Geriatric Nursing Commons^™

Evaluation Of A Care Management Program On Family Caregivers Of Persons With Dementia, Victoria L. Jackson

Doctoral Projects

Dementia due to Alzheimer’s and other disease is a growing concern for healthcare providers as the number of individuals in the U.S. population ages. Persons with dementia (PWDs) rely on caregivers, primarily family caregivers (FCGs), for basic and instrumental activities of daily living as the disease progresses. There may be negative outcomes, such as depression, strain, and distress for FCGs of PWDs. Routine assessment and intervention by healthcare providers can address needs of FCGs of PWDs. There are multiple interventions that have demonstrated effectiveness in caring for PWDs and FCGs; one such intervention is care management. The University of California, …

Improving The Process Of Pain Management By Implementing Best Practices In A Nursing Home, Sukhjit Dhillon

Doctoral Projects

Pain is often untreated or undertreated among older adults living in nursing homes. The lack of standardized pain management protocols makes it difficult to address pain in this population. Deficiencies in pain management and documentation were identified in a nursing home and a performance improvement project was implemented with the aim to improve pain management, pain documentation, and staff knowledge of pain management. A pre-and post-intervention study design was used, and data analysis included descriptive statistics and a paired samples t-test. Participants (n=12) included seven registered nurses and five licensed vocational nurses who provide direct care to the residents in …

Initiating A Geriatric Clinical Practicum In The Midst Of A Pandemic, April Wood

Faculty Research, Scholarly, and Creative Activity

No abstract provided.

Patient-Centered Emr Communication, Christi Lynn Camarena

Doctoral Projects

The electronic medical record (EMR) has become the standard in health care documentation. The EMR has been shown to improve the availability of medical records, provide tools to facilitate communication, and improve patient safety. Because of the absence of standardized training and EMR research, there is a gap in understanding the relationship between the EMR and the provider-patient relationship. The EMR requires the provider to use purposeful and deliberate patient-centered EMR communications behaviors to facilitate a meaningful, engaging, and educational dialogue with patients. These behaviors have been studied in physician populations and standardized tools have been developed to assist in …

A Retrospective Chart Review Pilot Study Of Fall Prevention Through A New And Innovative Care Model, Lydia Smith

Doctoral Projects

According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury-related mortality in the geriatric population, and they are the most common cause of brain injury and hip fracture. The prevalence for falls is 30% in patients over 65 in the United States who experience a fall annually, and the prevalence in dementia patients can be up to 80% annually; the consequences of falls can include injury, reduction in mobility, depression and decreased socialization with peers (CDC, 2015). The purpose of this retrospective chart review pilot study is to examine the number of falls …

Caregiver Outcomes Of A Dementia Care Program, Leslie Chang Evertson

Doctoral Projects

The University of California, Los Angeles Alzheimer’s and Dementia Care (ADC) program enrolls people with dementia (PWD) and their family caregivers as dyads to work with nurse practitioner dementia care specialists to provide coordinated dementia care. At one year, despite disease progression, the PWDs’ behavioral and depressive symptoms improved. In addition, at one-year, caregiver depression, distress related to behavioral symptoms, and caregiver strain also improved. Not all dyads enrolled in the ADC program appear to experience benefit. Although strain and distress remained stable or decreased for the majority of caregivers, a portion reported an increase in both. Semi-structured interviewed were …

Establishing A Hybrid Wound And Ostomy Continuing Education Program, Vivian K. Wong

Faculty Publications

Wound and ostomy nurses receive specialty training and certification to provide care in abdominal stomas, ostomies, wounds, fistulas, and pressure injuries. The eight existing nationwide programs in 2011 were inadequate to meet increasing patient population demands. We developed an innovative nondegree, postbaccalaureate continuing wound and ostomy education program using a hybrid design. The program integrated interactive online classes with intensive onsite classes and skills training. The program has been granted seven-year accreditation; student evaluations have been positive.

Enhancing Elderly Advance Care Planning Experience At A Primary Care Clinic, Oi Shan Wong

Doctoral Projects

The purpose of the project was to examine if the identification of readiness for an advance care planning (ACP) discussion of elderly participants would enhance the outcomes of participants' satisfaction, improve the likelihood of having an ACP discussion and increase the completion rates of an advance directive (AD) document after an office visit.

Forty-four elderly participants, who met the selection criteria, were recruited from a primary clinic in Northern California from October 1, 2017 to December 31, 2017 (Female, n =28). All participants were randomly assigned to either an intervention group (n= 22) or a control group ( …

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 …

The Effect Of Music Intervention On Cam Scores Of Hospitalized Older Adults Experiencing Delirium, Mae Lavente Dizon

Doctoral Projects

Older adults are vulnerable to developing while hospitalized is delirium. Research has shown that non-pharmacological interventions are effective in managing delirium and should be the first-line of treatment; however despite this, nurses fmd it difficult to address delirium. The purpose of this research study is to examine the effectiveness of classical music intervention in hospitalized older adults experiencing delirium by evaluating their Confusion Assessment Method (CAM) scores. A pre-and-post study design to compare the CAM scores of patients before and after music intervention was implemented. Study participants were patients 65 years and older identified to be experiencing delirium by a …

A Comparison Of Educational Approaches To The End-Of-Life-Nursing Education Consortium (Elnec) Course, Jennifer L. Bodine

Doctoral Projects

Purpose: The purpose of this project was to compare the effectiveness of two different educational approaches to teaching the End of Life Nursing Education Consortium course.

Background: Terminally ill patients frequently visit the emergency department for palliative care. However, various references show that staff does not have the knowledge base necessary to provide quality end-of-life care in the emergency setting.

Method: Participants from the emergency department at a Level I Trauma Center were recruited. A quantitative, cross-sectional pilot study was conducted to investigate whether lecture or lecture with simulation was more effective in increasing the knowledge base of participants regarding …

The Impact Of Intensive Case Management On Hospice Utilization, Debra Lowry Hummel

Doctoral Projects

Objective: The purpose of this study is to examine if patients enrolled in multi-disciplinary intensive case management program (ImPACT) alter the patient’s end-of-life path or setting of death.

Methods: The quality improvement project is a quantitative retrospective study that compared patients receiving standard primary care vs intensive case management (ImPACT) during 2/2013-1/2014. It is a secondary analysis of a larger study of a quality improvement evaluation that took place at the Veterans Administration facility in Palo Alto, Ca.

Results: Among the 82 patients who died, 19 were enrolled in ImPACT for approximately 249 days compared to 63 who received standard …

Undiagnosed Depression In The Elderly And Healthcare Education, Nancy J. Wynn-Grundy

Doctoral Projects

This descriptive study examined undiagnosed depression in the elderly and how it affects the elderly from retaining healthcare education. It is estimated by 2029, 20% of the United States population will be age 65 and older (Colby & Ortman, 2014). Depression in the elderly who have chronic diseases, is estimated to be undiagnosed up to 40% (Chaoyang et al., 2009). A hallmark symptom of depression is the inability to concentrate. It is unknown if undiagnosed depression will affect the older adult from retaining pertinent healthcare education. The 30 point Geriatric Depression Scale (GDS) was administered to a class of elderly …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …

The Use Of The "Get Up And Go Test" As The Initial Screening Measure For Fall Risk With Community Dwelling Seniors, Margaret E. Hermoso

Master's Projects

Falls represent a sizeable public health issue that has serious health-related consequences for both the individual and the medical system at large. Falls are one of the most common events that threaten the independence of older persons with one third of falls occurring in persons over the age of 65 and over 50% in persons over the age of 80 years (2). During an office appointment, senior adults are screened routinely for blood pressure, weight, medication adherence and lab result follow-up. One assessment that is commonly overlooked is evaluating seniors for fall risk. The purpose of this study was to …

Depression Among The Elderly: Screening Practices And Attitudes Among Nurse Practitioners, Grace Le

Master's Projects

Purpose: To examine California's nurse practitioners' (NPs) screening practices and attitudes towards depression among the elderly using the Depression Attitude Questionnaire (DAQ) (Botega, Mann, Blizard, & Wilkinson, 1992). Data sources: One hundred and fifty NPs, selected randomly from the membership of the California Association of Nurse Practitioners (CANP), were surveyed with electronic mailed questionnaires. Seventy-five (50%) self-reported surveys were completed and analyzed. Results: The majority of NPs routinely screened for depression among the elderly. Most thought that life events were not important in the development of depression, held a positive view with pharmacological and psychological treatments of depression, and felt …

Sexuality And The Aging Adult: The Attitude And Practice Of Physicians And Nurse Practitioners, Susan Runsvold

Master's Projects

Background: As the population ages, many quality of life issues will generate discussion. One such issue is sexuality of the aging adult. While there is substantial documentation related to the physiology and desires of the aging adult, little is known about medical practitioners' beliefs and practices regarding sexuality. Method: A 14 question survey with a comment section was developed and mailed to 269 physicians and nurse practitioners in Santa Clara County, California. The responses were evaluated using descriptive statistics. The comments received were grouped related to intent or topic. Results: There was no discernible difference between the beliefs and practices …

The Relationship Between Companion Animals And Health Status Among Older Adults Living In The Community, Agnes M. Eytchison

Master's Projects

A study was conducted on 18 older adult pet owners and non-pet owners residing in a mobile home park to determine self-perception of health status and the level of attachment to pets. Self-reported health status was high and equal for both pet owners and non-pet owners. The level of attachment to the pets was also high. Studies have demonstrated human-animal interactions being beneficial to both individuals and families; but for many residents of mobile home parks and common interest developments, such as condominiums and townhouses, rules prevent companion animal ownership. Family Nurse Practitioners (FNPs) aware of the benefits of animal …

Factors Influencing Compliance In The Treatment Of Elderly Hypertensive Vietnamese Clients, Cuong Phu Pham

Master's Projects

Little is known about health care beliefs and practices among Vietnamese elderly persons living in the United States. In general, studies of patient compliance with medical advice consistently demonstrate a high level of noncompliance. Not following recommendations can have serious negative consequences in the management of disease. The purpose of this study was to investigate compliance among a group of elderly Vietnamese clients with the plan given to them by their physicians for control of hypertension. Because the literature reports a high correlation between income and level of education with compliance in other groups, these factors were also studied as …

The Lived Experience Of Older Mexcian American Adults With Type 2, Non-Insulin Dependent Diabetes Mellitus, Lizza C. Abella

Master's Projects

Purpose: The purpose of this study was to explore the lived experience of Mexican American older adults with type 2, non-insulin dependent diabetes. Research design and results: A phenomenological research approach was used when interviewing a sample of ten English speaking Mexican American older adults in Santa Clara County, California. Three collective themes were identified: Emotions prevalent in living with diabetes, diabetes' impact on life, and cultural factors affecting diabetes self care. Discussion/conclusions/implications: A duality of thoughts and experiences in living with diabetes, and the strong influence of culture and its beliefs characterize the life-world of Mexican American non-insulin dependent …

Reducing The Potential For Falls Among Community Dwelling Older Adults, Sharon-Xiaowen Hu

Master's Projects

This research study used a pre-test and post-test design to determine if a nursing educational intervention would reduce the potential for falls among the community dwelling elderly. The participants (N=15) were: (a) age 65 or older, (b) mentally competent, (c) predisposed to falls, and (d) living independently. Four instruments were utilized to collect data: (a) the Folstein mini-mental state examination (MMSE), (b) a fall predisposition scale, (c) a home assessment checklist (Tideikaar, 1987), and (d) interview questions. Statistics were used to evaluate findings. The results show that a nursing educational intervention had a positive impact to help reduce the risk …

Depression In Immigrant Chinese-American Elders, Sandy Chen Stokes

Master's Projects

Depression in later life is a treatable mental disorder (Blazer, 1993) if it is recognized as depression. Because depressive disorders may often go unrecognized and untreated in the Chinese-American elderly population and because treatment for depression can dramatically improve the quality of these later years, correct diagnosis and intervention are vital.

The Effectiveness Of A Strength Training Program On Extremity Strength, Flexibility, And Balance Of Elderly Women, Patricia L. Murphy

Master's Projects

This quasi-experimental study, partially replicating that of Nelson and Wernick (1997), compares balance, flexibility, and extremity strength before and after an 8-week weight-bearing exercise class. Six women, aged 69 to 85, used 1-5 pound wrist weights and ankle weights up to 1 o pounds. Pre-and post-exercise measurements of biceps curls, seated leg lifts with weights, one leg stand, and seated stretches were gathered. Results showed improvement in every category, with the greatest improvement (41.6%) in balance and the least (8.3%) in trunk flexibility. Nursing is uniquely positioned to assist this population by promoting, developing, and implementing such exercise programs.

Caregiver Assessment Of Problem Behaviors In Relatives With Dementia, Barbara J. Glaze

Master's Projects

Caregivers were asked to rank the presence and difficulty of 15 specific behaviors in their relative with dementia. Results showed that in most cases, female caregivers ranked the prevalence and the difficulty of the behaviors higher than the male caregivers. In this study, caregivers experienced positive outcomes from the caregiving experience.

Identifying Polypharmacy In The Older Adult: A Survey Of Nurse Practitioners, Leslyn Ann Watson

Master's Projects

Currently 12% of the population are over the age of 65 and receive more than one third of all prescription medications. These clients are at risk for polypharmacy which defined in the current literature is greater than four or more medications taken on a daily basis (this includes prescription and over the counter (OTC) medications). Polypharmacy places a client at increased risk for adverse drug reactions which can lead to injury and death. This survey of 109 Nurse Practitioners (NPs) identified whether older adults were assessed for polypharmacy. The number of respondents was 64, or 59%. During routine history and …