Geriatric Nursing Commons^™

Addressing Obstacles In Following Prescribed Medication Regimens In Patients With Type 2 Diabetes Mellitus, Cristina Sarro

Doctor of Nursing Practice

Background. Type 2 diabetes is the ninth leading cause of death in the United States. Micro/macro vascular complications are common in diabetes. Purpose. To implement an evidence-based protocol addressing obstacles for patients with type 2 diabetes in following their prescribed medication regimens to reduce glycosylated hemoglobin levels. Evidence. Failure to follow treatment plans increases diabetes complications. Perceptions and complexities of treatment plans, side effects of therapies, and cost contribute to patients not taking their medications as prescribed. Goals. To increase the number of patients with type 2 diabetes who follow their prescribed medication regimen and reach their targeted glycosylated hemoglobin. …

Implementing A Cognitive Impairment Care Planning Toolkit To Enhance Dementia Care: A Quality Improvement Project, Raquel Garcia-Priestly

Doctor of Nursing Practice

Background: Alzheimer’s is the most expensive disease in the United States with costs reaching $277 billion a year and affecting 5.7 million Americans. By 2050, 14 million Americans will have Alzheimer’s disease and related dementias (ADRD). This burdensome disease not only affects the individual, but also those who are responsible for their care, making it extremely complex to manage. Purpose: To systematically integrate the Alzheimer’s Association’s Cognitive Impairment Care Planning Toolkit in an outpatient mental health clinic to enhance care by effectively addressing the needs of patients with ADRD and of their caregivers. Objectives: Increase the number of patients with …

A Quality Improvement Initiative To Implement The Geriatric Depression Scale In A Geriatric Inpatient Psychiatric Unit, Candice Hall

Doctor of Nursing Practice

The World Health Organization (2017) estimated that over 300 million people worldwide have depression. According to the Centers for Disease Control and Prevention (2013), 7 million Americans over 65 years old experience depression annually. The United States Preventive Health Services Task Force recommends the use of a depression screening tool in the adult population. The purpose of this evidence-based quality improvement project was to improve screening for depression in an inpatient geriatric psychiatric unit. The primary objectives included educating nursing staff on depression screening and using the geriatric depression scale (GDS) to assess patient's level of depression at admission and …

Recognizing Delirium At End Of Life In The Hospice Setting: A Process Improvement Project, Latonya Roberts

Doctor of Nursing Practice

Despite advancements in health care, hospice registered nurses and medical professionals caring for patients at end of life lack the required knowledge effectively to care for this patient population. Educational gaps contribute to deficiencies. This process improvement project aimed to increase nurses’ and medical staff’s knowledge and recognition of delirium at end of life through the use of a delirium assessment tool and evidenced-based treatment guideline when managing symptoms. Project implementation occurred at a small hospice company with a patient census of 180, utilizing 2 teams of registered nurses, medical doctors, and a nurse practitioner. A 2-hour educational session had …

Identification Of Potentially Inappropriate Medication Utilizing The Beers Criteria Among Elderly Patients, Christine B. Mitchell

Doctor of Nursing Practice

Background: The normal process of aging causes numerous physiological changes that affect pharmacodynamics and pharmacokinetics. Therefore, the geriatric population is more vulnerable to the effects of potentially inappropriate medication. The American Geriatric Society’s Beers Criteria identifies potentially inappropriate medication to be avoided for this population and can be implemented in efforts to avoid risks associated for this population.

Aim and Methods: The purpose of this project was to implement the Beers Criteria to identify potentially inappropriate medications among patients 65 years and older. The objectives were to increase the percentage of charts reviewed for inappropriate medications and to increase the …

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 …

A Quality Improvement Initiative To Increase Statin Therapy Adherence Among Patients With Diabetes Aged 65 Years And Older, Kelly Nunemaker

Doctor of Nursing Practice

The purpose of this project was to improve statin therapy adherence among diabetic patients aged 65 and older treated at a small family practice clinic in western San Antonio. Additionally, the project aimed to decrease LDL cholesterol (LDL-C) levels in this patient population as recommended to 70 mg/dl or less. Diabetic patients are more likely to die from a cardiac event than patients without diabetes. Statin therapy is an important factor in lowering cholesterol, which reduces the patient’s risk for atherosclerosis. Educating patients aged 65 and older about the role of statin therapy in preventing cardiovascular events, stroke, and vascular …

Evidence-Based Discharge Education Guidelines To Improve Adherence To Self-Care And Decrease 30-Day Readmissions For Older Heart Failure Patients, Lisette Melton

Doctor of Nursing Practice

Heart failure is a complex, debilitating, chronic disease characterized by high mortality and frequent hospital readmissions. Heart failure affects 5.7 million people in the United States with 670,000 new patients diagnosed each year. Patients are most vulnerable during the transition from the acute care setting to home. Limited patient knowledge on symptom recognition leads to detrimental outcomes for the patients; therefore, discharge education is paramount for decreasing readmissions. The national benchmark for 30-day readmission is 27%. The purpose of this quality improvement project was to improve compliance with the 2013 American Heart Association guidelines through discharge education by Telemetry staff …