risk factor for hypertension, heart disease, and stroke. Though alcohol-related deaths number 88,000 annually in the U.S., alcohol use has the lowest treatment rate of behavioral health disorders at 10%. Excessive alcohol consumption may compromise treatment of hypertension by primary care providers (PCP). This project aims to increase awareness of the hypertension and excessive alcohol use connection and promote screening of alcohol consumption.

Methods A protocol for improving alcohol screening and concurrent hypertension management was developed including: in-person educational presentations; patient education materials; and the use of motivational interviewing. Practice change was assessed …

Age And Functional Outcomes Post-Neurologic Insult In Patients Attending Inpatient Rehabilitation, Jonathan Bowman Spt, Elena Crooks Pt, Dpt, Phd, Doug Weeks Phd, Kimberly Honn Phd

2020 Symposium Posters

Introduction

Neurologic insults such as strokes and traumatic brain injuries (TBI) affect over 1 million Americans every year. The lack of current knowledge informing accurate prognoses causes victims and their loved ones distress, and is a focus of much research. The purpose of this study was to determine whether patient age at time of insult could predict change in functional outcomes during inpatient rehabilitation.

Methods

Subjects were patients of an inpatient rehabilitation facility (IRF) post-stroke or TBI. The Functional Independence Measure (FIM) assessed functional independence and cognitive status at admission and discharge from the IRF. The Montebello Rehabilitation Factor Score …

Increasing Health Literacy Through Noteaid Translational Tool In Nursing, Liz Catherine S. Cory

Doctor of Nursing Practice (DNP) Projects

Background: Many adults in the United States lack health literacy necessary to understand patient education materials given to them, such as discharge summary. Re-hospitalization rates are higher due to poor transition of care planning. Older adults may only be provided with written instruction for their complex chronic conditions with multiple changes in medical or treatment plan, or uncommon surgical procedures. Nurses are instrumental in bridging the gap, as they often educate, advocate, and use health technology.

Purpose: To educate nurses on the availability of NoteAid as a natural language translation system that can help increase their comprehension of electronic health …

In Beers We Trust: Using Deprescribing Tools To Reduce Inappropriate Polypharmacy In Adults Age ≥ 65, Angelica Ferrazzi

Doctor of Nursing Practice (DNP) Projects

Background: Adverse drug events (ADEs) are a significant cause of morbidity and mortality in older adults (age ≥ 65). Polypharmacy and potentially inappropriate medications (PIMs) are especially prevalent in this population and are a notable contributing risk factor for ADEs. Research demonstrates that comprehensive medication reconciliation that includes evaluation of both the risks and benefits of medications, in conjunction with deprescribing practices, can reduce PIMs; therefore, reducing ADEs.

Purpose: The aim of this quality improvement project was to empower clinicians to deprescribe current medications that are inappropriate, as well as reduce the rate of newly prescribed PIMs among patients age …

Engaging Patients With Dementia In The Acute Care Setting: A Quality Improvement Initiative For Staff, Andrea Lee

DNP Scholarly Projects

Caring for dementia patients in the acute care setting can be challenging. Staff is trained to manage the acute illness and the symptoms of dementia can impact that care. Training for the care and management of the patient with dementia is not routinely provided for the acute care setting. According to the Alzheimer’s Association (2018), 5.7 million people are living with Alzheimer’s Dementia with the numbers projected to continue to rise. Training in the management of symptoms can alleviate stress and complications for not only the patient but staff members as well. The goal of this project is to educate …

A Modified Screening Tool To Evaluate Risk Of Unanticipated Return Visits To The Emergency Department In The Geriatric Population, Tabitha Riley

DNP Projects

Purpose: To compare the Modified Screening Tool for Identifying at Risk Seniors (mSTIRS) against the Triage Risk Screening Tool (TRST) and the Identification of Seniors at Risk (ISAR) for predictive value and assess the relationship between presenting complaint with unanticipated return visit (URV) occurrence in geriatric patients.

Design: A prospective, observational study conducted at a large academic medical center. Descriptive statistics and psychometric analyses were used to analyze the association between demographics, clinical data, and to evaluate the modified screening tool.

Methods: 38 geriatric participants in the Emergency Department (ED) were enrolled and 21 completed the study. The screening tools …

Device Related Concerns Pertaining To Primary Caregivers Of Lvad Patients, Nicole Smith, Carissa Smith

DNP Projects

Abstract

PURPOSE: The purpose of this project was to focus on caregiver education with an emphasis on caregiver concerns regarding the LVAD; additionally, evaluating the efficacy of an educational video acknowledging those device-related concerns identified by caregivers. The goal of this project is to improve caregiver knowledge and decrease the rate of device related concerns among the primary caregivers.

METHODS: This project is a single center cross-sectional, pre-post-test implementation design to determine the efficacy of device related concerns education on primary caregivers’ knowledge and concerns. A 16-point device related concerns scale was designed to appraise primary caregiver concerns. The scale …

Nyc Is A Hotspot For Bedsores Among The Elderly And Immobile, Kara J. Brown

Capstones

New York City is a hotspot for bedsores in nursing homes, according to data provided by the federal government. The Big Apple is home to nine of the 10 nursing homes in the state with the highest rates of long-stay, high-risk patients suffering from bedsores. Nationwide, those 10 nursing homes are among the worst in the nation—the top 2%—for their high bedsore rates, the data shows. Residents considered high risk are, according to Medicare, those who are impaired in bed mobility or transfer, who are comatose, or who suffer from malnutrition.

More than one out of every four residents at …

Improving Identification Of Ssi In Snf, Jennifer Teng Yuan Yu

Master's Projects and Capstones

Educational deficit in basic wound assessment can lead to failure to recognize early signs of infection or wound deterioration. Despite many challenges towards wound care, there are potential opportunities to reduce patient injury and clinical outcomes through continuing education. The purpose of this paper is to review literature on current wound care knowledge in nurses and assess existing wound care knowledge in nurses at a skilled nursing facility. A 10-question pre-test wound assessment quiz based on the Bates-Jensen Wound Assessment Tool (BWAT) selected by the Wound Care Coordinator (WCC)/Wound Care Specialist (WCS) was given to 22 nurses: 5 Registered Nurses …

A Nurse Practitioner-Led Group Advance Care Planning Program In An Independent And Assisted Living Community, Alexander Bustos

DNP Qualifying Manuscripts

It has been well documented that the majority of people want to spend their last days in the comfort of their own homes, free of pain, and off any dependent machine. , However, the majority of people have not documented these wishes or talked with their family or provider about end of life care (Hamel, Wu, & Brodie, 2017). The Patient Self Determination Act (PSDA), which took effect on December 1, 1991, was enacted to raise awareness and promote discussions between patients and providers about end of life (EOL) healthcare decisions. The primary care nurse practitioner is in a prime …

Implementing A Cognitive Impairment Care Planning Toolkit To Enhance Dementia Care: A Quality Improvement Project, Raquel Garcia-Priestly

Doctor of Nursing Practice

Background: Alzheimer’s is the most expensive disease in the United States with costs reaching $277 billion a year and affecting 5.7 million Americans. By 2050, 14 million Americans will have Alzheimer’s disease and related dementias (ADRD). This burdensome disease not only affects the individual, but also those who are responsible for their care, making it extremely complex to manage. Purpose: To systematically integrate the Alzheimer’s Association’s Cognitive Impairment Care Planning Toolkit in an outpatient mental health clinic to enhance care by effectively addressing the needs of patients with ADRD and of their caregivers. Objectives: Increase the number of patients with …

Chronic Constipation Among Community-Dwelling Older People In The East Coast Region Of Peninsular Malaysia, Patimah Abdul Wahab, Azidah Abdul Kadir, Yeong Yeh Lee, Siti Hawa Ali, Dariah Mohd Yusoff

Makara Journal of Health Research

Background: This study aimed to investigate the prevalence, symptoms, and factors associated with chronic constipation among community-dwelling older people in the East Coast region of Peninsular Malaysia. Methods: A cross-sectional study was conducted in four selected health clinics using stratified cluster sampling. A face-to-face interview was carried out among the elderly outpatients, in order to complete a structured questionnaire. Results: A total of 400 participants were included in the study. The mean age was 68.7 ± 6.4 years, and 55% of the cohort were women. The prevalence of chronic constipation was 32.3% among the sample population. The …

You Learn When You Teach: A Narrative Pedagogy For Faculty And Doctoral-Level Student Teaching Assistants, Lauren A. Acosta Ms, Rn, Phd Candidate, Penny M. Overgaard Phd, Msn, Rn, Natalie M. Pool Phd, Rn, Bsn, Susan M. Renz Phd, Dnp, Rn, Gnp-Bc, Janice D. Crist Phd, Rn, Fwan, Faan

The Qualitative Report

The purpose of this study was to understand the meaning of online co-teaching for PhD faculty and teaching assistants (TAs). Narrative pedagogy underpinned the inquiry, which was designed to advance the discourse on mentorship of PhD future faculty. A faculty member and TA authors kept concurrent weekly journals or after-the-fact written reflections. The authors analyzed data as a team using a five-phase interpretive phenomenological analysis process to interpret the meaning of co-teaching for faculty and TAs. Lines of inquiry, central concerns, exemplars, shared meanings, and paradigm cases supported the overall interpretation, “You Learn When You Teach.” Co-mentorship should be a …

The Nurse As The Facilitator Of Patients' Narration: An Educational Intervention, Petra Stockman

Electronic Theses and Dissertations

More than one million resident patients live and receive care at certified long-term facilities in the United States, many of whom suffer from depressive symptoms and anxiety. Prior research recommended storytelling as a vibrant nursing intervention to assist long-term care residents in overcoming challenges and emotional pain. However, nurses frequently lack knowledge of successful planning and implementation of narrative reminiscence. This scholarly project was designed to increase nursing competence and confidence in using storytelling as a clinical tool to improve mental health in long-term care, using a quasi-experimental, nonrandomized pretest, intervention, and posttest study design. A convenience sample of 10 …