Geriatric Nursing Commons^™

Rounding With A Purpose: Reducing Falls In Geriatrics Residing In A Community Living Center, Ashley Wesson

Student Scholarly Projects

Practice Problem: Falls among geriatrics continue to be a significant concern for healthcare organizations and one of the costliest healthcare problems attributed to increased morbidity and mortality rates. Falls rates in residential dwellings such as nursing homes and community living centers (CLCs) continue to rise despite fall prevention efforts.

PICOT: The PICOT question that guided this project was In geriatrics, age 65 or older, who reside in the Community Living Center (P), how does one-hour purposeful rounding (I), compared to rounding without structured set time intervals (C), affect fall reduction rates (O), within eight weeks (T)?

Evidence: In fifteen high-quality …

Do-Not-Hospitalize Orders In Assisted Living Facilities: Perspectives From Direct Care Workers, Alanna Kates Dancis Dr.

Doctor of Nursing Practice Scholarly Projects

Context: Do-not-hospitalize (DNH) orders in assisted living facilities (ALFs) are often misunderstood, ignored, or countermanded by direct care workers (DCWs), potentially leading to residents being sent to the hospital against their wishes.

Objectives: The primary purpose of this study was to gather sufficient qualitative data to create an intervention that would help prevent DCWs from sending residents with DNH orders to the hospital against their wishes. To accomplish this goal, the study centered on three research objectives: 1) to understand more fully how DCWs interpret DNH orders; 2) to determine if carrying out DNH orders causes moral distress for DCWs; …

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Implementation Of Cocare Help, Kara Marie Roman, Aaron Mestemaker

Culminating Experience Projects

Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and …

Improving Identification Of Seniors At Risk Tool Adherence To Identify Emergency Department Readmissions In Older Adults, Joy Gao

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project (EBP) is to improve the emergency department (E.D.) staff adherence in completing the Identifying Seniors at Risk (ISAR) screening tool. The specific aim is to improve electronic health record (EHR) data collection to enhance the identification of older adults that are frequent utilizers of the E.D. at a local community hospital in Southern California. Based upon the most recent National Hospital Ambulatory Medical Care Survey, patients ages 65 and older make up 32% of all E.D. admissions. These patients also represent 50% of the moderate to severely ill patients seen in the E.D. …

Compliance In Fall Prevention In Dementia Vs Non-Dementia Nursing Home Units, Garima Shrestha

Merge

The student nurse researcher performed a research study to determine if there was a difference in the compliance of fall prevention interventions between dementia and non-dementia nursing home units. The student nurse researcher hypothesized the dementia nursing home units would be more compliant with fall prevention interventions than the non-dementia nursing home units. In contrast, the null hypothesis stated there would be no statistically significant difference in the compliance of fall prevention interventions between the dementia and the non-dementia nursing home units. The Fall Prevention Intervention Checklist was used to assess environmental fall hazards in occupied resident rooms. Of the …

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 …

Correlation Between Myostatin And Lean Muscle Mass In Older Adults, Mishann Luedders

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Correlation Between Myostatin and Lean Muscle Mass in Older Adults.

Luedders, M., Gray, M., Patton, S., Washington, T., Binns, A. Exercise Science Research Center, University of Arkansas, Fayetteville, AR.

Background: Our older adult population is growing exponentially and with it, the number of falls and debilitating injuries that afflict their population grows as well. A fall brings with it many possible injuries, healthcare costs, fear and increased mortality. There seems to be a lack of preventative measures in our healthcare system to help protect our elders. One possible measure is a simple blood test that looks at the level of …

The Relationship Between Fall Rates And Fall Risk Inducing Drugs In Older Adult Patients In The Hospital Setting, Kristen Eldridge, Susan Kane Patton

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The aim of this study was to analyze the risk of falls relative to the use of fall risk inducing drugs (FRIDs) among older adult patients admitted to the hospital setting. Quality improvement of nursing fall risk assessment was of special interest. To analyze this a retroactive review of fall incident reports was conducted in collaboration with the study hospital’s risk manager. Medications were correlated with injuries sustained to identify high risk FRIDs. The selected study population consisted of 166 patients over the age of 65 who fell on the acute care campus of a hospital in the mid-south region …

The Relationship Between Community Dwelling Older Adult’S Fall Risk And Beliefs Of Risk For Falling In Northwest Arkansas And Bolgatanga, Ghana., Natalie Gohman

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Title: The Relationship Between Community Dwelling Older Adult’s Fall Risk and Beliefs of Risk for Falling in Northwest Arkansas and Bolgatanga, Ghana.

Gohman, N., Patton, S., Smith-Blair, N., Agana, C.: University of Arkansas, Fayetteville, AR

Background: Older adults worldwide live with comorbidities, physical and psychological changes associated with aging. Statistically, however, older adults are more likely to die as a result of falling. As the worldwide population of individuals over 65 rises, so will the possibility for injuries from falls. Much research has been published concerning fall risk prevention, but minimal research surrounding protocols and practices for protecting against falls …

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 …

Geriatric Trauma Patients In The Emergency Department: Length Of Stay, Intensity Of Care, And Post Ed Destination", Elanor Gates, Doris Warner, Meg Bourbonniere, Patricia Williams

Department of Nursing papers and presentations

Background & Purpose: Research on emergency department length of stay (EDLOS) suggests that increased LOS may result in worse patient outcomes and increased overall LOS. Additional research suggests that increased age may not only result in lower intensity of care for some patients but might also increase EDLOS. For geriatric trauma patients, intensity of care and EDLOS may be different from non-geriatric patients. Given the nature of geriatric traumatic injury, it is important to understand if improvements can be made in geriatric trauma services.

Study/Project Design: A retrospective descriptive study utilizing the hospital’s trauma registry data was completed, including patient …

Sensitizing Students To Functional Limitations In The Elderly: An Aging Simulation, Sherry Allen, Viki Lorraine, Anne Lockett, Carolyn M. Rutledge

Nursing Faculty Publications

Background and Objectives: Using activities of daily living (ADLs) and instrumental activities of daily living (IADLs) as a focus, faculty at Eastern Virginia Medical School provide an aging simulation exercise for a mandatory fouth-year clerkship in geriatrics. The specific aims of the simulation are to 1) experience the physical frailties of aging, 2) develop creative problem-solving techniques, 3) identify feelings regarding the experience of functional loss, and 4) develop proactive clinical approaches to the care of the elderly.

Methods: Students are assigned one of four diagnoses (Parkinson's disease, rheumatoid arthritis, advanced diabetes, or stroke) and are then impaired to simulate …