scholarly journals The effectiveness of an educational project using older adult volunteers for training primary care nurse practitioners in geriatric assessment

2019 ◽  
Vol 10 (3) ◽  
pp. 51
Author(s):  
Jennifer M. Hackel ◽  
Teresa M. Eliot Roberts
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health Care ◽  
Clinical Practice ◽  
Older Adult ◽  
Geriatric Assessment ◽  
Primary Care Providers ◽  
Care Nurse ◽  
Primary Care Nurse ◽  
Adult Volunteers

This article reports on the effectiveness of a pilot project, where older adult volunteers attending college campus programs were recruited to act as mock patients (MP) in a two-hour clinical simulation experience for primary care nurse practitioner (NP) students learning about geriatric assessment. Primary care providers, such as NPs, study variable content on geriatrics and see older adults in their primary care clinical practica yet report they desire more time in their training to practice geriatric assessment techniques, apply clinical practice recommendations, and discuss broader aspects of cases being managed by NPs within the interdisciplinary team. Utilization of live models acting as MPs with small groups of students acting as one provider is one way in which health care trainees can take more time to learn from each other as well as the models in the simulated clinical setting. The professor wrote a hypothetical case study based on clinical practice experience that either a male or female volunteer retiree could play as the MP. The case was a 75-year-old retiree with multiple other chronic conditions, on multiple medications, presenting with acute on chronic fatigue. Of the 48 students who participated, 47 returned surveys. Aggregate scores indicated an overall effectiveness of 88% across multiple aspects of geriatric primary care. Qualitative data indicated that the NP students would like more such cases in which they get more lead time with the case information to consider the myriad factors at play and have smaller groups of students per MP. The older adults who volunteered as MPs reported overwhelmingly that they found participating in the students’ education to be rewarding and a chance to offer input about improvement in the care of older adults in the current health system in our aging society. There was consistent feedback that the program should be continued and enhanced. The case content is offered in this article for use by other health care professionals who educate trainees in primary care.

scholarly journals Clinical practice guidelines and principles of care for people with dementia: a protocol for undertaking a Delphi technique to identify the recommendations relevant to primary care nurses in the delivery of person-centred dementia care

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044843
Author(s):  
Caroline Gibson ◽  
Dianne Goeman ◽  
Mark William Yates ◽  
Dimity Pond
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Dementia Care ◽  
Care Nurse ◽  
Primary Care Nurse ◽  
People With Dementia ◽  
Primary Care Nurses

IntroductionNationally and internationally it is well recognised that dementia is poorly recognised and suboptimally managed in the primary care setting. There are multiple and complex reasons for this gap in care, including a lack of knowledge, high care demands and inadequate time for the general practitioner alone to manage dementia with its multiple physical, psychological and social dimensions. The primary care nurse potentially has a role in assisting the general practitioner in the provision of evidence-based dementia care. Although dementia-care guidelines for general practitioners exist, evidence on resources to support the primary care nurse in dementia care provision is scarce. The ‘Australian Clinical Practice Guidelines and Principles of Care for People with Dementia’ provides 109 recommendations for the diagnosis and management of dementia. This protocol describes a Delphi study to identify which of the 109 recommendations contained in these multidisciplinary guidelines are relevant to the primary care nurse in the delivery of person-centred dementia care in the general practice setting.Methods and analysisUsing a Delphi consensus online survey, an expert panel will grade each of the recommendations written in the ‘Clinical Practice Guidelines and Principles of Care for People with Dementia’ as high-to-low relevance with respect to the role of the primary care nurse in general practice. To optimise reliability of results, quality indicators will be used in the data collection and reporting of the study. Invited panel members will include Australian primary care nurses working in general practice, primary care nursing researchers and representatives of the Australian Primary Health Care Nurses Association, the peak professional body for nurses working in primary healthcare.Ethics and disseminationThis study has been approved by The University of Newcastle Human Research Ethics Committee (HREC) (H-2019-0029).Findings will be published in a peer-reviewed journal and presented at scientific conferences.

scholarly journals Implementation of an Opioid and Benzodiazepine Deprescribing Program for Older Adults in an Outpatient Setting

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 906-906
Author(s):  
Lori Armistead ◽  
Jan Busby-Whitehead ◽  
Stefanie Ferreri ◽  
Cristine Henage ◽  
Tamera Hughes ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
At Risk ◽  
Older Adult ◽  
Adult Population ◽  
Primary Care Providers ◽  
The United States ◽  
Outpatient Setting ◽  
Care Providers ◽  
Risk Of Falls

Abstract The United States spends $50 billion each year on 2.8 million injuries and 800,000 hospitalizations older adults (age 65 years and older) incur as the result of falls. Chronic use of central nervous system (CNS)-active medications, such as opioid and/or benzodiazepine (BZD) medications, increases the risk of falls and falls-related injuries in this older adult population. This Centers for Disease Control and Prevention (CDC)-funded randomized control trial uses electronic health record (EHR) data from primary care outpatient clinics to identify older adult patients at risk for falls due to chronic opioid or BZD use. The primary program aim is to test the efficacy of a targeted consultant pharmacist service to reduce the dose burden of these medications in the targeted population. Impact of this intervention on the risk of falls in this population will also be assessed. Licensed clinical pharmacists will review at-risk patients’ medical records weekly and make recommendations through the EHR to primary care providers for opioid or BZD dose adjustments, alternate medications, and/or adjunctive therapies to support deprescribing for approximately 1265 patients in the first two cohorts of intervention clinics. One thousand three hundred eighty four patients in the control clinics will receive usual care. Outcome measures will include reduction or discontinuation of opioids and BZDs and falls risk reduction as measured by the Stop Elderly Accidents, Death and Injuries (STEADI) Questionnaire. Primary care provider adoption of pharmacists’ recommendations and satisfaction with the consult service will also be reported.

scholarly journals Promoting Access Through Integrated Mental Health Care Education

2016 ◽  
Vol 10 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Karan Kverno
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Nurse Practitioners ◽  
Care Nurse ◽  
Primary Care Nurse ◽  
Mental Health Nurse ◽  
Health Nurse ◽  
Integrated Mental Health

Mental disorders are the leading cause of non-communicable disability worldwide. Insufficient numbers of psychiatrically trained providers and geographic inequities impair access. To close this treatment gap, the World Health Organization (WHO) has called for the integration of mental health services with primary care. A new innovative online program is presented that increases access to mental health education for primary care nurse practitioners in designated mental health professional shortage areas. To create successful and sustainable change, an overlapping three-phase strategy is being implemented. Phase I is recruiting and educating primary care nurse practitioners to become competent and certified psychiatric mental health nurse practitioners. Phase II is developing partnerships with state and local agencies to identify and support the psychiatric mental health nurse practitioner education and clinical training. Phase III is sustaining integrated mental health care services through the development of nurse leaders who will participate in interdisciplinary coalitions and educate future students.

Home-Based Care and Primary Care Settings for Delivery of Geropsychology Services to Older Persons

2019 ◽  
Author(s):  
Srijana Shrestha
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Mental Illnesses ◽  
Care Providers ◽  
Primary Care Clinics ◽  
Home Based

Despite high rates of mental illnesses, older adults face multiple barriers in accessing mental health care. Primary care clinics, and home- and community-based senior-serving agencies are settings where older adults routinely receive medical care and social services. Therefore, integration of mental health care with existing service delivery systems can improve access to mental health services and reduce the unmet mental health needs of seniors. Evidence suggests that with innovative components mental health provided in collaboration with primary care providers with or without co-location within primary care clinics can improve depression and anxiety. Home-based models for depression care are also effective, but more research is needed in examining home-based approaches in late-life anxiety treatment. It is noteworthy that integrative models are particularly helpful in expanding the reach in underserved communities: elders from minority and low-income backgrounds and homebound seniors.

Participation of Chronically Ill Older Adults in Their Life-Prolonging Treatment Decisions: Rights and Opportunity

1998 ◽  
Vol 17 (1) ◽  
pp. 1-23 ◽  
Author(s):  
Sarah Shidler
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Older Adult ◽  
Chronically Ill ◽  
Treatment Decisions ◽  
The Individual ◽  
The Right ◽  
Legal Guidelines

ABSTRACTThe right of the individual to participate in her life-prolonging treatment decisions, either as a decision maker or by having her treatment wishes used as a decision-making criterion, is the result of an evolution in legal guidelines over the last two decades. Although necessary, these legal guidelines are however not sufficient to assure the individual's opportunity to participate. For the chronically ill older adult residing in a health care institution, the opportunity to participate in decisions concerning life-prolonging treatments implicitly depends on the effective communication among three key actors (the individual, her physician, and her proxy). The necessity of this communication has important implications for clinical practice and future empirical research.

Middle-Aged and Older Adult Health Care Selection

2016 ◽  
Vol 36 (4) ◽  
pp. 441-461 ◽  
Author(s):  
Scott R. Sanders ◽  
Lance D. Erickson ◽  
Vaughn R. A. Call ◽  
Matthew L. McKnight
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health Care ◽  
Older Adult ◽  
Care Physician ◽  
Adult Health ◽  
Middle Aged ◽  
Community Ties ◽  
Local Primary Care ◽  
Adult Health Care

This study assesses the prevalence of primary-care physician (PCP) bypass among rural middle-aged and older adults. Bypass is a behavior where people travel beyond local providers to obtain health care. This article applies a precise Geographic Information System (GIS)-based measure of bypass and examines the role of community and non-health-care-related characteristics on bypass. Our results indicate that bypass behavior among rural middle-aged and older adults is multifaceted. In addition to the perceived quality of local primary care, dissatisfaction with local services, such as shopping, creates an effect that increases the likelihood of bypass, whereas strong community ties decrease the likelihood of bypass. The results suggest that the “outshopping theory,” where respondents select services in larger regional economic centers rather than local “mom and pop” providers, now extends to older adult health care selection.

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