Medicine and Health Sciences Commons^™

Engaging Caregivers To Use An Evidence‑Based Intervention For Medicaid Benefciaries With Alzheimer’S Disease: A Pilot Study, Sandra Lee Spoelstra, Alla Sikorskii, Monica Schueller, Viktoria Basso, Autumn Baldwin

Peer Reviewed Articles

Background This pilot study aimed to adapt an intervention, engaging informal caregivers to help clinicians with providing care to improve (or maintain) physical function of individuals with Alzheimer’s Disease or other dementias. To the best of our knowledge, for the frst time, we report on use of the intervention in those with Alzheimer’s Disease or other dementias.

Methods This was a 5-month mixed methods cohort study in a convenience sample of clinicians, caregivers, and benefciaries at 3-Medicaid Home and Community-based Service sites in Michigan. Two content experts and 5 caregivers modifed the intervention. We trained 116 clinicians to engage caregivers …

Results Of A Multi-Site Pragmatic Hybrid Type 3 Cluster Randomized Trial Comparing Level Of Facilitation While Implementing An Intervention In Community-Dwelling Disabled And Older Adults In A Medicaid Waiver, Sandra Spoelstra, Monica Schueller, Viktoria Basso, Alla Sikorskii

Peer Reviewed Articles

Background: Evidence-based interventions that optimize physical function for disabled and older adults living in the community who have difficulty with daily living tasks are available. However, uptake has been limited, particularly in resource-constrained (Medicaid) settings. Facilitation may be an effective implementation strategy. This study’s aim was to compare internal facilitation (IF) versus IF and external facilitation (EF) on adoption and sustainability of an intervention in a Medicaid home and community-based waiver.

Methods: In a hybrid type 3 trial, waiver sites (N = 18) were randomly assigned to implement the intervention using a bundle of strategies with either IF or IF …

Nonalcoholic Fatty Liver Disease And The Pnpla3 Gene, Lori Houghton-Rahrig, Debra Schutte, Jenifer I. Fenton, Jennifer Awad

Peer Reviewed Articles

Nonalcoholic fatty liver disease (NAFLD) is a rapidly emerging worldwide public health concern strongly associated with obesity, insulin resistance/diabetes type 2, and the metabolic syndrome (Younossi et al., 2011). It is the most common cause of liver disease in the world (World Gastro - enterology Organisation [WGO], 2012). Defined as a total liver weight comprised of more than 5% fat, NAFLD can progress from simple fatty liver disease to nonalcoholic steatohepatitis with or without fibrosis, liver cirrhosis, liver cancer, or liver failure resulting in premature death (Levene & Goldin, 2012). The development and progression of NAFLD is influenced by genetic …

Replicable Interprofessional Competency Outcomes From High-Volume, Inter-Institutional, Interprofessional Simulation, Deborah Bambini, Matthew Emery, Margaret De Voest, Lisa Meny, Michael J. Shoemaker

Peer Reviewed Articles

There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE) experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students’ perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students …

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 …

Search Strategies Used By Older Adults In A Virtual Reality Place Learning Task, Rebecca L. Davis, Catherine Weisbeck

Peer Reviewed Articles

Purpose of the study: Older adults often have problems finding their way in novel environments such as senior living residences and hospitals. The purpose of this study was to examine the types of self-reported search strategies and cues that older adults use to find their way in a virtual maze

Design and Methods: Healthy, independently living older adults (n = 129) aged 55–96 were tested in a virtual maze task over a period of 3 days in which they had to repeatedly find their way to a specified goal. They were interviewed about their strategies on days 1 and 3. …

Development Of An Index To Predict Risk Of Nursing Home Placement For Home And Community-Based Waiver Participants, Sandra L. Spoelstra, Charles W. Given

Peer Reviewed Articles

Nursing home placement (NHP) is costly, and the majority of older adults prefer to remain living in the community. The purpose of this research was to examine NHP among a cohort of participants in a home and community-based waiver program during 2002 to 2007 to develop a risk model for predicting who may transition to a nursing home. Methods: This longitudinal study was conducted on data from the minimum data set-home for care linked with medicaid claim files and death certificates. The sample included 6525 participants who had two assessments and survived through 2007 or had NHP. A risk index …

How Increasing Personal Care Service Might Delay Or Prevent Nursing Home Placement, Sandra L. Spoelstra, Charles W. Given, Tracy Dekoekkoek, Monica Schueller

Peer Reviewed Articles

There is a pressing need to retain dually eligible elderly Medicare and Medicaid beneficiaries in the community. The objective of this study was to examine median personal care services (PCS) hours, and how increasing PCS to the median (for those below), might delay nursing home placement (NHP) and save cost. Methods: Retrospective study of PCS hours, costs, and NHP in a statewide home and community based waiver program in the Midwest serving 6525 dually eligible Medicare-Medicaid beneficiaries aged 65 and older. Two Minimum Data Set-Home Care assessments and Medicaid claim files were examined to identify PCS hours and cost. A …

Measuring The Impact Of Health Education Modules In Cameroon, West Africa, Paulette A. Chaponniere, Susan M. Cherup, Lillie Lodge

Peer Reviewed Articles

Each year, more than two million people die from diarrhea-associated diseases. Although there is a global need for safe drinking water, culturally appropriate health teaching is essential to behavior change. This study evaluated the impact of a health education program in a small rural community in Cameroon. Flash cards and a modified version of the CDC-KPC 2000 survey were used to collect data in 57 homes. Children who lived in households with working Manz BioSand filters were less likely to have had diarrhea in the 2 weeks prior to the evaluation. There remained a gap between health knowledge and healthy …

How Can We Help Minority Nursing Students?, Nancy Schoofs

Peer Reviewed Articles

This article details the example of remediating an at-risk nursing student who failed two clinical rotations at a large university nursing program. It is a case of working with a minority student using six simulations and two clinical days in the hospital. The author describes the process of how the simulations and clinical experiences were used to assist the student in increasing her confidence and clinical abilities. In addition to the example of the student, an extensive literature review was done prior to working with the student. This aided the author not only in determining methods for assisting the student, …

A Qualitative Study Of Role Transition From Rn To Apn, Sandra L. Spoelstra, Lorraine B. Robbins

Peer Reviewed Articles

Role transition from registered nurse to advanced practice nurse is a difficult process. A qualitative thematic analysis guided the integration of various experiences of 24 students in a twocredit, web-based role development course in a Master’s of Science in Nursing program at a large Midwestern university. Findings supported that students had developed an understanding of the core competencies and complexity of the advanced practice nurse role, and that beginning role transition had occurred. An overarching theme, ‘the essence of nursing’ was evident. Three subthemes supported the occurrence of role transition, which included the importance of: a) building a framework for …

Exploring Possibilities: Virtual Reality In Nursing Research, Rebecca L. Davis

Peer Reviewed Articles

This paper describes the use of virtual reality (VR) as a method of measurement in nursing research. VR refers to the use of computerized displays to display a life-like environment in which the user interacts. Although many disciplines are beginning to use VR environments in research, nursing has yet to embrace this technology. Nursing, as a profession which values the interaction between the environment, individual, and health, can benefit from the use of VR in research. Establishing reliability and validity of the VR tool selected for research is important and requires special consideration. VR testing can produce side effects, such …

Delirium: Elders Tell Their Stories And Guide Nursing Practice, Cynthia Mccurren, Sherill Nones Cronin

Peer Reviewed Articles

Delirium is one of the most serious and prevalent cognitive disorders among hospitalized elders. Fourteen elders participated in this phenomenologic study describing the "lived experience " of delirium from the patient's perspective. Implications for nursing practice are derived from their reality and insight.

Blending The Roles Of Home Care Nursing And Cardiovascular Specialties: A Model For Nursing Practice In The Community, Margaret A. Guthaus, Diane White

Peer Reviewed Articles

Changes in reimbursement and advances in technology have resulted in a decreased hospital stay for patients undergoing cardiac surgery. These patients are being discharged into the community setting earlier, resulting in an increased demand for transitional specialty home care. This article relates the experience of a Midwest home care agency charged with the development of specialty home care for these complex patients. It offers a new practice model for professional nursing staff delivering this level of care. This model challenges traditional beliefs that cardiac specialty home care can best be provided by nurses with critical care or acute care cardiology …

Elders, Values, And Peppermint Candies, Sarah A. Klein, Andrea C. Bostrom

Peer Reviewed Articles

The demographics of the population of the United States are inexorably changing: The baby boomers, who have defined much of the culture of the past half century, will continue to do so over the next 50 years. Just as the population is aging, so are the members of the nursing profession. Working with elders as our patients and as our peers is a reasonable expectation. Encouraging younger nurses to embrace working with elders is a challenge. Learning about how we have come to value aging and our elders is one way to engage the change in the work that nurses …

Derivation And Testing Of Tenets Of A Theory Of Social Organizations As Adaptive Systems, Louette R. Johnson Lutjens

Peer Reviewed Articles

Management and organizational theories are commonly used to design nursing administration studies. This article proposes a nursing theory as a viable alternative and demonstrates its utility in the conduct of nursing administration research. The purpose of the research was to determine the explanatory power of the environmental stimuli of medical condition, nursing condition, nursing intensity, and medical severity on length-of-stay (LOS). Twenty-three percent of the variance in LOS was accounted for by the environmental stimuli with nursing acuity contributing 14%. The focal stimulus, medical condition (diagnosis-related groups), uniquely explained only one percent of the variance. The theory of social organizations …