Evidence-based geriatric nursing protocols for best practice / [edited by] Marie Boltz ... [et al.].

Format:

Book

Author/Creator:

Boltz, Marie, author.

Language:

English

Subjects (All):

Geriatric nursing--Methodology.

Geriatric nursing.

Nursing.

Older people.

Evidence-based nursing.

Nursing assessment.

Geriatric Nursing--methods.

Aged.

Evidence-Based Nursing.

Nursing Care.

Nursing Assessment.

Patient Care Planning.

Geriatric Nursing.

Medical Subjects:

Geriatric Nursing--methods.

Aged.

Evidence-Based Nursing.

Nursing Care.

Nursing Assessment.

Patient Care Planning.

Geriatric Nursing.

Physical Description:

xvii, 721 p.

Edition:

4th ed.

Place of Publication:

New York : Springer, 2012.

Summary:

Named a 2013 Doody's Core Title The evidence-based protocols are designed as a primary reference and are useful, substantive, and timely...The broader contributions of useful format and succinct review of the evidence make it likely that this text will continue to be the leading resource in nursing education and practice."-- The Gerontologist Now more than ever, nurses are called upon to lead efforts to embed evidence-based practice in daily operations. As the IOM report states, 'nurses have key roles to play as team members and leaders for a reformed and better-integrated, patient-centered health care system.' The process of implementing sweeping change in health care will likely take years; however, nurses must start pragmatically and focus on these critically important protocols that have demonstrated improved outcomes for older adults. Simply stated, 'Pick this book up and use it.' From the Foreword, Susan L. Carlson , MSN, APRN, ACNS-BC, GNP-BC, FNGNA President, National Gerontological Nursing Association As a gerontological clinical educator/research nurse, I will often use this as a reference. The format and the content are good, and the explanations of how to best use the evidence simplify the process of sifting through mountains of information to figure the best practice." Score: 97, 5 Stars. --Doody's One of the premier reference books for geriatric nurses in hospital, long-term, and community settings, this 4th edition has been thoroughly updated to provide the most current, evidence-based protocols for care of common clinical conditions and issues in elderly patients. Designed to improve the quality, outcomes, and cost-effectiveness of health care, these guidelines are the result of collaboration between leading practitioners and educators in geriatric nursing and New York University College of Nursing. Protocols for each clinical condition have been developed by experts in that particular area, and most have been systematically tested by over 300 participating hospitals in "Nurses Improving Care for Health System Elders" (NICHE). Evidence is derived from all levels of care, including community, primary, and long-term care. A systematic method in compliance with the AGREE appraisal process was used to rate the levels of evidence for each protocol. Protocols are organized in a consistent format for ease of use, and each includes an overview, evidence-based assessment and intervention strategies, and an illustrative case study with discussion. Additionally, each protocol is embedded within chapter text, which provides the context and detailed evidence for the protocol. Each chapter contains resources for further study. Key Features: Updated to provide a wide range of evidence-based geriatric protocols for best practices Contains new chapters on function-focused care, catheter-associated urinary tract infections, mistreatment detection, acute care models, and transitional care Illustrates application of clinical protocols to real-life practice through case studies and discussion Edited by nationally known leaders in geriatric nursing education and practice, who are endorsed by the Hartford Institute for Geriatric Nursing and NICHE Encompasses the contributions of 58 leading practitioners of geriatric care Written for nursing students, nurse leaders, and practitioners at all levels, including those in specialty roles

Contents:

Evidence-Based Geriatric Nursing Protocols for Best Practice

Half-Title

About the Author

Title Page

Copyright

Table of Contents

Contributors

Foreword

Acknowledgments

Introduction

Chapter 1: Developing and Evaluating Clinical Practice Guidelines:A Systematic Approach

Definition of Terms

The Agree Instrument

The Search for Evidence Process

Search Strategies for Broad Topics

Limits, Hedges, and Publication Types

Precision and Recall

Levels of Evidence

Summary

References

Chapter 2: Measuring Performance, Improving Quality

Educational Objectives

Background and Statement of Problem

Assessment of the Problem

Quality Health Care Defined

Clinical Outcomes and Publicly Reported Quality Measures

Interventions and Care Strategies

Measuring Quality of Care

Addressing the Challenges

Measuring Performance-Selecting Quality Indicators

Implementing the Quality Assessment and Performance Improvement Program

Resources

Additional Readings

Chapter 3: Age-Related Changes in Health

Cardiovascular System

Pulmonary System

Renal and Genitourinary Systems

Oropharyngeal and Gastrointestinal Systems

Musculoskeletal System

Nervous System and Cognition

Immune System and Vaccination

Atypical Presentation of Disease

Chapter 4: Sensory Changes

Normal Changes of Aging Senses

Vision

Visual Function Questionnaire-25

Conditions of the Eye

Hearing Impairment

Hearing Changes Common in Older Adults

Smell and Taste

Changes in Smell and Taste Common to Older Adults.

Diseases That Alter Taste Seen More Frequently as People Age

Peripheral Sensation

Implications of Peripheral Sensation Changes

Nursing Assessment and Care Strategies of Peripheral Sensation

Individualized Sensory Enhancement of the Elderly

Nursing Sensory Assessments

History

Physical Exam for All Systems

Nursing Actions and Referrals

Expected Outcomes

Follow-up Monitoring

Interprofessional Care of Sensory Changes

Chapter 5: Excessive Sleepiness

Overview

Consequences of Excessive Sleepiness

Physiological Changes in Sleep that Accompany Aging

Primary Causes of Excessive Daytime Sleepiness

Obstructive Sleep Apnea

Insomnia

Restless Legs Syndrome

Secondary Causes of Excessive Daytime Sleepiness

Sleep Disturbance During Hospitalization

Chapter 6: Assessment of Physical Function

Assessment Instruments

Direct Assessment of Patient

Specific Functional Assessments

Use of Assessment Information

Chapter 7: Interventions to Prevent Functional Decline in the Acute Care Setting

Physical Function as a Clinical Measure

Patient Risk Factors for Functional Decline

Hospital Care Systems and Processes

Social Climate

Policy and Procedure

Physical Design

Support for Cognition

Physical Therapy and Exercise

Functional Mobility Programs.

Critical Care Initiatives to Prevent Functional Decline

Function-Focused Care: A Multimodal Intervention

Chapter 8: Assessing Cognitive Function

Reasons for Assessing Cognitive Functioning

How to Assess Cognitive Functioning

When to Assess Cognitive Functioning

Cautions for Assessing Cognitive Functioning

Chapter 9: Depression in Older Adults

What is Depression?

Major Depression

Minor Depression

Course of Depression

Depression in Late Life is Serious

Depression in Late Life Is Misunderstood

Treatment for Late-Life Depression Works

Cause and Risk Factors

Depression Among Minority Older Adults

Depression Screening Tools

Individualized Assessment and Interview

Differentiation of Medical or Iatrogenic Causes of Depression

Clinical Decision Making and Treatment

Biologic Therapies in Treatment of Late-Life Depression

Electroconvulsive Therapy

Exercise Interventions

Psychosocial Approaches

Interdisciplinary Team Models of Care

Individualized Nursing Interventions for Depression

Acknowledgements

Resourcse

Chapter 10: Dementia

Goals of Assessment

History Taking

Functional Assessment

Cognitive Assessment

Behavioral Assessment

Physical Examination and Diagnostics

Caregiver Assessment

Pharmacological Interventions.

Pharmacological Therapy for Problematic Behaviors

Supplemental Drugs

Nonpharmacological Strategies

Physical/Functional Interventions

Environmental Interventions

Psychosocial Interventions

Behavioral Interventions

Advance Planning and End-of-Life Care Interventions

Chapter 11: Delirium

Definition

Etiology and Epidemiology

Chapter 12:Iatrogenesis: The Nurse's Role in Preventing Patient Harm

Iatrogenesis in the Older Adult

Endogenous Risk Factors for Iatrogenesis

Exogenous Risk Factors for Iatrogenesis

Adverse Drug Events

Adverse Effects of Diagnostic, Medical, Surgical, and Nursing Procedures

Hospital-Acquired Infection

Nursing Strategies for Hospital-Acquired Infections

Quality Improvement Initiatives to Minimize Infection

Geriatric Syndromes

Nursing Management of Geriatric Syndromes

Interventions Related to Changing Provider and Patient Knowledge, Beliefs, and Attitudes

Nurses' Knowledge, Attitudes, and Beliefs

Patient Knowledge, Attitudes, and Beliefs

Interventions Related to National and Organizational Priorities

Organizational Imperatives to Prevent Iatrogenesis

Safety-Promoting Structures and Processes

Partnering With Patients

Chapter 13: Physical Restraints and Side Rails in Acute and Critical Care Settings

Background and Legal Issues

Regulations and Accrediting Standards

Risks of Liability.

Professional Standards of Care

Prevalence and Rationale of Staff

Extent of Use

Decision to Use Physical Restraint

Ethical Issues in the use of Physical Restraint

Administrative Responsibilities

General Medical and Surgical Units

Critical Care Units

Alternatives to Physical Restraint

Fall Prevention

Protection of Medical Devices

Side Rails

Chapter 14: Pain Management

Assessment of Pain

Self-Reported Pain

Observed Pain Indicators

Pharmacological Pain Treatment

Nonpharmacological Pain Treatment

Improving Pain Management in Care Settings

Chapter 15:Fall Prevention:Assessment, Diagnoses, and Intervention Strategies

The Importance of Fall and Injury Prevention in Acute Care

Deciding Risk for a Serious Fall-Related Injury

Assess and Diagnose the Older Adult Patient's Risk for Serious Injury

Best Practice Interventions for Suspected Serious Injury

Why Do Older Adult Patients in an Acute Care Setting Fall and Who Is at Greatest Risk

Patient-Specific Factors Linked to Fall Risk

Physical Restraint Use Contributing to Fall Risk

Medications Contributing to Fall Risk in Older Adults

Postfall Assessment

The Immediate Postfall Assessment

Interim Postfall Assessment

Longitudinal Postfall Assessment

Overview of Effective Fall and Injury Prevention in Hospitals

Fall Prevention Program

Interventions for All Prevention and Management

Instituting General Safety Measures

Early Mobility for Older Patients Who Fall.

Some Best Practice Exemplars Used by Acute Care Hospitals.

Notes:

Includes bibliographical references and index.

ISBN:

1-78268-184-1

1-280-12888-7

9786613532763

0-8261-7129-X

OCLC:

779454295