Geriatric Nursing Commons^™

Medical Crises In Older People: Cohort Study Of Older People Attending Acute Medical Units, Developmental Work And Randomised Controlled Trial Of A Specialist Geriatric Medical Intervention For High-Risk Older People; Cohort Study Of Older People With Mental Health Problems Admitted To Hospital, Developmental Work And Randomised Controlled Trial Of A Specialist Medical And Mental Health Unit For General Hospital Patients With Delirium And Dementia; And Cohort Study Of Residents Of Care Homes And Interview Study Of Health-Care Provision To Residents Of Care Homes, John Gladman, Rowan Harwood, Simon Conroy, Pip Logan, Rachel Elliot, Rob Jones, Sarah Lewis, Jane Dyas, Justine Schneider, Davina Porock, Kristian Pollock, Sarah Goldberg, Judi Edmans, Adam Gordon, Lucy Bradshaw, Matthew Franklin, Katherine Whittamore, Isabella Robbins, Aidan Dunphy, Karen Spencer, Janet Darby, Lukasz Tanajewski, Vladislav Berdunov, Georgios Gkountouras, Pippa Foster, Nadia Frowd

Publications and Research

Background: This programme of research addressed shortcomings in the care of three groups of older patients: patients discharged from acute medical units (AMUs), patients with dementia and delirium admitted to general hospitals, and care home residents.

Methods: In the AMU workstream we undertook literature reviews, performed a cohort study of older people discharged from AMU (Acute Medical Unit Outcome Study; AMOS), developed an intervention (interface geriatricians) and evaluated the intervention in a randomised controlled trial (Acute Medical Unit Comprehensive Geriatric Assessment Intervention Study; AMIGOS). In the second workstream we undertook a cohort study of older people with mental health problems …

Prevention Of Alzheimer's Disease: The Roles Of Nutrition And Primary Care, Connie Cole Dnp, Rn-Bc, Np-C

Connie Cole

No abstract provided.

Clinical Effectiveness Of Inr Patient Self-Testing: Adults On Warfarin Therapy In Private Practice, Anisa Munshi

Doctor of Nursing Practice Final Manuscripts

Background: Warfarin is the most commonly prescribed oral anticoagulant for the prevention and treatment of venous thromboembolism. Due to its narrow therapeutic index, warfarin requires close monitoring of the international normalized ratio (INR) to ensure proper anticoagulation control and safety. INRs outside of this range are strongly associated with an increased risk of major bleeding, thromboembolic events, and death. Patient self-testing (PST) using a point-of-care device allows patients to monitor INR results at home. Evidence shows that PST improves the clinical outcomes of warfarin therapy compared to usual care, which includes laboratory INR monitoring. Purpose: To compare the clinical effectiveness …

The Effects Of 12 Weeks Of Instructor-Led Yoga Classes On Balance In Older Adults, Patricia C. Hart

Evidence-Based Practice Project Reports

Participation in a regular exercise program is an effective way to reduce and/or prevent a number of functional declines associated with aging (Chodzko-Zajo et al., 2009). Older adults are advised to participate in regular aerobic activity and practice muscle strengthening activities and exercise that maintains or improves balance (U.S. Department of Health and Human Service, [USDHHS], 2012). Less than one third of older adults engage in 30 minutes of low to moderate intense physical activity at least five days a week as recommended in current guidelines (USDHHS, 2012), and these guidelines fail to address losses in strength and flexibility seen …

Barriers To Music Therapy In The Care Of Those With Alzheimer's/Dementia, Karin E. Kvam

Honors College Theses

This pilot study examines the barriers caregivers encounter when implementing music therapy in the care of those with Alzheimer’s/dementia. An 8-question survey was distributed at two long-term care facilities and an Alzheimer’s support group to understand how often and in what ways music therapy is utilized, as well as what barriers caregivers face when using the therapy. Results indicated that, although the majority of caregivers report using music therapy, it is not implemented as frequently as it could or should be. Caregivers report a knowledge deficit as the main reason for not implementing music therapy. The data suggests that an …

Exploring The Transition From Hospital To Home In The Older Adult Population, Sharon Coffey

Research Horizons Day Posters

No abstract provided.

The Meaning Of Patient-Nurse Interaction For Older Hospitalized Women: A Phenomenological Study, Deborah Mize

Doctor of Education (EdD)

The purpose of this dissertation is was to explore how older women perceived their interactions with nurses after receiving care in a hospital setting. Older women are a vulnerable population subject to being overlooked or misunderstood by the nurses caring for them, hence the importance of this study. To gather the data on older women’s lived world of nursing care, I used a phenomenological approach based on a hermeneutic framework that considers linguistic, historical, and social factors to interpret older women’s lived world of nursing care while hospitalized. I personally interviewed seven women between the ages of 66 and 81 …

Student Perspectives Of Service Learning With Older Adults, Karen Brown, Carol Bashford

Karen Brown

The presenters will describe the findings of a mixed-methods research study designed to explore students’ perspectives of skills and knowledge gained through engaging with older adults with physical and/or cognitive limitations living in a continuing care retirement community (CCRC). Participants in the study included students enrolled as juniors and seniors in a baccalaureate nursing program. Community partnerships with several CCRCs provided the opportunities for students to interact with elders. During the service-learning course, students developed and implemented evidence-based health promotion activities directed towards enhancing the elders’ cognitive, physical, and psychosocial functioning. Additionally, students were paired, one-to-one, with an elder-partner in …

The Relationship Between Hearing Status And Cognitive Performance And The Influence Of Depressive Symptoms In The Older Adult, Julie A. Daugherty

USF Tampa Graduate Theses and Dissertations

Hearing loss and cognitive impairment are significant health problems, threatening the independent function of older adults. While there appears to be a strong relationship between the two conditions, the mechanisms underlying this association are complex and are not fully elucidated.

The purpose of this secondary analysis was to explore the relationship between hearing ability and cognitive performance in older adults. In addition, this study attempted to examine the role of depressive symptoms in the relationship between hearing loss and cognitive performance. Comprehensive measures of peripheral hearing, central auditory processing and cognitive performance were utilized to examine these relationships in a …

Search Strategies Used By Older Adults In A Virtual Reality Place Learning Task, Rebecca L. Davis, Catherine Weisbeck

Peer Reviewed Articles

Purpose of the study: Older adults often have problems finding their way in novel environments such as senior living residences and hospitals. The purpose of this study was to examine the types of self-reported search strategies and cues that older adults use to find their way in a virtual maze

Design and Methods: Healthy, independently living older adults (n = 129) aged 55–96 were tested in a virtual maze task over a period of 3 days in which they had to repeatedly find their way to a specified goal. They were interviewed about their strategies on days 1 and 3. …

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 …

The Effect Of Art Therapy On Hospice And Palliative Caregivers, Carol E. Gress

Nursing Theses and Capstone Projects

A quazi-experimental, one-group, pretest/posttest study was conducted with a group of 25 hospice workers employed by a medium sized county hospice organization in the southeastern United States that was experiencing rapid personnel turn-over. Participants in the study included a doctor, a physician’s assistant, a nurse practitioner, a massage therapist, a grief counselor, a licensed practical nurse, a certified nursing assistant, two clergy, three administrative staff, three social workers, seven volunteers, eight registered nurses and one other. The purpose was to investigate whether attending four 1-hour art therapy sessions could help reduce stress and thereby Burnout. Stamm’s (2010) Professional Quality of …

Early Intervention Of Non-Invasive Positive Pressure Ventilation In Elderly Patients With Rib Fractures, Jaclyn Gosnell

Nursing Theses and Capstone Projects

Rib fractures in the elderly population, 65 years and older, is more prevalent than any other population. Mortality increases with each year over the age of 65 and with each number of ribs fractured. Rib fractures are painful and can lead to a decreased respiratory effort. This results in complications such as pneumonia, respiratory depression, respiratory failure, Acute Respiratory Distress Syndrome (ARDS), and respiratory infections. Non-Invasive Positive Pressure Ventilation (NIPPV) assists with reducing the patient efforts to breathe while also ensuring spontaneous lung expansion. NIPPV can assist with promoting positive outcomes in patients with respiratory complications. The purpose of this …

Rural Healthcare Providers' Behavioral Intentions With Hospice Referrals: Attitudes, Knowledge, Beliefs, Benefits And Barriers, Meki Jacobs Graham

Nursing Theses and Capstone Projects

As hospice programs gain recognition, hospice referrals are gaining momentum. Yet for multiple reasons hospice referrals are challenging amongst rural healthcare providers (HCPs). For rural healthcare providers, lack of knowledge about hospice services and care contributes to a decrease in hospice referrals. The purpose of this capstone project was to develop an intervention to improve rural health care providers' behavioral intention to make hospice referral. The study sought to determine if an educational intervention would improve behavioral intentions to make a hospice referral resulting in increased hospice referral rates. Outcome data was based on utilizing a pretest/posttest survey design. An …

Polypharmacy Practice Inquiry Project, Mary T. Skinner

DNP Projects

“The impending crisis, which has been foreseen for decades, is now upon us.The nation needs to act now to prepare the health care workforce to meet the care needs of older adults.” Institute of Medicine.

Given the rising tide of people over the age of 65, taking multiple medications or polypharmacy is a becoming more prevalent in older adults. Unfortunately, there are many negative consequences associated with polypharmacy. Specifically, this burden has been associated with greater health care costs and an increased risk of adverse drug events, drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes including cognitive impairment. …

Delirium Screening Instrument Knowledge And Perception Among Cardiovascular Intensive Care Nurses, Brittany Lynn Dahl

DNP Projects

Background: Delirium is a serious condition that affects critically ill adult patients in the intensive care unit. Bedside nursing delirium measurements are considered a dependable source of information that can be used for clinical decision-making. Nurse education and assessment of perceptions is important when building a framework for successful delirium assessment. However, few data exist about nursing perceptions and practices associated with delirium screening instruments. The overall purpose of this project is to examine nurse perceptions and knowledge about delirium and delirium screening instruments at the University of Kentucky (UK) Hospital’s Cardiovascular Intensive Care Unit (CVICU).

Objectives: The aims of …

Perception And Use Of Communication Care Plans By Certified Nursing Assistants In Nursing Homes: The Role Of Professional Support, Christen G. Page

Theses and Dissertations--Rehabilitation Sciences

The majority of individuals in nursing homes have cognitive-communication impairments which impact quality of care because direct care providers, certified nursing assistants, (CNAs) are unsure how to respond to resident’s communication behaviors. One intervention that facilitates staff-resident communication in nursing homes is communication plans; however, the research to date about communication plans has not specifically involved CNAs.

The purpose of this study, using a grounded theory qualitative approach, was to describe development, implementation and evaluation of communication care plans (CCPs) for residents with cognitive-communication impairments in nursing homes by CNAs who did and did not receive professional support. Communication care …

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Use Of Bed/Chair Alarms In Skilled Nursing Facilities For Reduction Of Patient Falls, Nicole Werner, Juliana Wilson

Nursing Student Work

No abstract provided.

Music Therapy Effects On Dementia, Aimee Fernback, Amy Shubert

Nursing Student Work

No abstract provided.