Geriatric Nursing Commons^™

Standardized Education On Physician Orders For Life Sustaining Treatment (Polst) Conversations, Venessa Oteniya

Doctor of Nursing Practice Final Manuscripts

According to research literature, 15% of Medicare beneficiaries spend more than 7 days in the intensive care unit before they die. These Medicare beneficiaries receive aggressive, life-prolonging medical treatments that might not be in agreement with their wishes. Approximately 13% of SNF residents have improperly completed POLST forms that can result in intensive treatments that patients did not want. One barrier to the lack of POLST completion in SNFs is staff difficulty with understanding and explaining the form, a result of inadequate education.

In August 2020, the San Diego Coalition for Compassionate Care formed an education program to provide virtual …

Improving Identification Of Seniors At Risk Tool Adherence To Identify Emergency Department Readmissions In Older Adults, Joy Gao

Doctor of Nursing Practice Final Manuscripts

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. …

Efficacy Of Telehealth Modalities In Medication Adherence For Older Adults, Mitchell Adrian C. Siy

Doctor of Nursing Practice Final Manuscripts

About half of the geriatric population who take at least one medication find medication adherence challenging. Average adherence of an elderly patient taking one medication a day is about 80%. This adherence decreases to about 50% for patients taking medications four times a day. Nonadherence can lead to a myriad of preventable adverse effects that can reduce the quality of life and even result in death. In the United States, $100-300 billion could be saved in health care costs due to adverse effects of poor medication adherence. The purpose of this evidence-based project (EBP) is to improve medication adherence in …

"It's The Way You Sing It": Translating Music Therapy For Isolated Older Adults Affected By Covid-19 To The Television Screen, Eunice Wong

Expressive Therapies Capstone Theses

The current Covid-19 pandemic has increased the likelihood of loneliness and social isolation among older adults due to the restrictions on movement and visitations in care facilities. Loneliness and social isolation have consistently been identified as risk factors for poor mental and physical health in older people. Meanwhile, a growing number of older adults are utilizing technological resources to enhance their interpersonal relationships and overall quality of life. In the winter of 2020/2021, an innovative music therapy-informed television program was designed and produced for isolated older adults in need of mental and emotional support. This project, produced jointly by a …

How Various Exercise Modalities Impact Quality Of Life, Physical Activity, And Program Adherence In Patients With Copd, Hannah Brookshire, Sarah Barnes, Natalie Cagle, Nancy Starnes, Elia Schaefer

Symposium of Student Scholars

How Various Exercise Modalities Impact Quality of Life, Physical Activity, and Program Adherence in Patients with COPD

Background: Chronic obstructive pulmonary disease (COPD) is a group of diseases that causes breathing difficulty due to airway obstruction. Adherence to physical activity recommendations for those with COPD is often problematic and leads to worsening dyspnea and quality of life. Due to the prevalence of COPD, it is important to understand how different exercise modalities impact quality of life and adherence to physical activity.

Objective: The purpose of this systematic review was to determine if patients with COPD have a better quality of …

The Effect Of Alternative And Personalized Therapy In The Treatment Of Depression In Older Adults Living In Long-Term Care Facilities, Amber Davis, Olivia Gilbert, Kayla Kelley, Mitch Elliot, Deanna Hebert

Symposium of Student Scholars

Abstract

Title: The effect of alternative and personalized therapy in the treatment of depression in older adults living in long-term care facilities

Background: In older adults, depression can lead to changes in memory, physical pain, fatigue, sleep disturbances, and even suicidal ideations. Due to the shortage of healthcare workers in long-term care facilities, older adults have a difficult time receiving treatment. Therefore, alternative treatment methods and personalized therapy are becoming more important when treating patients in long-term care facilities.

Objectives: This systematic review set out to determine whether personalized therapy and alternative treatment methods may significantly reduce the symptoms of …

Understanding Older Adults Living In Medically Underserved Areas Perspectives Regarding Type 2 Diabetes Care Received, Christopher Rogers

Seton Hall University Dissertations and Theses (ETDs)

Older adults with type 2 diabetes living in medically underserved areas (MUAs) have unique health and social needs that must be taken into consideration when supporting their type 2 diabetes treatment and management care. Effective treatment and management of type 2 diabetes for older adults living in MUAs requires incorporating the preferences, desires, needs, values, and goals of the person at the center of the care into his/her care plan. Shifting care to be conducive to the treatment and management goals and plans co-created with older adults living in MUAs based on their individual physical, psychological, social, and spiritual preferences, …

Evidence-Based Recommendations For Assistive Technologies For Safety In Dementia Care, Lee A. Diener

Culminating Experience Projects

A Quality Improvement (QI) project in a Midwestern Continuing Care Residential Community (CCRC) was designed to examine the evidence-base of four assistive technology platforms marketed as safety platforms as means to improve outcomes for older adults residing in memory care environments. Using the Evidence-Based Design Model Socio-Technical Systems Theory, survey data and observational data collected from the organization were considered with respect to the evidence-base supporting each technology. Ten organizational priorities derived from collected data were used to develop an Evidence-Based Assistive Technology Fitness score for each of the AT platforms reviewed. This methodology provides a means to evaluate planning …

A Quality Improvement Initiative To Decrease Fall Risk In Community Dwelling Elderly, Michele Shearer

Doctor of Nursing Practice (DNP) Manuscripts

Falls are a health concern for the elderly and are the leading cause of fatal and non-fatal fall injuries in this population (Burns & Lee, 2016). Meijers, et al. (2012) found that one in three community dwelling elderly will experience at least one fall per year with an even higher rate in adults greater than 80 years old. Numbers of falls are expected to increase as this population ages. This increase in falls and their consequences will produce an enormous economic burden on the United States health care system (Burns & Lee, 2016). The purpose of this program was to …

Dnp Final Report: Reducing The Rate Of Falls With A Stuctured Fall Program, Elanda L. Douglas

DNP Final Reports

Background: Fall rates continue to be a significant problem in health care facilities despite all the research and tool kits created to prevent falls. Hospitals that have successfully reduced fall rates find it challenging to sustain a reduction in the fall rates. During hospitalizations, 3%-20% of patients fall, with 30%-50% resulting in injury (Joint Commission, [JC], 2015).

Internal Evidence: Despite Medical City Alliance (MCA) having an evidence-based fall program, the fall rate has not decreased. Falls are one of the quality measures identified at the division level that needs improvement.

PICOT: In adult patients in a progressive care unit (P), …

A Quality Improvement Report: Assessing The Geriatric Population For Anxiety Using The Gad-7, Lirio E. Lopez-Urias

Cohort IX

Working with geriatric patients, I have had a firsthand view of the effects of the COVID-19 pandemic on their well-being. While visiting my patients in their homes, I have become aware of several issues. These were highlighted in my practice review, during which I documented the diagnoses and interventions used in my practice with my geriatric patients in a 10-day reflective log. In particular, reports of anxiety drew my attention. In my practice, I have noticed that I assess anxiety by accepting self-reporting. Within the ten days covered in the reflective log, 15 out of 26 patients reported uncontrolled anxiety. …

Do Young Adults With Close Family Experiencing Alzheimer's Have Higher Depression Rates, Ali Sullivan

Chancellor’s Honors Program Projects

No abstract provided.

Improving Cognitive Function In Persons With Dementia Through Music Therapy, Jillian Natividad

Nursing | Senior Theses

People diagnosed with dementia experience cognitive alterations that cause overwhelming challenges and lead to distinctive life changes. Declining cognitive function noticeably experienced in dementia not only inflicts difficulty with achieving independent living but increases feelings of agitation and disturbs quality of life. Advanced medical care is widely available for managing mental conditions but may not always be effective in treating cognitive changes like memory loss and confusion. Because the stages of dementia vary from person to person, medical interventions are often patient centered to effectively focus on an individual’s specific needs. With non-pharmacological methods, flexibility in adjusting to an individual’s …

Understanding The Role Of Hospice Care: Reflections From A Service-Learning Project, Avery Mccutcheon

The Eleanor Mann School of Nursing Undergraduate Honors Theses

There is little known about the part end-of-life care plays in patient care. This paper examines the role of end-of-life care in the care of a dying patient and consists of findings from a service-learning project with Circle of Life hospice. To be able to effectively care for those in the end stages of life, healthcare professionals must turn away from the curative aspects of medicine, to treating symptoms and improving quality of whatever life remains for the patient. In order to normalize EOL Care and consequently make it more accessible, we must educate our healthcare practitioners regarding the benefits …

Letters Against Loneliness: The Effect Of A Pen Pal Program Uniting Older Adults And College Students On Perceived Loneliness, Allyson Miriani, Caroline Crawford

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Surveys within years and particularly the COVID-19 pandemic have revealed increasing rates of loneliness. More research is also emerging linking loneliness with a myriad of negative health outcomes as well as reduced quality of life. There is little research about effective interventions addressing loneliness. This paper reviews the available literature on the topic and proposes a pen pal program for college students and older adults developed based on available evidence.

The Changing Face In The Workplace: The Arrival Of The Millennial Generation, Sarah Clonch

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The entrance of the Millennial generation into the nursing workforce signifies a bright future for the nursing profession and the nursing workforce. This study began with a current review of available research that identified the Millennial generation and their views toward job satisfaction and work engagement, as compared with Baby Boomer and Generation X nurses.

PubMed, CINAHL Complete, and Google Scholar databases were employed to find 15 peer-reviewed articles for evaluation. The research findings suggest that Millennial nurses have lower rates of job satisfaction and work engagement, compared to nurses of older generations. Overall, the extracted data results were significant …

A Quality Improvement Project To Improve Communication And Reduce Hospital Readmissions, Mackenzie Thomas

DNP Scholarly Projects

Background: More than 25 million people are readmitted to the hospital within 30 days of nursing home admission. With most nursing home patients receiving Medicare, Medicaid, or other publicly funded services, readmissions significantly burden the healthcare system. Poor communication within nursing homes may contribute to poor health outcomes and unplanned hospital readmissions. Purpose: To reduce readmission rates at two skilled nursing facilities by improving staff communication through consistent use of the INTERACT STOP AND WATCH (SW) tool. Design: The quality improvement project reviewed all admissions, transfers, and readmissions occurring before and during the project to determine the impact of the …

Complementary Alternative Medicine: An Education Of Guided Self-Care In The Elderly Population For Management Of Chronic Conditions, Janice B. Gerber

Theses and Graduate Projects

The elderly population, specifically the residents in the Skilled Nursing Facility (SNF) or nursing homes, suffer from chronic conditions, many of which have a psychological and behavioral component. Conventional medicine treats the chronic conditions from one symptom to another through pharmacological interventions, which resulted in polypharmacy. Gathering evidenced-base practice of Complementary Alternative Medicine (CAM) will maximize opportunities for the elderly population to manage chronic conditions. The application of Parse’s Theory of Human Becoming (HBT) with self-guided education of CAM modalities in SNF explores the significant concepts of personal meaning, rhythmical patterns, and transcendence. Grounded on HBT, the self- guided education …

Compliance In Fall Prevention In Dementia Vs Non-Dementia Nursing Home Units, Garima Shrestha

Merge

The student nurse researcher performed a research study to determine if there was a difference in the compliance of fall prevention interventions between dementia and non-dementia nursing home units. The student nurse researcher hypothesized the dementia nursing home units would be more compliant with fall prevention interventions than the non-dementia nursing home units. In contrast, the null hypothesis stated there would be no statistically significant difference in the compliance of fall prevention interventions between the dementia and the non-dementia nursing home units. The Fall Prevention Intervention Checklist was used to assess environmental fall hazards in occupied resident rooms. Of the …

A Descriptive Study Of Health-Related Risks And Outcome Differences By Loneliness Status In A Sample Of Older Veterans, Rachael Beard

Dissertations

There is a need to understand the influences and outcomes related to loneliness in veterans living with complex illness. Patients require self-care to manage complications and exacerbations associated with complex illness. Deficits in self-care result in negative health outcomes and drive resource utilization upward. The identification of potential factors related to self-care is important. Loneliness may be one factor that influences patients’ ability and desire to care for themselves. Descriptive correlational design was used to evaluate loneliness both as a predictor and outcome in veterans admitted to the hospital for three complex respiratory illnesses (heart failure, chronic obstructive pulmonary disease, …