HRSA Comprehensive Geriatric Education Grant Poster

This grant funds a Clinical Nurse Specialist position to work with current Gerontological CNS in providing education, mentoring / support, developing / measuring outcomes for knowledge, practice change and patient outcomes by:

Expanding NICHE training at Piedmont Hospital in Atlanta beyond Acute Care nurses to include Emergency Department nurses;

2) Introducing NICHE training at Piedmont Fayette, Piedmont Newnan and Piedmont Mountainside for Acute Care and Emergency Department nurses;

3) Introducing NICHE training for nursing staff at two of our Long-Term Care facility partners; and

4) Disseminating program materials and information to other healthcare entities throughout Georgia and the U.S. through local workshops and presentations at national healthcare conferences.

1. Older Patients:
are 40-54% of admissions at the four Piedmont
Healthcare facilities
 have increased length of stay, more frequent
hospitalizations, and increased severity of illness
 enter the healthcare system through the
Emergency Department
Reality
Hospital Nursing staff have minimal training and
resources to manage complex geriatric patients
Areas in the hospital, such as the Emergency
Department, are not “elder friendly”
The older population in Georgia is growing faster
than the national average- more older adults and
they are living longer
Nursing homes / rehab facilities are common
discharge destinations are a hospital stay; 75% of
the NH staff were found to be inadequately
prepared by their initial nursing education to
manage the clinical challenges of frail, complex
elderly patients.
Awarded an HRSA Grant: July 2009 to June 2012
Over the three-year grant period, Piedmont HealthCare
intends to build on its successful three-year geriatric
training of acute care inpatient nurses at the
Piedmont Hospital Atlanta facility.
Adapting the Hartford Institute’s NICHE training model,
PHC will expand training at its Atlanta hospital into
the Emergency Department and will also launch
training programs in its other three hospital facilities
and at two long-term care facilities, all of which are
located within the 20-county Atlanta EMA
Methods
Comprehensive Geriatric Education Program
Dee Tucker RN, MS, GCNS-BC, Monica Tennant RN, MSN, CCNS
This program is 100% funded by the Health Resources and Services Administration grant: $450,000
This grant funds a Clinical Nurse Specialist position to
work with current Gerontological CNS in providing
education, mentoring / support, developing /
measuring outcomes for knowledge, practice change
and patient outcomes by:
1)Expanding NICHE training at Piedmont
Hospital in Atlanta beyond Acute Care nurses
to include Emergency Department nurses;
2) Introducing NICHE training at Piedmont
Fayette, Piedmont Newnan and Piedmont
Mountainside for Acute Care and Emergency
Department nurses;
3) Introducing NICHE training for nursing staff at
two of our Long-Term Care facility partners;
and
4) Disseminating program materials and
information to other healthcare entities
throughout Georgia and the U.S. through local
workshops and presentations at national
healthcare conferences.
By expanding current nurse training to include staff at
the initial point of contact (Emergency Department)
and to a common point of discharge (Long-Term
Care / Rehabilitation facilities), the PHC Geriatric
Education and Training Program will increase access
to quality geriatric care across the healthcare
continuum.
Introduction Outcomes
Piedmont Hospital Mountainside Hospital
Fayette Hospital
Newnan Hospital
.
.
.
Progress
Bibliography
The evaluation of this programs efficacy will be determined
through 4 methods:
4) validation of skills at yearly check. Nursing competency
for skills associated with patient care are revalidated
annually. During this period, PHC will allow the bedside
nurse that has participated in the training program to
demonstrate key topics presented from the original
course.
7) surveying nurses who have completed our class, for
their knowledge and skills six months post class
completion. This written survey will have basic questions
regarding important information that is vital to serving an
elderly population. The retention of knowledge will be
determined from the scores that are received from the
survey. A nurse that receives eighty percent or above,
for the purpose of this survey, will be considered to have
retained basic knowledge and skills with regard to
eldercare. These evaluation processes will allow us to
assess the nurses’ ability to properly identify needs of an
elderly patient as well ensure that the skills knowledge
taught in the class are being performed at the bedside
correctly. Areas of weakness found during this skill
validation and post testing will prompt a review of class
material to ensure that the material and teaching
methods used appropriate for the target audience.
10)the Press Ganey satisfaction survey results from the
1st quarter after completion of the first series of classes.
We will analyze data regarding questions associated
with the patients’ perception of the Nurse’s knowledge
base, ability to explain disease and diagnosis and
general communication skills with the patients. An
increase in satisfaction quantified by higher scores will
indicate an improvement in clinical knowledge regarding
elderly concepts and care.
13) monitoring clinical outcomes. The methodology in
which
identifier to improved clinical outcomes. We will initially
start by looking at broad outcomes such as length of
stay, reduction of medication induced delirium and
advance directive communication. As we continue the
program we will re-examine and add additional
outcomes as they reveal themselves to be significant to
elder care.

Carpezuti, E., Zwicker, D., Mezey, M., & Fulmer, T. (2008).
Evidence-Based Geriatric Nursing Protocols for Best Practice. 3
rd

edition. Springer Publishing Company.
Fulmer, T. (1991). He Geriatric Nurse Specialist Role: A New
Model. Nursing Management. 22(3), 91-93.
Geriatric Emergency Nursing Education (GENE) course from
Emergency Nurses Association 2004.
GeroNurse; www.geronurseonline.org
Graf, C. (2006). Functional decline in hospitalized older adults.
American Journal of Nursing. 106(1) 58-67.
Nurses Improving the Care of the Healthsystem Elders. NICHE
project. Hartford Institute for Geriatric Nursing.
www.hartfordign.org
Classes for Inpatient staff were 2 days in length and offered
twice a year at each of the 4 Piedmont Healthcare facilities.
Classes for the ED and Outpatient staff were 1 day in
duration and offered twice a year at each of the 4 Piedmont
Healthcare facilities.
Feedback from class attendees, managers, directors, and
administration suggested shortening the classes. Inpatient
classes are currently 1 day in length and ED/Outpatient
classes are currently 4 hours in length. Classes placed in the
online learning system allow staff to access the classes at
any time and earn education credits.
Video in-services rotated class topics in short 10minute
videos to staff who could not attend other educational
opportunities. As requested, the full version of these videos
were posted on the hospital intranet site for access by any
staff on any shift in any of the 4 sites.
Bedside mentoring of staff by a Geriatric Clinical Nurse
Specialist (CNS) at all 4 facilities has provided valuable
support of the knowledge gained during both formal and
informal educational opportunities.
Posters in each facility covers topics such as: Geriatric skin:
aging differences and prevention techniques Delirium versus
Dementia: know the difference Incontinence in Older
Adults/ Prevention of CAUTI Transitioning: Geriatric
Functional Assessment
Visibility of the Comprehensive Geriatric Education Program
grant has been increased through participation in Research
Fairs hosted by each facility as well as CNS participation in
Skills/Competency days for staff.
Geriatric simulation scenarios have been used with the New
Graduate program and will be utilized for all staff at facilities
with Simulation mannequins.