2.50
Hdl Handle:
http://hdl.handle.net/10755/166387
Category:
Abstract
Type:
Presentation
Title:
Development of TEACH (Transitioning Elders Across the Continuum of Healthcare)
Author(s):
Murphy, Tamara; Schirm, Victoria
Author Details:
Murphy, Tamara, MS, APRN, BC, CCRN, at Penn State Milton S. Hershey Medical Center, Department of Care Coordination, email: tmurphy1@hmc.psu.edu; Victoria Schirm, PhD, RN
Abstract:
HEALTHCARE ORGANIZATION DESCRIPTION: Penn State Hershey Medical Center (PSHMC) is a 500-bed tertiary Academic Medical Center within rural central Pennsylvania. BACKGROUND OF PRACTICE INNOVATION: The presence of an aging population within the immediate area of PSHMC provided impetus to create a position for a geriatric Clinical Nurse Specialist (CNS). This lead to the development of TEACH (Transitioning Elders Across the Continuum of Healthcare), a nurse-led initiative to improve care for hospitalized elders by providing nurses with geriatric knowledge and skills. Recognition of the growing needs of the elder population served in rural Pennsylvania provided momentum for ongoing development of TEACH in the community. PRACTICE INNOVATION PURPOSE: To provide nursing staff with specialized knowledge and skills to enhance care and outcomes for elderly patients and their families, assess and adapt available evidence-based geriatric resources to the needs of our facility, identify hospitalized elders who are at risk for functional decline, and establish links with community agencies to enhance the continuum of care for elderly patients and their families. PRACTICE INNOVATION QUESTIONS: (1) What is the best way to serve the needs of elders and improve their outcomes in an academic tertiary care system? (2) What are the best educational strategies to employ with nursing staff to increase levels of geriatric awareness and expertise? (3) What effect does a multidisciplinary approach to care of vulnerable elders have on improving outcomes such as discharge destination, length of stay, and patient satisfaction? (4) How can patient data on nurse sensitive quality indicators be used to plan improvements and enhance outcomes related to the care of elders? PRACTICE INNOVATION IMPLEMENTATION: Experience and the literature support a multidisciplinary approach to any complex patient care. Engaging physician support within the academic medical center was a first step. An internal medicine physician, board certified in geriatrics, was identified and was willing to meet and discuss approaches to improve patient outcomes. Administrative and managerial support was obtained to launch a systems and programs approach to care of elderly patients and their families at PSHMC. The John A. Hartford Foundation Institute for Geriatric Nursing was identified as a resource. The Geriatric Nurse Specialist (GRN) model was identified as the best vehicle to deliver best practices nursing care to hospitalized elderly patients. The ongoing MAGNET journey provided inspiration and empowerment to staff nurses to effect change in their practice. In addition, principles of the American Association of Critical Care Nurses (AACN) synergy model were used to move the TEACH program forward. PRACTICE INNOVATION OUTCOMES: Results of TEACH can be seen in the work carried out by individuals as well as in the collective efforts of the team. A significant educational outcome has been development of competency requirements for nurses who care for older adults. Staff nurses on units where older adults are located must complete annually two hours of geriatric specific content in addition to gerontological hours mandated by the trauma and stroke programs. The CNS established a Geriatric Nursing website at PSHMC that provides staff nurses with ready access to evidence-based geriatric tools from the John A. Hartford Institute for Geriatric Nursing. She formed a task force with the operating room staff to address the need for clients to wear their hearing and visual aids to the OR. The TEACH social worker collaborated with health care providers in the Orthopedics Department to develop pre-hospital discharge planning for elder joint replacement candidates. Pneumonia and falls among older adults were addressed by the CNS. Electronic charting and documentation were modified to identify high-risk elders with two or more geriatric vulnerabilities. An alert automatically generates a consult to the CNS who can then readily identify patients at risk for functional decline, and make timely recommendations to prevent physical and functional decline. Multidisciplinary consultation rounds were developed, providing collaborative and evidence-based care to patients and families. The team of physicians, nurses, social workers, nutritionists, pastors, pharmacist, therapists, and students meet regularly to provide consults for complex patients identified by the CNS. Additionally, the CNS is a preceptor for baccalaureate and graduate nursing students, thereby getting students actively involved in TEACH as a unique, nurse-led program to improve eldercare. CONCLUSIONS: The CNS was given unimpeded authorization to focus on program development for care of an elderly population. The Director of Nursing Research who also has a gerontological nursing focus mentored the CNS, sharing knowledge, experience, and professional connections. This leadership and mentorship enabled sharing of the TEACH program at the national level via presentations and publications. As a professional model of care, TEACH has shown that direct care nurses, when given the skills and resources, are better able to assume responsibility and accountability for care of the specialized elderly patient population.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2008
Conference Name:
ANCC Magnet Practice Innovations
Conference Host:
American Nurses Credentialing Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host for further details regarding this item.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleDevelopment of TEACH (Transitioning Elders Across the Continuum of Healthcare)en_GB
dc.contributor.authorMurphy, Tamaraen_US
dc.contributor.authorSchirm, Victoriaen_US
dc.author.detailsMurphy, Tamara, MS, APRN, BC, CCRN, at Penn State Milton S. Hershey Medical Center, Department of Care Coordination, email: tmurphy1@hmc.psu.edu; Victoria Schirm, PhD, RNen_US
dc.identifier.urihttp://hdl.handle.net/10755/166387-
dc.description.abstractHEALTHCARE ORGANIZATION DESCRIPTION: Penn State Hershey Medical Center (PSHMC) is a 500-bed tertiary Academic Medical Center within rural central Pennsylvania. BACKGROUND OF PRACTICE INNOVATION: The presence of an aging population within the immediate area of PSHMC provided impetus to create a position for a geriatric Clinical Nurse Specialist (CNS). This lead to the development of TEACH (Transitioning Elders Across the Continuum of Healthcare), a nurse-led initiative to improve care for hospitalized elders by providing nurses with geriatric knowledge and skills. Recognition of the growing needs of the elder population served in rural Pennsylvania provided momentum for ongoing development of TEACH in the community. PRACTICE INNOVATION PURPOSE: To provide nursing staff with specialized knowledge and skills to enhance care and outcomes for elderly patients and their families, assess and adapt available evidence-based geriatric resources to the needs of our facility, identify hospitalized elders who are at risk for functional decline, and establish links with community agencies to enhance the continuum of care for elderly patients and their families. PRACTICE INNOVATION QUESTIONS: (1) What is the best way to serve the needs of elders and improve their outcomes in an academic tertiary care system? (2) What are the best educational strategies to employ with nursing staff to increase levels of geriatric awareness and expertise? (3) What effect does a multidisciplinary approach to care of vulnerable elders have on improving outcomes such as discharge destination, length of stay, and patient satisfaction? (4) How can patient data on nurse sensitive quality indicators be used to plan improvements and enhance outcomes related to the care of elders? PRACTICE INNOVATION IMPLEMENTATION: Experience and the literature support a multidisciplinary approach to any complex patient care. Engaging physician support within the academic medical center was a first step. An internal medicine physician, board certified in geriatrics, was identified and was willing to meet and discuss approaches to improve patient outcomes. Administrative and managerial support was obtained to launch a systems and programs approach to care of elderly patients and their families at PSHMC. The John A. Hartford Foundation Institute for Geriatric Nursing was identified as a resource. The Geriatric Nurse Specialist (GRN) model was identified as the best vehicle to deliver best practices nursing care to hospitalized elderly patients. The ongoing MAGNET journey provided inspiration and empowerment to staff nurses to effect change in their practice. In addition, principles of the American Association of Critical Care Nurses (AACN) synergy model were used to move the TEACH program forward. PRACTICE INNOVATION OUTCOMES: Results of TEACH can be seen in the work carried out by individuals as well as in the collective efforts of the team. A significant educational outcome has been development of competency requirements for nurses who care for older adults. Staff nurses on units where older adults are located must complete annually two hours of geriatric specific content in addition to gerontological hours mandated by the trauma and stroke programs. The CNS established a Geriatric Nursing website at PSHMC that provides staff nurses with ready access to evidence-based geriatric tools from the John A. Hartford Institute for Geriatric Nursing. She formed a task force with the operating room staff to address the need for clients to wear their hearing and visual aids to the OR. The TEACH social worker collaborated with health care providers in the Orthopedics Department to develop pre-hospital discharge planning for elder joint replacement candidates. Pneumonia and falls among older adults were addressed by the CNS. Electronic charting and documentation were modified to identify high-risk elders with two or more geriatric vulnerabilities. An alert automatically generates a consult to the CNS who can then readily identify patients at risk for functional decline, and make timely recommendations to prevent physical and functional decline. Multidisciplinary consultation rounds were developed, providing collaborative and evidence-based care to patients and families. The team of physicians, nurses, social workers, nutritionists, pastors, pharmacist, therapists, and students meet regularly to provide consults for complex patients identified by the CNS. Additionally, the CNS is a preceptor for baccalaureate and graduate nursing students, thereby getting students actively involved in TEACH as a unique, nurse-led program to improve eldercare. CONCLUSIONS: The CNS was given unimpeded authorization to focus on program development for care of an elderly population. The Director of Nursing Research who also has a gerontological nursing focus mentored the CNS, sharing knowledge, experience, and professional connections. This leadership and mentorship enabled sharing of the TEACH program at the national level via presentations and publications. As a professional model of care, TEACH has shown that direct care nurses, when given the skills and resources, are better able to assume responsibility and accountability for care of the specialized elderly patient population.en_US
dc.date.available2011-10-27T15:32:34Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T15:32:34Z-
dc.conference.date2008en_US
dc.conference.nameANCC Magnet Practice Innovationsen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host for further details regarding this item.-
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