Digital Commons Network^™

An Assessment Of Potentially Inappropriate Medications Among The Elderly And The Effect Of An Educational Intervention On Provider Knowledge Of These Medications, Amanda Brown

DNP Projects

Objectives: The aims of this study were to assess potentially inappropriate medications (PIMs) or Beers medications among outpatient older adults within one Midwestern healthcare system, to determine rates of patient education on Beers medications, and to pilot an educational intervention for providers.

Methods: This study involved two parts. For part 1 of the study, a randomized retrospective chart review of 493 older adult patients seen in 2017 from four practices was conducted to assess Beers medication prescriptions and rates of patient education. Following the chart review, for part 2 of the study, an educational intervention was delivered to two providers …

Barriers To Promoting Mobility In Hospitalized Older Adults, Gordana Dermody, Christine R. Kovach

Research outputs 2014 to 2021

Hospitalized older adults who do not receive sufficient mobility are more likely to sustain negative health outcomes, including higher rates of mortality and institutionalization. Accordingly, the purpose of the current secondary data analysis was to examine the nurse-promoted mobility of hospitalized older adults and the association between nurses’ barriers and nurse-promoted mobility. In addition, the relationship among patient severity of illness, proxy levels for function, and nurse-promoted mobility was examined. The final study sample included 61 nurses working in medical units caring for a total of 77 older adults. Findings suggest nurse knowledge gaps and attitude barriers could potentially influence …

The Effectiveness Of Nurse-Driven Early Mobility Protocol, Viktoriya Fridman

Seton Hall University DNP Final Projects

Purpose: The purpose of this quality initiative is to introduce the nurse driven evidence-based practice change related to patient mobility in the hospital setting with the aim to improve nurse knowledge, attitude, and behavior on a medical-surgical unit.

Significance of Project: The proposed DNP quality project is devised from the American Academy of Nursing (AAN) Choosing Wisely campaign unique to the elements of “don’t let older adults lay in bed or only get up to a chair during their hospital stay” to achieve a practice change. A significant aspect of patient care in a hospital setting is patient …

Individualized Glycemic Targets For The Elderly Residing In Long Term Care Facilities, Abegail Hubberd

Doctor of Nursing Practice

Of people age 65 and older residing in a long-term care facility, 1 in 4 has Type 2 diabetes (Smide & Nygren, 2013). Care and management of this population is a challenge for nurses and other providers. Results of a needs assessment in a local long-term care facility identified deficiencies in the provision of evidence-based Type 2 diabetes care for this target population. American Diabetes Association Guidelines (2017) recommend application of individualized HbA1c targets for the elderly residing in long-term care facilities, especially for those with compromises in clinical and functional status. This two prong quality improvement project strove to …

An Exploration Of Dementia Friendly Communities From The Perspective Of Persons Living With Dementia, Catherine Hebert

Electronic Theses and Dissertations

The growing global prevalence of dementia coupled with a shift in public perception from a hopeless disease to the possibility of living well with dementia has led to the formation of dementia friendly communities (DFC). DFCs are a new phenomenon in the United States, with a gap in knowledge on input from people living with dementia (PLWD). This study investigated DFCs from the perspective of PLWD in Western North Carolina, with the following research questions:

1. How are interactions and relationships experienced by persons living with dementia in the community?
2. How is community engagement experienced by PLWD?
3. To what extent and …

Predictors Of Cognitive Function Among Cognitively Impaired Older African Americans Living In Congregate Residential Settings, Zyra Daffodil Apugan

Dissertations

The purpose of this secondary data analysis was to identify potential psychosocial predictors of cognition, including social support, depression, and functional activity, among older African Americans, ≥ 65 years, with a diagnosis of Alzheimer’s disease and living in congregate residential settings. Guided by the main effect model of social support, this study used existing data from the National Alzheimer’s Coordinating Center Uniform Data Set, an NIH-funded multicenter study. Results showed that on average, the participants (n=56) were 81.7 years of age with 13.8 years of education. All, but six, were married. Bivariate Pearson correlations indicate a moderately strong negative relationship …

Grace Peterson Research Colloquium, Emma Pfeiffer

Grace Peterson Nursing Research Colloquium

Mental illness is commonly under-diagnosed, misdiagnosed, or untreated, particularly in the elderly population. An expected population increase for those 65 years and older, increased in health care expenses coupled with the moral and ethical obligation of health care providers to promote quality of life at all ages makes investigation to alternative treatments in this population is worth investigating. The purpose of this literature review is to synthesize existing studies to clarify the following questions: What are the effects of pet therapy on those experiencing signs and symptoms of depression and anxiety? Why is pet therapy still lagging in validated studies, …

“I Feel Like I’M Drawing Strength From It”: Lived Experiences Of Filipino Elderly Participating In Craft-Making, Sharon B. Cajayon, Romeo Luis A. Macabasag, Norilyn Limchanco, Vanessa O. Umali, Ellayza N. Blas, Michelle S. Angulo, Cristine Joy A. Breguera, Nikka Angela A. De Guzman, Sheila N. Malapi, Emmalyn E. Quibote

The Qualitative Report

In this phenomenological study, we offer an insightful understanding of the lived experiences of seven (7) Filipino elderly participating in craft-making. We purposively selected the key informants from a municipality in the province of Bulacan, Philippines. The transcribed data gathered through a semi-structured in-depth interview was analyzed using Colaizzi’s approach. Six themes describing the lived experiences emerged: “Fostering friendship,” “Flourishing health,” “Furthering service,” “Facing aging with acceptance,” “Finding felicity and self-fulfillment,” “Feelings of belongingness and security.” Just like the sun, the elderly’s participation in craft-making serves as a nourishment for them. This exploration speaks to understanding the potential of craft-making …

Nurse Perception Of Care Of Hospitalized Older Adults – A Comparative Study Between Northern And Central Regions Of Portugal, João Paulo De Almeida Tavares, Alcione Leite Da Silva, Pedro Sá-Couto, Marie Boltz, Elizabeth Capezuti

Publications and Research

Objective: to analyze the relationship between the perceptions of nurses about geriatric care (GC) environment and geriatric nurses’ knowledge and attitudes according to unit type considering the northern and central regions of Portugal.

Method: a cross-sectional study was developed among 1068 Portuguese’s nurses in five hospitals. The instrument was Geriatric Institutional Assessment Profile – Portuguese version. The independent samples t-test was when the assumption of normality was verified, otherwise, the Mann-Whitney U test was used. The level of significance was 5%.

Results: the profile of perceptions of GC showed a relatively homogeneous pattern (no statistically significant results were found). For …

Evaluating The Effectiveness Of Abilities Care Approach™ Training, Michelle E. D'Amato, Sophie E. Miller, April Perez, Carmen Joaquin, Louiza Alexandria Villarina

Student Research Posters

Approximately 50% of US nursing home residents have a diagnosis of dementia. Abilities Care Approach® was created by occupational therapists (OTs) to promote quality dementia care for residents in skilled nursing facilities (SNFs). Certified nursing assistants (CNAs) are often the primary caregiver for residents with dementia. To ensure carryover of ACA principles, ACE dementia training was targeted towards CNAs. The purpose of this study was to evaluate Abilities Care Experts®(ACE) training program which provides CNAs with an occupation-based dementia care approach by focusing on the importance of occupational engagement and knowledge of dementia stages. Results indicated that ACE trained CNAs …

Alzheimer's Disease, Kirstin Fortune

Nursing Student Class Projects (Formerly MSN)

This presentation is an overview on Alzheimer's disease. Signs, symptoms, pathophysiology and pharmaceuticals are all incorporated in this poster. The United States is planning to address the possible crisis of Alzheimer's with many initiatives.

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

Alzheimer’S Disease And The Impact Of Music Therapy A Systematic Literature Review, Hayley Guess

Senior Honors Projects, 2010-2019

Currently ranked as the sixth leading cause of death in the United States, Alzheimer’s disease (AD) has become the most prevalent form of dementia, a term commonly associated with memory loss and other progressive cognitive deficits that compromise patients’ lives. What may begin as a mindlessly misplaced object or momentary inability to recall newly learned information will eventually advance to a loss of personal identity, forgotten loved ones, and utter misperception of reality. Although a cure for AD has yet to be discovered, there are several non-pharmacological treatments that can improve patients’ quality of life and provide temporary relief from …

Antimicrobial Stewardship: Incentives And Barriers To Implementation In Skilled Nursing Facilities, Gloria M. Escalona

Doctoral Projects

This study was part of a quality improvement effort of a Skilled Nursing Facility (SNF) to develop and establish an antimicrobial stewardship program to comply with recently enacted California State Senate Bill 361 (SB 361), which went into effect January l, 2017 (Skilled nursing facilities, 2015). The division of the facility into two sections, one staffed largely by Licensed Vocational Nurses (L VNs) and another staffed largely by Registered Nurses (RNs) provided an study opportunity that easily differentiated the licensed nurses. This study used three methods: 1) an educational intervention to licensed nurses, 2) a post-educational intervention survey of licensed …

Relationship Between Physical Activity And Risk Of Falls In Elderly Of West Marin, Chelsey White, Crystal Hunter, Fasha Ruys-Solorzano, Nancy Hunt, Shay Mozzetti, Nima Tso, Nicholas Ward, Tony Guevara, Kayla Kinsman, Dolma Tso, Sadaf Sardar, Halina Truong

Scholarly and Creative Works Conference (2015 - 2021)

Background: Fall injury is a leading cause of death and disability among older adults (Alamgir, 2012). Fall injury may result in fractures, infection and fear of movement. By reinforcing engagement in muscles used during balance and walking, seniors may avoid unnecessary falls within their homes and the community.

Setting/Target Population: West Marin is the largest rural area of Marin County, California and includes seven unincorporated communities. A large percentage of the elderly population who reside in West Marin live alone--thus suffering from isolation. Within the rural, isolated communities of West Marin, the rate of falls among the elderly …

Care Coordination In Bone Health Screening Between Individual Behaviors And Health Care Services Among Korean-American Women Across Three Age Groups, Young-Shin Lee

Asian/Pacific Island Nursing Journal

Integrated continuous care is important to prevent and treat brittle bone status in the aging process; however, minority groups often have limited access to health services. The purpose of this study was to identify the care coordination among women’s perceptions about their bone health, information from health care providers, and the results of Bone Mineral Density (BMD) tests across three age groups. The study was a cross-sectional comparative design. A total of 63 Korean American women completed both the assessment of BMD of the femoral neck and an interview survey. One’s own risks of osteoporosis, screening behaviors, and health care …

Exploring The Impact Of A Training Programme On Acute Healthcare Professionals' Attitudes And Understanding Of Dementia, Orla Quirke

Theses

Acute healthcare professionals lack education and training in dementia care. This results in people with dementia having poorer outcomes when admitted to the acute healthcare setting. An overarching aim of The National Dementia Strategy (2014) is the provision of optimal care for people with dementia in all healthcare and community settings. In response to this, Dementia Elevator a national inter-professional suite of educational programmes were developed by Dublin City University and the Health Service Executive to help individuals, communities and health systems engage positively with people with dementia. This study aimed to evaluate the impact of a four-hour dementia training …

A Resident-Centered Dementia Care Staff Education Project To Reduce Challenging Behaviors At A Long-Term Care Facility, Margaret Huryk

Seton Hall University DNP Final Projects

Frequent use of antipsychotic medication (APM) for behavioral and psychological symptoms of dementia (BPSD) persists at high levels in long- term care (LTC) facilities despite extensive evidence of modest clinical benefits, serious adverse effects, public health advisories and a national initiative to improve dementia care. There is a gap between best-practice evidence and actual clinical practice related to pharmacological and nonpharmacological care for persons with dementia (PWD) and BPSD and/or neuropsychiatric symptoms (NPS) of dementia. The literature shows that clinicians often ignore FDA (Food and Drug Administration) warnings, CMS (the Centers for Medicare and Medicaid Services) initiatives and expert opinion …

Self-Care Among Older Adults With Heart Failure, Sumayya Attaallah, Kay Klymko, Faith Pratt Hopp

Social Work Faculty Publications

Background: It is estimated that 5.7 million Americans are living with heart failure (HF) today. Despite the fact that HF is one of the most common reasons people aged 65 years and older are admitted into the hospital, few studies describe the self-care in this older adult population. Purpose: The purpose of the study was to review the current literature on self-care in this population to better understand the influence of selected factors on self-care and health outcomes. Methods: A literature search was completed and resulted in including 28 studies. Results: Multiple factors have been reported as barriers to self-care …

Older Adults Perspectives Of Bed Bathing, Nikki D. Sumner, Katherine C. Hall Phd

Undergraduate Honors Theses

The purpose of this qualitative pilot study is to explore the patient perspectives about what it is like to receive a bed bath. Examining studies of bath basins versus alternative methods has shown a decrease in the spread of nosocominal infections. However, there is not sufficient evidence evaluating the patient perspectives of assistive bed bathing and interactions with nurses and nursing support staff. This information can provide healthcare providers, especially nurses, with a better understanding of patient perspectives and values. It also supports the national healthcare approach towards patient-centered care.

Factors And Outcomes Associated With Potentially Inappropriate Medication Use In Rural Community-Dwelling Older Adults, Marcia Y. Shade

Theses & Dissertations

Potentially inappropriate medications (PIMs) use in older adults is a significant public health concern. The use of PIMs to avoid may lead to negative outcomes such as adverse drug events. Prior conceptual analysis of PIMs use and observation of health-related factors in rural adults led to the design of this dissertation study. A sample was recruited from a population of rural community-dwelling older adults to examine the following specific aims: 1) Describe the use of PIMs to avoid, 2) Explore individual demographic characteristics (age, gender, income, education, and rural home location), health experience (comorbidity, number of medications and health providers), …

Using An Online Learning Module In A Nursing Program To Improve Knowledge And Skills To Prevent Falls In The Community Dwelling Older Adult Population, Susan Kane Patton

Graduate Theses and Dissertations

Nationally, 28.4% of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence based protocols by providers to identify older adults at risk of falling is limited and rates of participation by older adults in prevention activities is low. Because of nursing’s increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community dwelling older adults and increased access of older adults to falls risk assessment. There is a …

Driving In Early-Stage Alzheimer’S Disease: An Integrative Review Of The Literature, Rebecca L. Davis, Jennifer M. Ohman

Peer Reviewed Articles

One of the most difficult decisions for individuals with Alzheimer’s disease (AD) is when to stop driving. Because driving is a fundamental activity linked to socialization, independent functioning, and wellbeing, making the decision to stop driving is not easy. Cognitive decline in older adults can lead to getting lost while driving, difficulty detecting and avoiding hazards, as well as increased errors while driving due to compromised judgment and difficulty in making decisions. The purpose of the current literature review was to synthesize evidence regarding how individuals with early-stage AD, their families, and providers make determinations about driving safety, interventions to …

Beers Medication: Empowering The Elderly Through Education, Amanda J. Parker

DNP Projects

The elderly population (those aged 65 years and older) has an increased risk of experiencing adverse effects from their prescribed medications. These adverse effects are due to many reasons, one being changes that naturally occur in the aging body, such as diminished kidney function or decreased gastrointestinal motility. This project explores the prescribing practices of one primary care practice setting. Specifically, this project sought to determine the number of patients in a primary care practice who were prescribed medications on the Beers list and whether or not the patients received education on adverse effects. The results concluded the most frequently …

Transitions To Assisted Living Within A Continuing Care Retirement Community, Judith H. Scott

Dissertations

Purpose/Aims: The purpose of this study was to explore the lived experience of older single women who moved from their independent homes to the assisted living setting, both situated within a Continuing Care Retirement Community (CCRC).

Rationale: Anecdotally, CCRC transitions have been viewed as either one dreaded possible step toward the end of life or a supportive place to open a new chapter in older adults’ lives. However, no studies have actually examined this experience among older single women, who comprise a large proportion of people making this transition.

Background: Older adults move to assisted living within a CCRC when …

A Phenomenological Study Of Anticipated Intimacy And Sexual Expression Needs Of Aging Male And Female Baby Boomers., Charles Shawn Oak

Electronic Theses and Dissertations

The purpose of this study was to understand the phenomenon of how heterosexual Baby Boomers define and understand intimacy, sexual expression, along expectations and desires relating to their respective expressions across the lifespan through their individual experiences and reflections. A set of guiding questions were used in a hermeneutic phenomenological qualitative research design. Data was gathered from thirteen subjects (n=13) using the Rappaport Time Line (RTL) that was used to develop individualized semi-structured interviews and follow-up interviews that were professionally transcribed. These were coded to identify emergent themes. Results of the study provided insight into the phenomenon of how heterosexual …

Assessing The Psychoeducational Approach To Transcendence And Health (Path) Program : An Intervention To Foster Self-Transcendence And Well-Being In Community-Dwelling Older Adults., Valerie Lander Mccarthy, Sharon Bowland, Lynne A. Hall, Jennifer Connelly

Faculty and Staff Scholarship

The late-life developmental process of self-transcendence shapes elders’ perspectives on self, others, the nature of this world, and of a dimension beyond the here and now. This qualitative pilot study evaluated the Psychoeducational Approach to Transcendence and Health (PATH) Program, a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling women at a senior center. The intervention involved eight weekly group sessions using group processes, mindfulness practices, creative experiences, and independent at-home practice. The findings supported the underlying theory-based structure and content of the intervention and indicated the intervention may empower elders to attend to self-care, develop acceptance, and learn …

The Lived Experience Of Aging: Listening To The Oldest-Old, Julia A. Pusztai

Loma Linda University Electronic Theses, Dissertations & Projects

Although embraced as desirable by most, living into very old age is largely unexplored as a distinct season of life, with increased, varied, and cumulative changes during a unique time of vulnerability and frailty. The purpose of this study was to listen to the oldest-old, and to explore their lived experience of growing old. This hermeneutic phenomenology study examines the experience of finding meaning and living with losses and gains in advanced old age. This study design included three separate interviews one month apart with participants over 85 years of age. Purposive sampling resulted in 13 participants, 5 being male …

Promoting Self-Transcendence And Well-Being In Community-Dwelling Older Adults : A Pilot Study Of A Psychoeducational Intervention., Valerie Lander Mccarthy, Jiying Ling, Sharon Bowland, Lynne A. Hall, Jennifer Connelly

Faculty and Staff Scholarship

Self-transcendence changes how older adults perceive themselves, their relationships with others, the material world, and the metaphysical or spiritual dimension. It is associated with multiple indicators of well-being. The purpose of this pilot study (N = 20) was to examine the feasibility and effectiveness of a psychoeducational intervention to increase self-transcendence and well-being of older adults. Data were analyzed using generalized estimating equations. All variables trended in the directions hypothesized. Self-transcendence increased in the intervention group and decreased in the control group but not significantly. The group × time interaction for life satisfaction was significant (z = 2.89, …

Psychometric Properties Of The Family Caregiver Delirium Knowledge Questionnaire, Margaret J. Bull, Jennifer M. Sjostedt, Lesley Boaz, Debra L. Oswald

College of Nursing Faculty Research and Publications

A valid, reliable measure of family caregivers’ knowledge about delirium was not located in the literature; such an instrument is essential to assess learning needs and outcomes of education provided. The purpose of the current study was to (a) develop a family Caregiver Delirium Knowledge Questionnaire (CDKQ) based on the Symptom Interpretation Model; and (b) establish validity and reliability of the measure. The 19-item CDKQ was developed and administered to 164 family caregivers for community-dwelling older adults. Descriptive statistics were examined for all variables. Psychometric testing included confirmatory factor analysis, item-to-total correlations, and internal consistency reliability. A three-factor model provided …