"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.
Acute Care for Elders (ACE) is a model of care designed to improve functional outcomes and to improve the processes for the care of older patients. This model includes: an environment of care designed to promote improved function for older patients; an interdisciplinary team that works together to identify/address the vulnerabilities of the older patients; nursing care plans for prevention of disability; early planning to help prepare the patient to return home and a review of medical care to prevent iatrogenic illness. Acute Care for Elders: A Model for Interdisciplinary Care is an essential new resource aimed at assisting providers in developing and sustaining an ACE program. The interdisciplinary approach provides an introduction to the key vulnerabilities of older adults and defines the lessons learned from the Acute Care for Elders model. Expertly written chapters describe critical aspects of ACE: the interdisciplinary approach and the focus on function. The fundamental principles of ACE described in this book will further assist hospital leaders to develop, implement, sustain and disseminate the Acute Care for Elders model of care. Acute Care for Elders: A Model for Interdisciplinary Care is of great value to geriatricians, hospitalists, advance practice nurses, social workers and all others who provide high quality care to older patients.
As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.
Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
Intro -- Foreword -- Acknowledgements -- Contents -- Part I: Nutritional Care in Geriatrics -- 1: Overview of Nutrition Care in Geriatrics and Orthogeriatrics -- 1.1 Defining Malnutrition -- 1.2 Nutrition Care in Older Adults: A Complex and Necessary Challenge -- 1.3 Malnutrition: A Truly Wicked Problem -- 1.4 Building the Rationale for Integrated Nutrition Care -- 1.5 Managing the Wicked Nutrition Problems with a SIMPLE Approach (or Other Tailored Models) -- 1.5.1 Keep It SIMPLE When Appropriate -- 1.5.2 A SIMPLE Case Example -- 1.5.2.1 S-Screen for Malnutrition -- 1.5.2.2 I-Interdisciplinary Assessment -- 1.5.2.3 M-Make the Diagnosis (es) -- 1.5.2.4 P-Plan with the Older Adult -- 1.5.2.5 L-Implement Interventions -- 1.5.2.6 E-Evaluate Ongoing Care Requirements -- 1.6 Bringing It All Together: Integrated Nutrition Care Across the Four Pillars of (Ortho) Geriatric Care -- 1.7 Summary: Finishing Off with a List of New Questions -- References -- Recommended Reading -- 2: Nutritional Requirements in Geriatrics -- 2.1 Nutritional Recommendations for Older Adults, Geriatric and Orthogeriatric Patients -- 2.2 Nutritional Recommendations for Older Adults -- 2.2.1 Energy Requirement and Recommended Intake -- 2.2.2 Protein Requirement and Recommended Intake -- 2.2.3 Micronutrients and Dietary Fibers -- 2.3 Nutritional Risk Factors in Older Adults -- 2.4 Estimating Intake in Older Adults -- 2.5 Nutritional Status of Older Adults, Geriatric and Orthogeriatric Patients -- 2.6 Summary -- References -- Recommended Reading -- 3: Nutritional Assessment, Diagnosis, and Treatment in Geriatrics -- 3.1 The Nutrition Care Process -- 3.2 Nutritional Screening/Risk Detection -- 3.3 Nutritional Assessment and Diagnosis -- 3.3.1 Nutrition Impact Symptoms -- 3.3.2 Nutritional Diagnosis -- 3.3.3 Etiologic Criteria.
The authors discuss their experience as participants in the groundbreaking Hartford Foundation initiative to create geriatric interdisciplinary team training (GITT) programs in 8 model sites nationwide. They suggest various solutions to the problems one is most likely to encounter while designing and implementing GITT programs.
Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
The purpose of restorative care nursing is to take an active role in helping older adults maintain their highest level of function, thus preventing excess disability. This book was written to help formal and informal caregivers and administrators at all levels to understand the basic philosophy of restorative care, and be able to develop and implement successful restorative care programs. The book provides a complete 6-week education program in restorative care for caregivers, many suggestions for suitable activities, and practical strategies for motivating both older adults and caregivers to engage in restorative care. In addition, the book provides an overview of the requirements for restorative care across all settings, the necessary documentation, and ways in which to complete that documentation.
Nursing Care for the Hospitalized Older Patient is a comprehensive, quick-reference resource for registered and advanced practice nurses working with older patients in a hospital setting. Organized in user-friendly format, the book provides vital information on all aspects of hospital care and the full range of health issues encountered by elderly patients. The book is organized into four major sections. The first section provides an overview of the aging patient, including demographics, normal aging changes, and the general impact of hospitalization. The second section covers proper health assessment, providing guidance on history taking and evaluating laboratory values. The third section is the largest part of the book and is made up of short, similarly-structured chapters dedicated to individual clinical issues ranging from burns to depression. These chapters are organized by body system to maximize ease of use. The book concludes with a section on special considerations that cross common clinical areas, such as palliative care, pain management, fall prevention, and discharge planning.
