scholarly journals Nurse Practitioner’s Clinical Triggers for Referral to Other 3D Team Members

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 745-745
Author(s):  
Shawn Ladda
Keyword(s):  
Older Adults ◽  
Community Health ◽  
Nurse Practitioners ◽  
Physical Therapists ◽  
Exercise Program ◽  
Health Educator ◽  
Problem Solving Therapy ◽  
Team Members ◽  
Resource Information ◽  
Registered Dietician

Abstract This presentation features how 3D Team nurse practitioners (NP) use results of clinical assessments to determine whether older adults and caregivers enrolled in the study are referred to other Team members; these assessment results are called “clinical triggers”. Other team members who receive referrals based on NP-generated clinical triggers include: Licensed Clinical Social Workers, who deliver Problem Solving Therapy to older adults with significant depressive symptoms; Occupational Therapists, who deliver an evidence-based dementia care intervention; Physical Therapists, who deliver an adapted Otago exercise program; Registered Dietician, who provides nutrition and dietary instruction; and Community Health Educator, who provides community resource information to address social determinants of health. All clinical triggers will be detailed in this presentation, along with a description of each intervention delivered by other team members except the Community Health Educator. Case studies will be presented to illustrate how study participants receive multiple interventions from the 3D Team.

scholarly journals Community Health Educator’s Role on the 3D Team

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 745-745
Author(s):  
Alba Santiago
Keyword(s):  
Community Health ◽  
Nurse Practitioners ◽  
Community Resources ◽  
Community Resource ◽  
Health Educator ◽  
Team Care ◽  
Linguistic Barriers ◽  
Types Of Information ◽  
Study Participants ◽  
To Receive

Abstract As a member of the 3D Team, the bilingual, bicultural Community Health Educator (CHE) addresses needs expressed by study participants related to social determinants of health. Clinical triggers generated by nurse practitioners (NPs) that lead to CHE referral include: social isolation and loneliness; lack of transportation access; lack of resources to sustain nutritional adequacy, purchase medications, and purchase assistive devices; and cultural and linguistic barriers that lead to lack of knowledge about community resources. To date, 50% of study participants randomized to receive 3D Team care have triggered referral to the CHE. In this presentation, the team CHE will provide details on the frequency of different needs expressed by study participants, how she utilizes an ever-growing community resource directory, and specific types of information and guidance she provides to address their expressed needs. Case studies will help illustrate ways in which CHE services have successfully provided assistance to study participants.

scholarly journals QOL-48. INTERDISCIPLINARY SPIRITUAL CARE TRAINING IN PEDIATRIC NEURO-ONCOLOGY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii439-iii440
Author(s):  
Alex Lion ◽  
Saneta Maiko ◽  
Csaba Szilagyi ◽  
James Slaven ◽  
Christina Puchalski
Keyword(s):  
Nurse Practitioners ◽  
Spiritual Care ◽  
Cancer Biology ◽  
Physical Therapists ◽  
Pediatric Brain Tumors ◽  
Child Life ◽  
Team Members ◽  
Train The Trainer ◽  
Before And After ◽  
Key Barrier

Abstract INTRODUCTION Pediatric neuro-oncology requires attention to not only cancer biology and therapeutics, but also to the suffering of the patient. In addressing patient suffering, consensus guidelines direct attention to the spiritual distress and resources of patients and families. A lack of training has been a key barrier to integrating this aspect of health into patient care. METHODS A neuro-oncologist and a chaplain participated in a train the trainer for the Interprofessional Spiritual Care Education Curriculum (ISPEC) through the George Washington University’s Institute for Spirituality and Health. After the train the trainer, the online curriculum was offered to interdepartmental team members, combined with in-person discussion groups, which met weekly for six sessions. A survey was given before and after the training, and Likert scores were analyzed using the Wilcoxon rank-sum non-parametric test. OUTCOMES: 17 interdisciplinary members participated in the training. These members included neuro-oncologists, neuro-surgeons, rehabilitation physicians, nurse practitioners, nurses, physical therapists, music therapists, a child life specialist, a school liaison, and a patient experience specialist. The training resulted in multiple improvements, including increased ability to identify spiritual issues (p=.0278) and increased ability to respond to these issues (p=.0056). CONCLUSION ISPEC addressed a key barrier to providing generalist spiritual care to patients with pediatric brain tumors. Diverse disciplines were represented during the training. With implementation of interdisciplinary spiritual care, outcomes that may be measured in the future include improved quality of life, patient satisfaction, and the resilience of both patients and team members.

A Multidimensional Exercise Program in the Home for Older Adults Designed to Improve Function

2019 ◽  
Vol 31 (3) ◽  
pp. 147-154
Author(s):  
Susan L. Whitney ◽  
Jennifer Ellis ◽  
Laurie Otis ◽  
Gregory Marchetti
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Functional Outcomes ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Exercise Program ◽  
Group Differences ◽  
Score Change ◽  
Physical Therapist Assistants ◽  
Information Set

The purpose of this study was to determine whether there was difference in the OASIS (Outcome and Assessment Information Set) activities of daily living (ADL) items scores between the Safe Strides program and Safe Strides plus Zōntago program. Eight home care offices were selected for this prospective randomized quality improvement study where Safe Strides versus Safe Strides plus Zōntago were compared. Rehabilitation outcome OASIS ADL change scores were analyzed for 112 total patient care episodes. The Safe Strides + Zōntago mean total ADL score change and ADL change per visit were higher than the Safe Strides group. Differences in ADL outcomes in older adults undergoing home care provided by physical therapists and physical therapist assistants in the Safe Strides exercise program versus the Safe Strides plus Zōntago program were noted. The Safe Strides + Zōntago compared with Safe Strides alone improved patient functional outcomes as measured by the OASIS.

scholarly journals Referral Processes and Dispositions in a Multidisciplinary Team for Older Adults With Cognitive Vulnerability

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 326-326
Author(s):  
Richard Fortinsky ◽  
Kristen Annis-Brayne ◽  
Marie Smith ◽  
Kathleen Obuchon ◽  
Julie Robison ◽  
...  
Keyword(s):  
Older Adults ◽  
Nurse Practitioners ◽  
Multidisciplinary Team ◽  
Cognitive Vulnerability ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Multidisciplinary Teams ◽  
Referral Patterns ◽  
Team Members ◽  
Team Care

Abstract Multidisciplinary team care for community-dwelling older adults with multiple chronic conditions has proven value. Older adults receiving team care experience better outcomes than by solo practitioners alone, and teams are being established as outgrowths of primary care and other clinical settings. Yet little is known about the inner workings of multidisciplinary teams, both in terms of how referral patterns among team members are established and the extent to which older adults and their families accept referrals from team leaders to other clinical disciplines within teams. In this presentation, we provide details about referral patterns and rates of acceptance by study participants in an ongoing clinical trial testing a multidisciplinary team designed to provide care management to older adults (age >65) with cognitive vulnerability due to dementia, depression, and/or delirium (3D Team). Nurse practitioners lead the 3D Team, conduct in-home clinical assessments and make referrals to other team members based on study protocols specifying participants’ eligibility for each 3D Team member. Results are based on the first 209 older adults randomized to the 3D Team. Pharmacist: all 209 members accepted having their medications reviewed and reconciled. Registered Dietician: of 134 referrals, 52 (38.8%) accepted. Occupational Therapist, of 117 referrals, 65 (55.6%) accepted. Physical Therapist: of 109 referrals, 92 (84.4%) accepted. Community Health Educator: of 106 referrals, 101 (95%) accepted. LCSW for depression-related problem solving therapy: of 76 referrals, 55 (72.4%) accepted. Criteria for referrals and interpretations of variations in referral acceptance rates by older adults and their families will be discussed.

Community health worker interventions for older adults with complex health needs: A systematic review

2021 ◽  
Author(s):  
Meaghan A. Kennedy ◽  
Kayla E. Hatchell ◽  
Peter R. DiMilia ◽  
Stephanie M. Kelly ◽  
Heather B. Blunt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Health Needs

scholarly journals Comparison of the caregivers’ and community health professionals’ views on home health care services for disabled older adults: a cross-sectional study in Beijing, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojingyuan Xu ◽  
Chunyan Zhao ◽  
Meirong Wang ◽  
Xiaolei Chen ◽  
Shuang Shao ◽  
...  
Keyword(s):  
Older Adults ◽  
Community Health ◽  
Home Health Care ◽  
Health Professionals ◽  
Home Nursing ◽  
Cross Sectional ◽  
Guidance Services ◽  
Nursing Services ◽  
Beijing China ◽  
Health Guidance

Abstract Background In an era of an increasingly ageing society, part of healthcare for older adults can be provided in patients’ homes, and the need for home health care services (HHCSs) is increasing. This study sought to determine whether a gap exists between the views of community health professionals and the caregivers of disabled older adults towards HHCSs in Beijing, China. Methods A cross-sectional study with two comparative questionnaire surveys was conducted in Beijing, China. One survey was administered to the caregivers of disabled older adults, and the other was administered to health professionals in community health service institutions (CHSIs). T-tests and Wilcoxon signed-rank tests were used to explore potential differences between the views of caregivers and community health professionals towards HHCSs. Results We received 370 valid questionnaires from caregivers and 224 questionnaires from health professionals. Of the 370 caregivers, 314 (84.9%) were willing to apply for HHCSs for the older adults, but only 20.5% (N = 76) received HHCSs. Over 80% of the caregivers accepted out-of-pocket costs less than 100 yuan per visit. Caregivers’ demands on home nursing services were significantly higher than those of health guidance services (Z = − 7.725, P < 0.001). Most of the 224 health professionals chose “health professionals’ personal safety cannot be guaranteed” as a problem limiting the provision of HHCSs (N = 151, 40.8%). The health professionals’ attitudes towards home nursing services were significantly less positive than those towards health guidance services (Z = − 10.081, P < 0.001). For home nursing services, health professionals’ attitude scores were lower than the caregivers’ demand scores (Z = − 4.960, P < 0.001), while for health guidance services, health professionals’ attitude scores were higher than the caregivers’ demand scores (Z = − 8.373, P < 0.001). Conclusions Gaps exist between the views of caregivers and health professionals on HHCSs. Compared to health professionals with a higher willingness to provide health guidance services, caregivers need home nursing services. Feasible policies should be implemented to safeguard the rights and interests of health professionals, and qualified health professionals should be trained for HHCSs.

scholarly journals Innovative Approaches to Inclusive Design for Technology to Support Aging With Disability: Examples From TechSAge

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 599-599
Author(s):  
Tracy Mitzner ◽  
Anne Ordway
Keyword(s):  
Older Adults ◽  
Research And Development ◽  
Health Management ◽  
Exercise Program ◽  
Target Population ◽  
Interview Study ◽  
Inclusive Design ◽  
Adults With Disabilities ◽  
Engineering Research ◽  
Expert Interview

Abstract Technology research and development often exclude older adults with disabilities from participating in the design process. As a result, technologies may not be useful or usable by older adults with diverse abilities. This symposium, featuring projects at the TechSAge Rehabilitation Engineering Research Center, highlights ongoing efforts toward inclusive design, representing unique approaches to engage older adults with disabilities and their stakeholders in the research and development of technology supports. First, Mitzner et al., will describe the development of an online, group Tai Chi intervention, and the integral involvement of older adults with mobility disabilities, the exercise program developers, and technology partner in all steps of the process. Exploring the potential of voice-activated assistants, like Amazon Alexa, to support health management activities of older adults with mobility disabilities, Kadlyak et al. will present findings from a needs assessment of the target population and user testing in the lab and home environments. Koon et al. will present findings from a subject matter expert interview study with caregivers and medical professionals designed to identify the scope of activity challenges among people aging with long-term mobility and sensory disabilities that should be explored in more depth through our future interview study with the target population. Sanford et al., will describe a student design competition and hackathon that incorporates immersive experiences with people aging with disabilities to inspire innovative design concepts that respond to the needs of real people. NIDILRR Project Officer, Anne Ordway, will serve as the discussant.

71 Developing A Portfolio for Advanced Practitioners Working with Older People

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
L MacDiarmid
Keyword(s):  
Action Research ◽  
Older People ◽  
Nurse Practitioners ◽  
Professional Competence ◽  
Written Feedback ◽  
Advanced Practice ◽  
Participatory Action ◽  
Advanced Level ◽  
Team Members ◽  
Acute Trust

Abstract Introduction Advanced Nurse Practitioners (ANP’s) have a professional responsibility to ensure that they maintain professional competence (Whiteing, N. in Hinchcliffe and Rogers Eds pp192–219, 2008). The aim of the portfolio is to assist ANP’s in developing evidence demonstrating continued advanced level practice. At the time of the study, there was a dearth of evidence relating to competencies for qualified ANP’s, working with older people. The aim was to move away from the traditional confines of “nurse does this, doctor does this”, and to embrace the concept of developing skills to meet the clinical demands of service provision for our older people. Methods Participatory action research methodology was adopted—using the Review, Plan and act cycle (Edwards and Talbot, p63 1999; Holloway & Wheeler p155–156, 1996). Review A literature search and review of competencies relating to advanced practice and older people was undertaken. Plan A portfolio of knowledge and skills was collated utilising the information from the review. A matrix was created incorporating four Pillars of Advanced Practice (SGHD 2008), the Nursing and Midwifery Code (NMC, 2015) and modified competencies for Joint Royal Colleges of Physicians Training Board Geriatric curriculum (JRCPTB), (2010, amended 2013 and 2015). The portfolio was sent out to existing team members, and local Consultant Geriatricians based in the Acute Trust and local University for comment and amendments were made. Act The portfolio was used by staff as a trial and evaluated. Written feedback was obtained through questionnaires. Results The portfolio was well evaluated by staff using it, including recommendations for improvement. Portfolio has been shared at national groups and via social media and has been well received. Conclusions An Advanced Practice Portfolio of capabilities is being used, based on action research cycles, enhancing the level of care received by older people.

scholarly journals Predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes: a cross-sectional survey

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e041578
Author(s):  
Linglin Kong ◽  
Huimin Zhao ◽  
Junyao Fan ◽  
Quan Wang ◽  
Jie Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Community Health ◽  
Community Dwelling ◽  
Central China ◽  
Chinese Community ◽  
Cross Sectional ◽  
Community Dwelling Older Adults

ObjectivesTo assess the prevalence of frailty and identify predictors of frailty among Chinese community-dwelling older adults with type 2 diabetes.DesignA cross-sectional design.SettingTwo community health centres in central China.Participants291 community-dwelling older adults aged ≥65 years with type 2 diabetes.Main outcome measuresData were collected via face-to-face interviews, anthropometric measurements, laboratory tests and community health files. The main outcome measure was frailty, as assessed by the frailty phenotype criteria. The multivariate logistic regression model was used to identify the predictors of frailty.ResultsThe prevalence of prefrailty and frailty were 51.5% and 19.2%, respectively. The significant predictors of frailty included alcohol drinking (ex-drinker) (OR 4.461, 95% CI 1.079 to 18.438), glycated haemoglobin (OR 1.434, 95% CI 1.045 to 1.968), nutritional status (malnutrition risk/malnutrition) (OR 8.062, 95% CI 2.470 to 26.317), depressive symptoms (OR 1.438, 95% CI 1.166 to 1.773) and exercise behaviour (OR 0.796, 95% CI 0.716 to 0.884).ConclusionsA high prevalence of frailty was found among older adults with type 2 diabetes in the Chinese community. Frailty identification and multifaceted interventions should be developed for this population, taking into consideration proper glycaemic control, nutritional instruction, depressive symptoms improvement and enhancement of self-care behaviours.

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