Geriatric Nursing Commons^™

Incarceration-Related Stigma And Caring Self-Efficacy Among Long-Term Care Nurses, Sandra D. Langston

Dissertations, Theses, and Capstone Projects

Background: A silver tsunami is occurring in U.S. prisons because of an unprecedented increase in the older population. Prisons are structurally ill-suited to care for this population and financially burdened with providing the necessary medical and nursing care. States have enacted legislation to afford justice-involved persons parole to manage chronic conditions in community-based long-term care (LTC) facilities. Changes in Medicaid regulations provide a seamless transition from prison to community long-term care for this population. However, it is not known if the stigma of justice involvement impacts the perception of long-term nurses concerning this population.

Aims/Purpose: This study examined the effects …

Factors Associated With Technology Adoption By Community-Dwelling Older Adults During The Covid-19 Pandemic, Elizabeth A. Sutton

Dissertations, Theses, and Capstone Projects

The COVID-19 pandemic brought to the forefront the disparity between older and younger Americans in the utilization of information and communication technologies (ICT) when measures such as the COVID vaccine rollout were dependent on technology use. Technology adoption has implications for overall health and the continuation of disparities in technology adoption is associated with poor aging outcomes. The aim of this study was to understand factors associated with technology adoption by community-dwelling older adults during the COVID-19 pandemic. A nationally representative sample of 2,954 community-dwelling older adults who completed the National Health and Aging Trends Study (NHATS) COVID-19 Questionnaire was …

Efficacy, Acceptance, And Feasibility Of Virtual Reality For Chronic Pain Relief In Older Adult Veterans Residing In Long Term Care, Valicia Philibert

Dissertations, Theses, and Capstone Projects

Older adults residing in Long-Term Care (LTC) have a high prevalence of chronic pain. Pain management strategies have primarily focused on pharmacological approaches, but with physiological changes associated with aging, this population is at an increased risk for adverse effects from prescribed medications. More research is needed on innovative non-pharmacological interventions in the LTC setting. This study examined the feasibility, acceptance, and preliminary efficacy of Virtual Reality (VR) for chronic pain among older adult veterans in LTC. In this quasi-experimental, 12 older adult participants living with chronic pain in a long-term care facility received two sessions of VR. Pain intensity …

Clinical Nurse Specialist Job Description Assignment, Diane R. Maydick Youngberg

Open Educational Resources

The Clinical Nurse Specialist (CNS) is an advanced practice registered nurse with expertise in assessment, diagnosis, and treatment of specialty patient populations. In addition to direct care, the CNS role expands to other areas including research, education, quality improvement, and inter professional teamwork. Creating a detailed CNS Job description helps to clarify the role.

Admissions Of Covid-Positive Patients To Us Nursing Homes With Personal Protective Equipment Or Staffing Shortages, Diane M. Gibson, Jessica Greene

Publications and Research

Background: US nursing homes are required to follow Centers for Disease Control guidance for COVID-19 transmission-based precautions (TBP) when admitting COVID-positive patients.

Objective: To assess how frequently nursing homes had shortages of personal protective equipment (PPE) or staffing in weeks when they admitted COVID-positive patients, which likely made it more difficult to follow TBP, and to compare facility characteristics by admissions practices.

Design and Setting: Facility-level data from the Nursing Home COVID-19 Public File for the period between June 7, 2020 and March 7, 2021 was combined with additional data. The percentages of nursing homes that admitted COVID-positive patients and …

Assisting Nursing Students In Their Development Of Empathy: A Guide To Fostering Requisite Skills For The Art Of Empathetic Communication, Susan Mee

Open Educational Resources

This 7-week lesson plan is designed for use in clinical nursing courses. It is designed specifically for use by Nursing faculty teaching in the absence of state required patient facing clinical opportunity due to COVID restrictions. The lesson plan describes pedagogical techniques and provides video and education OER resources designed to help support the development of empathetic communication skills over 7 weeks. Refection and video debriefing techniques will be employed. Role play will culminate in the group presentation project of a brief video modeling effective therapeutic empathetic communication.

State Actions And Shortages Of Personal Protective Equipment And Staff In U.S. Nursing Homes, Diane M. Gibson, Jessica Greene

Publications and Research

BACKGROUND: It is crucial that nursing homes have adequate personal protective equipment (PPE) and staff to protect residents and staff from COVID-19. Some states have taken actions to mitigate shortages of PPE and staffing in nursing homes, including creating dedicated long-term care (LTC) teams and supporting staffing capacity.

OBJECTIVE: To examine whether state actions and nursing home characteristics are associated with shortages of PPE and staffing.

DESIGN AND SETTING: Facility-level data, released July 31, 2020, from the Nursing Home COVID-19 Public File, were combined with data from other sources. Our sample was the 13,445 facilities with information about PPE and …

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 …

Relations Amongst Power, Self-Health Patterning, And Quality Of Life In Older Adults With Chronic Illness, Philip J. Gimber

Dissertations, Theses, and Capstone Projects

The aim of this study was to examine the relationships between power, self-health patterning, and quality of life in older adults with chronic illness using Rogers’ science of unitary human beings and Barrett’s theory of power. A cross-sectional, correlational design was used to examine the variables in a sample of approximately 100 older adults with chronic illness. This study revealed that power, self-health patterning, and quality of life are related to one another and that both power and self-health patterning are associated with enhanced quality of life.

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

A Systematic Review Of Non-Pharmacological Interventions To Improve Nighttime Sleep Among Residents Of Long-Term Care Settings, Elizabeth Capezuti, Rana Sagha Zadeh, Kevin Pain, Aleksa Basara, Nancy Ziyan Jiang, Ana C. Krieger

Publications and Research

Background: Disturbances in sleep and circadian rhythms are common among residents of long-term care facilities. In this systematic review, we aim to identify and evaluate the literature documenting the outcomes associated with non-pharmacological interventions to improve nighttime sleep among long-term care residents.

Methods: The Preferred Reporting Items for Systematic Reviews guided searches of five databases (MEDLINE, Embase, CINAHL, Scopus, and Cochrane Library) for articles reporting results of experimental or quasi-experimental studies conducted in long-term care settings (nursing homes, assisted-living facilities, or group homes) in which nighttime sleep was subjectively or objectively measured as a primary outcome. We categorized each intervention …

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 …

Remembering Time, Jonathan Carey

Capstones

My parents were dressed in their Sunday best, heading to a church revival. I was 12 and still the baby of the family, so staying home alone was out of the question. My grandmother Lillian, who preferred to be called Nana, came to babysit me. She relished a little time away from the doldrums and senior citizen gossip that engulfed the high-rise building where she lived,five minutes from my house in Petersburg, Virginia. That evening, as the sounds of “The Young and the Restless” echoed through the house, I tiptoed downstairs to give Nana a playful scare.

Hope And Health Related Quality Of Life Of Older Women Who Have Had Heart Attacks, Alice Mary Kelly-Tobin

Dissertations, Theses, and Capstone Projects

Background: Heart disease is the number one cause of death and leading cause of disability in adults in the United States. Coronary heart disease (CHD) is the most common form of heart disease with heart attack as its acute manifestation. Health Related Quality of Life (HRQoL) is a multidimensional concept of self-perception of physical, emotional health, and overall sense of well-being. Hope, an inner process focusing on maintaining physical and mental well-being, is considered necessary for survival of chronic illnesses, such as CHD.

Method: Women age 65 and older who have had heart attacks (N=91) volunteered to participate in this …

Medical Crises In Older People: Cohort Study Of Older People Attending Acute Medical Units, Developmental Work And Randomised Controlled Trial Of A Specialist Geriatric Medical Intervention For High-Risk Older People; Cohort Study Of Older People With Mental Health Problems Admitted To Hospital, Developmental Work And Randomised Controlled Trial Of A Specialist Medical And Mental Health Unit For General Hospital Patients With Delirium And Dementia; And Cohort Study Of Residents Of Care Homes And Interview Study Of Health-Care Provision To Residents Of Care Homes, John Gladman, Rowan Harwood, Simon Conroy, Pip Logan, Rachel Elliot, Rob Jones, Sarah Lewis, Jane Dyas, Justine Schneider, Davina Porock, Kristian Pollock, Sarah Goldberg, Judi Edmans, Adam Gordon, Lucy Bradshaw, Matthew Franklin, Katherine Whittamore, Isabella Robbins, Aidan Dunphy, Karen Spencer, Janet Darby, Lukasz Tanajewski, Vladislav Berdunov, Georgios Gkountouras, Pippa Foster, Nadia Frowd

Publications and Research

Background: This programme of research addressed shortcomings in the care of three groups of older patients: patients discharged from acute medical units (AMUs), patients with dementia and delirium admitted to general hospitals, and care home residents.

Methods: In the AMU workstream we undertook literature reviews, performed a cohort study of older people discharged from AMU (Acute Medical Unit Outcome Study; AMOS), developed an intervention (interface geriatricians) and evaluated the intervention in a randomised controlled trial (Acute Medical Unit Comprehensive Geriatric Assessment Intervention Study; AMIGOS). In the second workstream we undertook a cohort study of older people with mental health problems …

Care In Specialist Medical And Mental Health Unit Compared With Standard Care For Older People With Cognitive Impairment Admitted To General Hospital: Randomised Controlled Trial (Nihr Team Trial), Sarah E. Goldberg, Lucy E. Bradshaw, Fiona C. Kearney, Catherine Russell, Kathy H. Whittamore, Pippa E R Foster, Jil Mamza, John R F Gladman, Rob G. Jones, Sarah A. Lewis, Davina Porock, Rowan H. Harwood

Publications and Research

Objective To develop and evaluate a best practice model of general hospital acute medical care for older people with cognitive impairment.

Design Randomised controlled trial, adapted to take account of constraints imposed by a busy acute medical admission system.

Setting Large acute general hospital in the United Kingdom.

Participants 600 patients aged over 65 admitted for acute medical care, identified as “confused” on admission.

Interventions Participants were randomised to a specialist medical and mental health unit, designed to deliver best practice care for people with delirium or dementia, or to standard care (acute geriatric or general medical wards). Features of …

Dentures, A Matter Of Health: Proper Fitting Oral Prosthetics Improve Elderly Patients’ Overall Wellbeing, Michelle Gellar, Daniel Alter

Publications and Research

No abstract provided.

Long-Term Care, Emma Kontzamanis, Keville Frederickson

Publications and Research

In chis chapter, the need for long-term care services is explained from the perspective of the explosive growth of the older population as well as the increase in disability and chronic illness in the general population. A definition of long-term care within the contexts of inpatient and community-based services is also explained. In the United States the focus of long-term care is on nursing homes. This will be discussed as well as alternatives co nursing home care which involve integrated services such as case management, social health maintenance organizations, and programs of all inclusive care for elders. Solutions to the …

The Mds Mortality Risk Index: The Evolution Of A Method For Predicting 6-Month Mortality In Nursing Home Residents, Davina Porock, Debra Parker-Oliver, Gregory F. Petroski, Marilyn Rantz

Publications and Research

Background: Accurate prognosis is vital to the initiation of advance care planning particularly in a vulnerable, at risk population such as care home residents. The aim of this paper is to report on the revision and simplification of the MDS Mortality Rating Index (MMRI) for use in clinical practice to predict the probability of death in six months for care home residents.

Methods: The design was a secondary analysis of a US Minimum Data Set (MDS) for long term care residents using regression analysis to identify predictors of mortality within six months.

Results: Using twelve easy to collect …