Geriatric Nursing Commons^™

End-Of-Life Care And The Use Of An Integrated Care Pathway, Marianne Brattgjerd, Rose Mari Olsen, Inger Jorun Danielsen

The Qualitative Report

Liverpool Care Pathway is an integrated care pathway (ICP) designed to ensure the provision of high-quality end-of-life care. However, the ICP has come under substantial criticism, suggesting that its use is related to poor care. This study explores nurses’ use of the ICP to dying patients in Norwegian nursing homes. We conducted a qualitative study using an abductive, mystery-focused method to analyze the experiences of 12 registered nurses. Our findings show that the nurses experienced the ICP as a very useful tool in end-of-life care, although they were actually working independently of the ICP in the provision of ongoing bedside …

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 …

Age And Functional Outcomes Post-Neurologic Insult In Patients Attending Inpatient Rehabilitation, Jonathan Bowman Spt, Elena Crooks Pt, Dpt, Phd, Doug Weeks Phd, Kimberly Honn Phd

2020 Symposium Posters

Introduction

Neurologic insults such as strokes and traumatic brain injuries (TBI) affect over 1 million Americans every year. The lack of current knowledge informing accurate prognoses causes victims and their loved ones distress, and is a focus of much research. The purpose of this study was to determine whether patient age at time of insult could predict change in functional outcomes during inpatient rehabilitation.

Methods

Subjects were patients of an inpatient rehabilitation facility (IRF) post-stroke or TBI. The Functional Independence Measure (FIM) assessed functional independence and cognitive status at admission and discharge from the IRF. The Montebello Rehabilitation Factor Score …

Increasing Health Literacy Through Noteaid Translational Tool In Nursing, Liz Catherine S. Cory

Doctor of Nursing Practice (DNP) Projects

Background: Many adults in the United States lack health literacy necessary to understand patient education materials given to them, such as discharge summary. Re-hospitalization rates are higher due to poor transition of care planning. Older adults may only be provided with written instruction for their complex chronic conditions with multiple changes in medical or treatment plan, or uncommon surgical procedures. Nurses are instrumental in bridging the gap, as they often educate, advocate, and use health technology.

Purpose: To educate nurses on the availability of NoteAid as a natural language translation system that can help increase their comprehension of electronic health …

In Beers We Trust: Using Deprescribing Tools To Reduce Inappropriate Polypharmacy In Adults Age ≥ 65, Angelica Ferrazzi

Doctor of Nursing Practice (DNP) Projects

Background: Adverse drug events (ADEs) are a significant cause of morbidity and mortality in older adults (age ≥ 65). Polypharmacy and potentially inappropriate medications (PIMs) are especially prevalent in this population and are a notable contributing risk factor for ADEs. Research demonstrates that comprehensive medication reconciliation that includes evaluation of both the risks and benefits of medications, in conjunction with deprescribing practices, can reduce PIMs; therefore, reducing ADEs.

Purpose: The aim of this quality improvement project was to empower clinicians to deprescribe current medications that are inappropriate, as well as reduce the rate of newly prescribed PIMs among patients age …

Engaging Patients With Dementia In The Acute Care Setting: A Quality Improvement Initiative For Staff, Andrea Lee

DNP Scholarly Projects

Caring for dementia patients in the acute care setting can be challenging. Staff is trained to manage the acute illness and the symptoms of dementia can impact that care. Training for the care and management of the patient with dementia is not routinely provided for the acute care setting. According to the Alzheimer’s Association (2018), 5.7 million people are living with Alzheimer’s Dementia with the numbers projected to continue to rise. Training in the management of symptoms can alleviate stress and complications for not only the patient but staff members as well. The goal of this project is to educate …

A Modified Screening Tool To Evaluate Risk Of Unanticipated Return Visits To The Emergency Department In The Geriatric Population, Tabitha Riley

DNP Projects

Purpose: To compare the Modified Screening Tool for Identifying at Risk Seniors (mSTIRS) against the Triage Risk Screening Tool (TRST) and the Identification of Seniors at Risk (ISAR) for predictive value and assess the relationship between presenting complaint with unanticipated return visit (URV) occurrence in geriatric patients.

Design: A prospective, observational study conducted at a large academic medical center. Descriptive statistics and psychometric analyses were used to analyze the association between demographics, clinical data, and to evaluate the modified screening tool.

Methods: 38 geriatric participants in the Emergency Department (ED) were enrolled and 21 completed the study. The screening tools …

Device Related Concerns Pertaining To Primary Caregivers Of Lvad Patients, Nicole Smith, Carissa Smith

DNP Projects

Abstract

PURPOSE: The purpose of this project was to focus on caregiver education with an emphasis on caregiver concerns regarding the LVAD; additionally, evaluating the efficacy of an educational video acknowledging those device-related concerns identified by caregivers. The goal of this project is to improve caregiver knowledge and decrease the rate of device related concerns among the primary caregivers.

METHODS: This project is a single center cross-sectional, pre-post-test implementation design to determine the efficacy of device related concerns education on primary caregivers’ knowledge and concerns. A 16-point device related concerns scale was designed to appraise primary caregiver concerns. The scale …

Creating Restful Environments: Applying Evidenced-Based Interventions To Increase The Patients Perceptions Of Room Quietness At Night, Timothy Marks

West Chester University Doctoral Projects

Florence Nightingale first described the detrimental effects of noise on patients as an element nurses could control. Hospitalized patients who sleep in the hospital are at risk for poor periods of rest from unwanted noise in the care environment. This Doctor of Nursing Practice Project will assess interventions aimed at increasing the patient’s perception of quietness around the care environment at night for a pilot population. Swanson’s Theory of Caring will be utilized as a framework for the project. Outcomes of nursing interventions were reviewed for the improved patient perception of the care environment at night and resultant health outcomes. …