Geriatric Nursing Commons^™

Predictive Behavioral Cues Of Patient Violence In The Emergency Department, Jessica A. Roy

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Nurses are often subject to violence at the hands of their patients. The Emergency Department (ED) has become the area most vulnerable in the hospital setting, with contributing factors including the rise of polysubstance drug abuse, the increasing psychiatric population, and overall stressors related to the economy. The ED is the “gateway” to the availability of shelter, medications, and resources for many people that pass through every year. Accurate and timely identification of the most common and easily identifiable precursors of violence is essential in order to develop and implement effective de-escalation techniques that have the potential to reduce actual …

Gerontological Nursing, Kristine Williams

Kristine N. Williams

No abstract provided.

A Case Study Of Resistiveness To Care And Elderspeak, Jacqueline Cunningham, Kristine Williams

Kristine N. Williams

Resistiveness to care (RTC) by persons with dementia significantly adds to subjective and objective burden for caregivers and may be triggered by environmental factors, including communication. This case study evaluated behavioral responses of a nursing home resident with dementia to nursing staff use of elderspeak communication (infantilizing speech). Four videotaped staff-resident interactions that were previously recorded were coded for staff elderspeak communication and resident RTC. Total elderspeak scores (M = 29.5, SD = 25.74) and RTC scores (M = 8.75, SD = 13.79) were correlated r = 0.93, p = .03. This preliminary single-subject observational study suggests a …

Pain In Parkinson’S Disease: Characteristics And Responses In Ambulatory Care Patients, Lisette Bunting-Perry

Lisette K Bunting-Perry

Pain is often a disabling symptom in Parkinson’s disease (PD), and is currently underassessed, underdiagnosed, and undertreated in this population of primarily older adults. Guided by the Rugh Model of Psychological Components of Pain, an exploration of the characteristics of pain experienced by individuals with PD, and the relationships among the emotional, cognitive, perceptual, and behavioral aspects of pain was undertaken. A convenience sample of 125 patients with PD reporting average daily pain as 2 or greater on the Brief Pain Inventory-Short Form, were recruited for a cross-sectional descriptive survey from two large urban movement disorder centers. Multiple measures were …

Effectiveness Of A Pilot Gerontological Nursing Certification Preparation Support Program For Registered Nurses Working In Long Term Care, Gail B. Sprigler

Graduate Theses, Dissertations, and Capstones

Between 2000 and 2025 there will be a 30% increase in the prevalence of Alzheimer’s disease (AD) in Indiana (Alzheimer’s Association, 2010). Many individuals with AD and related dementia are cared for in long term care communities. Adequate knowledge and expertise of nurses caring for older adults, particularly those with dementia, is important for the delivery of quality care and the promotion of quality of life for residents living in long term care. This pilot project examined the benefit of a resource support program to encourage Gerontological Nursing certification for registered nurses in the long term care setting.

Impact Of Social Marketing On Nurse Practitioners' Acceptance Of Clinical Video Telehealth For Elderly Patients In Rural Mississippi, Teresa Lynn Langley

Doctoral Projects

Elderly patients 65 years and older who have chronic illness and disabilities living in rural Mississippi have increased difficulty in obtaining timely cost-effective healthcare services from nurse practitioners. The purpose of the capstone project was to utilize social marketing strategies for promoting nurse practitioners’ acceptance of clinical video telehealth (CVT) in improving healthcare access for rural elderly patients in Mississippi. Clinical video telehealth is an innovative way to provide healthcare services to populations in need by reducing barriers to healthcare, such as distances, time, and transportation, and financial resources. However, providing healthcare through the use of technology has not always …

Successful Aging In Hispanic Elders: A Narrative Inquiry, Julie Kay Carr

Boise State University Theses and Dissertations

Purpose: The purpose of this narrative study was to describe and provide an understanding of the unique cultural factors that are associated with successful aging in the elder Hispanic population.

Background: The number of aging Hispanic in Americans is on the rise. The Center for Disease Control recently released data showing the life expectancy for the Hispanic population is 80.6 years — a 2.5 year advantage over the non-Hispanic white population and 7.7 years over the non-Hispanic black population. With longer life spans resulting in an increased number of Hispanic older adults, we are presented with a difference that – …

Late-Life Body Mass Index And Dementia: An Integrative Literature Review, Sarah Slade, Patricia K. Ravert

Faculty Publications

Dementia and obesity are significant public health concerns. Alzheimer's disease affects 5.3 million adults, while 72.5 million adults are obese. Emerging evidence linking body mass index (BMI) and dementia suggest that, although a high BMI in midlife is associated with a greater risk for dementia, a high BMI in late life is considered protective and should not necessarily be considered a risk factor for dementia. Beginning in midlife, practitioners should trend patient BMI numbers. Major fluctuations during this time should be monitored and nutritional counseling and cognitive screenings offered to help patients maintain a healthy BMI and detect early cognitive …

Path Tortuosity In Everyday Movements Of Elderly Persons Increases Fall Prediction Beyond Knowledge Of Fall History, Medication Use, And Standardized Gait And Balance Assessments., William D. Kearns Phd, James L. Fozard Phd, Marion Becker Rn/Phd, Jan M. Jasiewicz Phd, Jeffrey D. Craighead Phd, Lori Holtsclaw Ba, Charles Dion Ma

William D. Kearns, PhD

Abstract Objectives: We hypothesized that variability in voluntary movement paths of assisted living facility (ALF) residents would be greater in the week preceding a fall compared with residents who did not fall. Design: Prospective, observational study using telesurveillance technology. Setting: Two ALFs. Participants: The sample consisted of 69 older ALF residents (53 female) aged 76.9 (SD=11.9 years). Measurement: Daytime movement in ALF common use areas was automatically tracked using a commercially available ultra-wideband radio real-time location sensor network with a spatial resolution of approximately 20 cm. Movement path variability (tortuosity) was gauged using fractal dimension (fractal D). A logistic regressionwas …

The Relationship Of Basic Conditioning Factors, Knowledge, Self-Care Agency, Self-Care Behavior, And Urinary Sodium Excretion Of Hypertensive Older Adults: Testing Orem’S Self-Care Theory, Pratsani Srikan

Doctoral Dissertations

Understanding the powerful factors of sodium reduction benefits older adults by leading to reduce many health risks, lower the health care cost and diminished economic and social burden. This study had two aims: 1) to explore to what degree four factors--selected basic conditioning factors, knowledge of sodium reduction, sodium reduction self-care agency, and sodium reduction self-care behavior predict urinary sodium excretion in hypertensive seniors, 2) to test whether these variables related to sodium reduction were congruent with Orem’s Self-Care Theory.

Based on this theory, internal and external conditioning factors were proposed as either positively or negatively influencing an individual’s knowledge …

Patient And Nurse Considerations In Home Health Routing With Remote Monitoring Devices, Jessica Spicer

Graduate Theses and Dissertations

We build on the current consistent vehicle routing problem literature by formulating a novel multi- objective mathematical model of the home health scheduling and routing problem that includes the option of assigning some patient visits to remote monitoring devices, with the objectives of mini- mizing total cost, achieving nurse consistency and creating balanced nurse workloads. A heuristic solution approach that approximates the efficient frontier of this multiobjective problem is pre- sented and validated, and the results of using this methodology to solve several realistic instances are included. We also analyze the assignment of patients to devices and present some managerial …

Surgical Delay For Hip Fracture Clients And The Use Of Clopidogrel: An Integrative Review, Phoebe Genevieve Waller

Senior Honors Theses

Abstract

Hip fractures in elderly patients have very high postoperative mortality rates and the number of hip fractures in the United States is expected to increase exponentially before 2030. Early surgery is essential to improve outcomes, but patients on clopidogrel (Plavix) have a high risk for increased bleeding if surgery is performed within the usual 72 hour window. This paper presents literature and research addressing the dangers of delaying surgery versus undergoing surgery before the effects of the clopidogrel are gone. Based on articles published after 2006, most researchers advocated earlier surgical intervention than previously recommended and emphasized an individualized …

Geriatric Trauma Patients In The Emergency Department: Length Of Stay, Intensity Of Care, And Post Ed Destination", Elanor Gates, Doris Warner, Meg Bourbonniere, Patricia Williams

Department of Nursing papers and presentations

Background & Purpose: Research on emergency department length of stay (EDLOS) suggests that increased LOS may result in worse patient outcomes and increased overall LOS. Additional research suggests that increased age may not only result in lower intensity of care for some patients but might also increase EDLOS. For geriatric trauma patients, intensity of care and EDLOS may be different from non-geriatric patients. Given the nature of geriatric traumatic injury, it is important to understand if improvements can be made in geriatric trauma services.

Study/Project Design: A retrospective descriptive study utilizing the hospital’s trauma registry data was completed, including patient …

Two Cultures Of Caring: A Comparative Study, Lisa Armstrong, Chistina Polito

Honors Theses and Capstones

There is much that the UK and the US could and should learn from each other to understand the quality of end-of-life care, through comparison of practice, analysis of care patterns and via original research (Higginson, 2005, p.170). Although comparisons between end-of-life care in the United Kingdom and United States have demonstrated similarities and disparities in many contexts, there is little evidence of research that directly compares nursing perspectives between the two Atlantic partners. This research explores nurse’s perceptions and experiences of caring for people within a hospice context and identifies themes of commonalities and disparities in theory and practice, …

Nursing Satisfaction In Caring For Elders, Sarah L. Vlachos

Honors Theses and Capstones

Despite the increasing number of Americans who are over 65 years of age, little research exists about the satisfaction of nurses who care for this population. This qualitative descriptive study investigated the factors that influence the satisfaction of such nurses, and yielded five main themes. Registered Nurses (RNs) reported providing high-quality care, developing relationships, and making a difference to be rewarding components of geriatric nursing. The nurses also discussed challenges, which included caring for elders with dementia and being unable to deliver the high-quality care they felt patients deserve. Several of these finding were consistent with existing studies that addressed …

An Exploration Of Knowledge Translation Amongst Homecare Providers, Family Caregivers, And Clients, L. Jansen

Electronic Thesis and Dissertation Repository

The aim of this two-phased investigation was to enhance understanding of urinary incontinence (UI) knowledge translation (KT) to inform how UI management knowledge might be translated within in-home nursing practice and family caregiving. Although UI can be managed conservatively, it is a principal reason for the breakdown of family-care and care recipient admission to long-term care. Research has afforded little insight into family caregivers’ experience of KT and the process of in-home KT for UI management.

The first study used a hermeneutic phenomenological approach to explore family caregivers’ experience of UI KT. Data were collected from in-depth interviews with a …

Increasing Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. States design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control. The incorporation of multiple, sometimes conflicting incentives into state reimbursement systems has resulted in enormously complex and demanding methodologies that inhibit consumer participation in state rating setting decisions. In turn, the lack of consumer involvement has the potential to result in the adoption of reimbursement systems that favor industry and government interests at the expense of issues important …

Hospice Nurse Perceptions Of Constipation And Attitudes Towards Abdominal Massage, Elizabeth Everette

Nursing Theses and Capstone Projects

Constipation is a prevalent symptom in the hospice population, negatively effecting quality of life for patients. Constipation is frequently overlooked, undiagnosed, and untreated by healthcare providers. The role of the hospice nurse is ideal for managing the symptom of constipation with traditional and alternative therapies. Literature review reveals very limited research on constipation and hospice patients, and alternative therapies for constipation. No research was found regarding nurse attitudes towards alternative therapies, such as abdominal massage for constipation. This research study tested the following hypothesis: Hospice nurses perceive constipation as significantly impacting the quality of life for the hospice patient, and …

Knowledge Of And Attitude Toward Pain Control Among Hospice Nurses In A Southeastern State In The Us, Brandy C. Leroy

Nursing Theses and Capstone Projects

The hospice philosophy is based on pain and symptom management, comfort measures, and enhancement of quality of life at end-of-life (EOL). Pain management at EOL requires advanced knowledge and understanding by the healthcare team caring for these patients. A primary concern for the nurse caring for a patient at EOL is to achieve adequate pain control, provide comfort measures and maximize the patient's quality of life. This descriptive correlation study examined the hospice RN's knowledge and attitude of pain control at end-of-life. Forty-nine nurses employed at a hospice facility in a Southeastern state in the US were surveyed. Findings of …

The Use Of Peppermint Oil To Reduce The Nausea Of The Palliative Care And Hospice Patient, Mary Seale

Nursing Theses and Capstone Projects

A descriptive study was initiated to investigate the use of peppermint oil to reduce the nausea of the palliative care and hospice patient. Two local palliative care and hospice programs were used as sites for the study. Patients eighteen and older complaining of nausea were invited to participate in the study. The study was conducted for one and a half months. A total of eight patients consented to participate in the study with a mean age of seventy one years. The Bieri Scale, a visual-numeric analog, was used as the measurement instrument for the patients to evaluate their nausea. Results …