Geriatric Nursing Commons^™

Implementation Of Cognitive Testing Via Video-Telemedicine, Lindsay Mills Holland, Rosemary Dale, Mary Val Palumbo

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Early diagnosis and timely follow-up of cognitive decline are essential to preserve individual function and memory, improve quality of life, and decrease healthcare costs. Many barriers to in-person assessment exist, the most recent one being COVID-19. Video-telemedicine has been studied as a solution with promising results. Most notably, research shows that the Mini Mental State Examination (MMSE) administered via video-telemedicine has comparable results to in-person assessment.

Purpose: The purpose of this project was to implement cognitive testing via video-telemedicine for follow-up management of cognitive impairment and dementia.

Methods: A protocol for conducting the MMSE via Zoom was developed. Next, …

Improving Recognition Of Delirium In Elderly Patients Hospitalized For Hip Fracture, Jennifer Synnott, Mary Val Palumbo

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background:

Delirium is a frequent, yet often under recognized, condition affecting elderly patients hospitalized with hip fracture. In the literature, delirium rates vary for this population.

Objective:

This project aimed to determine the delirium rate in elderly patients hospitalized for femur fracture and improve recognition through use of a screening tool at an academic medical center.

Methods:

The pre-intervention delirium rate in elderly hip fracture patients was determined via retrospective chart review with a validated instrument for patients hospitalized during a 3-month window. To improve delirium recognition, nurses completed training covering delirium and using the Confusion Assessment Method (CAM), a …

A National Dementia Care Pathway Explored, Mary Val Palumbo, Betty Rambur, Lori P. Mckenna

College of Nursing and Health Sciences Faculty Publications

Background: A national, systematic diagnosis and care pathway has the potential to alleviate pressing challenges experienced by individuals with dementia, their carers, and healthcare providers. International exemplars were sought to compare/contrast dementia care with current practice in the United States (US). The 2013 New Zealand (NZ) Framework for Dementia Care was explored. The aim was to understand this systematic, primary care-led, home- and community-focused dementia management approach from the perspective of those delivering care. Providers in one US state were similarly studied.

Method: Maximum variation purposive sampling was used in this qualitative descriptive study of 28 participants (18 New Zealand, …

Screening For Palliative Care Services In An Assisted Living Facility, Maria Delia Crosby

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Palliative care services remain under-utilized, even as evidence suggests that early palliative care leads to positive health outcomes, reduced ED visits, and substantial cost savings. Barriers include a lack of knowledge of palliative care services in the community, and under-utilization of validated assessment tools, including a symptom checklist. Aims of this project: 1. To determine whether the integration of validated community-based palliative care screening tool in an assisted living setting will identify older adults with unmet palliative care needs. 2. To determine if tool implementation could lead to a referral for palliative care consultation.

Methods: A screening tool developed …

Evidence Based Treatment For Excessive Alcohol Consumption And Concurrent Hypertension, Kimberly Ann Ward

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose. Excessive alcohol consumption is a preventable risk factor for hypertension, heart disease, and stroke. Though alcohol-related deaths number 88,000 annually in the U.S., alcohol use has the lowest treatment rate of behavioral health disorders at 10%. Excessive alcohol consumption may compromise treatment of hypertension by primary care providers (PCP). This project aims to increase awareness of the hypertension and excessive alcohol use connection and promote screening of alcohol consumption.

Methods A protocol for improving alcohol screening and concurrent hypertension management was developed including: in-person educational presentations; patient education materials; and the use of motivational interviewing. Practice change was assessed …

Impact Of An Ehr-Based Tool On Copd Management In Primary Care, Nancy Ann C. Kelly Rn

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: GOLD (2017) guidelines provide evidence based recommendations for treating COPD, although their employment in clinical practice is inconsistent. Lack of a standardized method to view COPD specific information within the EHR during patient encounters complicates visits and development of GOLD-guided treatment plans. Our goal is to determine the impact of an EHR-based tool on relevant COPD disease measurements (spirometry rates, pneumococcal vaccination rates and COPD Action plans)

Methods: An EHR-based tool (SmartPhrase) was developed and released to providers to facilitate GOLD(2017) guideline reference during patient encounters. Computer based instructional videos of GOLD (2017) guidelines and EHR-based tool …

Improving Palliative Care Management In The Nursing Home Setting: An Interprofessional Approach, Nicholas Adam Fredette

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Purpose: Current projections indicate that the number of individuals age 65 and older throughout the U.S. will reach nearly 88 million by 2050, nearly double current estimates. With the increase in older adults, an increase in persons with chronic illness requiring nursing home care is also sure to rise. Currently, roughly 1.4 million adults reside in certified nursing facilities throughout the U.S. while nearly 25% of older adults die within this setting. Palliative care, an approach aimed at improving the quality of life of patients facing life-threatening illness is one strategy utilized to help manage this population. As the quality …

Physical Activity And Fall Prevention In Older Adults, An Educational Intervention, Caleb Daniel Knight

Family Medicine Clerkship Student Projects

Falls in adults over 65 years of age constitute a significant health burden in our country, and this age group is growing rapidly. Falls are addressed with a multifactorial approach, addressing comorbidities, medications, and the physical environment, however, an effective point of intervention accessible by most older adults is physical activity. A brief educational presentation about the morbidity and mortality associated with falls, and the protective effects of physical activity, was provided to Meadowbrook Healthcare subacute nursing home residents in Plattsburgh, NY. Questions were encouraged and answered afterwards, and copies of the presentation were left for the residents to review …

Interprofessional Care Of Elders: Utilizing The Virtual Learning Environment, Mary Val Palumbo, Jennie De Gagne

College of Nursing and Health Sciences Faculty Publications

Background: Video conferencing and a virtual environment was used for teaching interprofessional practice (IPP) when caring for the elderly with students from eight healthcare professions. Is this pedagogy perceived as effective by the students in Interprofessional Competency Domains¹?

Methods: Twenty interprofessional conferences (90 minutes in length) were conducted. Students from nursing, physical therapy, speech and language therapy, social work, nutrition, medicine, exercise science, and pharmacy collaboratively developed a plan of care for a frail elder.

Using the Interprofessional Competency Domains¹, an evaluation survey was developed which included 14 Likert-scaled, five open-ended, and demographic questions. Quantitative data …