Evidence-Based Geriatric Nursing Protocols for Best Practice / Edition 5

by Marie Boltz PhD, RN, GNP-BC, FGSA, FAAN, Elizabeth Capezuti PhD, RN, FAAN, Terry T. Fulmer PhD, RN, FAAN, DeAnne Zwicker DrNP, APRN, BC

Overview

This new edition of one of the premier references for geriatric nurses in hospital, long-term, and community settings delivers current guidelines,real-life case studies, and evidence-based protocols developed by master educators and practitioners. With a focus on improving quality of care,cost-effectiveness, and outcome, the fifth edition is updated to provide the most current information about care of common clinical conditions and issuesin older patients. Several new expert contributors present current guidelines about hip fractures, frailty, perioperative and postoperative care,palliative care, and senior-friendly emergency departments. Additionally, chapters have been reorganized to enhance logical flow of content and easyinformation retrieval.

Protocols—systematically tested by more than 300 participating NICHE (Nurses Improving Care for Healthsystem Elders) hospitals—are organized in aconsistent format and include an overview, evidence-based assessment and intervention strategies, and an illustrative case study with discussion.Additionally, protocols are embedded within chapter text, providing the context and detailed evidence for each. Chapter objectives, annotated references,and evidence ratings for each protocol are provided along with resources for additional study.

New to the Fifth Edition:

• Reorganized to enhance logical flow of information and ease of use
• Updated and revised
• Includes new contributions from expert educators and practitioners
• Provides new chapters on perioperative and postoperative care, general surgical care, care of hip fracture, palliative care, and the senior-friendly emergency department

Key Features:

• Includes PowerPoints and a test bank for instructors
• Delivers evidence-based, current guidelines and protocols for care of common clinical conditions in the older person
• Illustrates the application of clinical protocols to real-life practice through case studies and discussion
• Edited by nationally known geriatric leaders who are endorsed by the Hartford Institute for Geriatric Nursing and NICHE
• Written for nursing students, nurse leaders, and practitioners at all levels, including those in specialty roles

Product Details

ISBN-13:	9780826171665
Publisher:	Springer Publishing Company, Incorporated
Publication date:	03/28/2016
Edition description:	Older Edition
Pages:	752
Product dimensions:	8.00(w) x 10.00(h) x (d)

About the Author

Marie Boltz, PhD, RN, GNP-BC, FGSA, FAAN,
is associate professor at the Boston College William F. Connell School of Nursing, where she teaches both advanced practice nursing and doctoral students.
Also, she is currently a senior nurse scientist at the Munn Center for Nursing Research, Massachusetts General Hospital, and a gerontological nurse consultant at the Hospital of the University of Pennsylvania, the Office of Inspector General, and the Department of Justice. She served as director of practice at the Hartford Institute for Geriatric Nursing from 2003 to 2013. Her areas of research are the geriatric care environment including measures of quality, dementia-capable and family-centered interventions, the prevention of functional decline in hospitalized older adults, and the functional recovery of older adults during post-acute care. She has presented nationally and internationally, and authored and coauthored numerous journal publications,
organizational tools, and book chapters in these areas, and has coedited five books. She is the lead editor for Evidence-Based Geriatric Nursing Protocols for Best Practice.

Dr. Boltz is a former John A. Hartford Foundation Claire Fagin fellow (2009–2011), recipient of the American Nurses Credentialing Center (ANCC) Margretta
Madden Styles Credentialing Scholar Award, and Eastern Nursing Research Society John A. Hartford Geriatric Nursing Research Award. She is a fellow in the
American Academy of Nursing and the Gerontological Society of America. Dr. Boltz received her bachelor’s degree in nursing from LaSalle University, her master’s degree as a geriatric nurse practitioner from the University of Pennsylvania, and her doctoral degree from New York University. She participated in postdoctoral study at the University of Maryland.

Elizabeth (Liz) Capezuti, PhD, RN, FAAN,

is the William Randolph Hearst chair in gerontology and assistant dean for research at the Hunter-Bellevue School of Nursing of Hunter College of the City
University of New York (CUNY). Dr. Capezuti teaches in the graduate doctor of nursing practice (DNP) program and is a professor in the Graduate Center and the PhD program in nursing science of CUNY. She is known for her work in improving the care of older adults by interventions and models that positively influence health care providers’ knowledge and work environment. Dr. Capezuti’s research interests include fall prevention, restraint and side-rail elimination, APN-facilitated models, palliative care, the geriatric nursing work environment, and the design of the “built environment” to facilitate function. Dr. Capezuti has disseminated the findings of 35 funded projects in five coedited books and more than 100 peer-reviewed articles and book chapters. She is the recipient of the Otsuka/American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award in 2001 and received the American Academy of Nursing Nurse Leader in Aging Award in 2013. Dr. Capezuti received her bachelor’s degree in nursing at the Lehman College
(CUNY), her master’s degree as a geriatric advanced practice nurse from Hunter College, and her doctoral degree in nursing from the University of
Pennsylvania.

Terry Fulmer, PhD, RN, FAAN,

is president of the John A. Hartford Foundation and leads its work to improve the health of older adults in the United States. Dr. Fulmer was previously university distinguished professor and dean of the Bouvé College of Health Sciences at Northeastern University where she was also professor of Public
Policy and Urban Affairs in the College of Social Sciences and Humanities. Previous to her role as dean of the Bouvé College of Health Sciences, Dr. Fulmer served as the Erline Perkins McGriff Professor of Nursing and founding dean of the New York University (NYU) College of Nursing. Dr. Fulmer is nationally and internationally recognized as a leading expert in geriatrics, and is best known for her research on elder abuse and neglect, which has been funded by the National Institute on Aging and the National Institute for Nursing Research. Dr. Fulmer is an elected member of the Institute of Medicine and serves as the chair of the National Advisory Committee for the Robert Wood Johnson Foundation Executive Nurse Fellows program. She has served as the first nurse on the board of the American Geriatrics Society and as the first nurse to serve as president of the Gerontological Society of America. For 15 years, Dr.
Fulmer served as the codirector of the Hartford Institute for Geriatric Nursing at NYU, which the foundation began supporting in 1996. She has also held faculty appointments at Boston College, Columbia University, Yale University, and the Harvard Division on Aging. Dr. Fulmer received her bachelor’s degree from Skidmore College, her master’s and doctoral degrees from Boston College, and her geriatric nurse practitioner postmaster’s certificate from NYU. She has received the status of fellow in the American Academy of Nursing, the Gerontological Society of America, and the New York Academy of Medicine.

DeAnne Zwicker, DrNP, AGNP-BC,

is an American Nurses Credentialing Center (ANCC)-certified adult nurse practitioner and geriatric nurse practitioner. She is currently working as an independent geriatric consultant. She completed her doctor of nursing practice degree in 2010 with a primary focus as a clinical scientist and secondary in nursing education at Drexel University in Philadelphia. Her dissertation was a mixed-method study titled, “Preparedness, Appraisal of Behaviors, and Role
Strain in Dementia Family Caregivers and the Caregiver Perspective of Preparedness.” She has been a coeditor and chapter author for many versions of the

Evidence-Based Geriatric Nursing Protocols for Best Practice

book, as well as a content editor for ConsultGeriRN.org since its inception. She has been a registered nurse for 32 years with clinical practice experience as a geriatric nurse practitioner since 1992 in primary care, subacute, long-term care, and recently palliative care and a clinical expert consultant in many domains in geriatrics. She has also taught nursing at the graduate level at New York University, Drexel University, and George Mason University. Her areas of interest in geriatrics include proactive intervention in older adults to prevent adverse drug events, pain control to aid in maintaining function and quality of life, and preventing hospital iatrogenesis particularly in persons with dementia.

Table of Contents

Contents

Contributors

Foreword J. Taylor Harden, PhD, RN, FGSA, FAAN

Preface

Acknowledgments

PART I. INCORPORATING EVIDENCE INTO PRACTICE

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

Rona F. Levin and Susan Kaplan Jacobs

Educational Objectives

Overview

Definition of Terms

2. Measuring Performance and Improving Quality

Lenard L. Parisi

Educational Objectives

Overview

Quality Health Care Defined

Clinical Outcomes and Publicly Reported Quality Measures

Measuring Quality of Care

Addressing the Challenges

Measuring Performance-Selecting Quality Indicators

Implementing the Quality-Assessment and Performance-Improvement Program

PART II. ASSESSMENT AND MANAGEMENT PRINCIPLES

3. Age-Related Changes in Health

Constance M. Smith and Valerie T. Cotter

Educational Objectives

Overview

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

4. Health Care Decision Making

Linda Farber Post and Marie Boltz

Educational Objectives

Overview

Background and Statement of Problem

Decision Aids

Assessment of the Problem

Interventions and Care Strategies

5. Sensory Changes

Pamela Z. Cacchione

Educational Objectives

Overview

Background and Statement of Problem

Normal Changes of Aging Senses

Assessment of the Problem

Interventions and Care Strategies

6. Assessing Cognitive Function

Pieter Heeren, Johan Flamaing, Jos Tournoy, Marquis D. Foreman, and Koen Milisen

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

7. Assessment of Physical Function

Denise M. Kresevic

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Interventions and Care Strategies

8. Oral Health Care

Linda J. O’Connor

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Intervention and Care Strategies

9. Managing Oral Hydration

Janet C. Mentes

Educational Objectives

Overview

Background and Statement of Problem

Definitions

Assessment of the Problem

10. Nutrition

Rose Ann DiMaria-Ghalili

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Interventions and Care Strategies

11. Family Caregiving

Deborah C. Messecar

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Interventions and Care Strategies

12. Issues Regarding Sexuality

Elaine E. Steinke

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Interventions and Care Strategies

13. Mistreatment Detection

Billy A. Caceres and Terry Fulmer

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Interventions and Care Strategies

PART III. CLINICAL INTERVENTIONS

14. Preventing Functional Decline in the Acute Care Setting

Marie Boltz, Barbara Resnick, and Elizabeth Galik

Educational Objectives

Overview

Physical Function as a Clinical Measure

Patient Risk Factors for Functional Decline

The Care Environment and Function

Interventions to Promote Physical Function

15. Late-Life Depression

Glenise L. McKenzie and Theresa A. Harvath

Educational Objectives

Overview

Background and Statement of Problem

Cause and Risk Factors

Assessment of the Problem

Differentiation of Medical or Iatrogenic Causes of Depression

Interventions and Care Strategies

Psychosocial Approaches

16. Dementia: A Neurocognitive Disorder

Kathleen Fletcher

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Interventions and Care Strategies

17. Delirium: Prevention, Early Recognition, and Treatment

Dorothy F. Tullmann, Cheri Blevins, and Kathleen Fletcher

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

18. Pain Management

Ann L. Horgas, Mindy S. Grall, and Saunjoo L. Yoon

Educational Objectives

Overview

Assessment of Pain

Interventions and Care Strategies

Improving Pain Management in Care Settings

19. Preventing Falls in Acute Care

Deanna Gray-Miceli and Patricia A. Quigley

Educational Objectives

Overview

Background and Statement of Problem

Falls and Injury Risk Assessment

Interventions for Fall Prevention and Management

20. Reducing Adverse Drug Events

DeAnne Zwicker and Terry Fulmer

Educational Objectives

Overview

Background and Statement of Problem

Evaluation of the Problem

Assessment Strategies

Interventions and Care Strategies

21. Urinary Incontinence

Annemarie Dowling-Castronovo and Christine Bradway

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Assessment Parameters

Interventions and Care Strategies

22. Prevention of Catheter-Associated Urinary Tract Infection

Heidi L. Wald, Regina M. Fink, Mary Beth Flynn Makic, and Kathleen S. Oman

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Interventions and Care Strategies

23. Physical Restraints and Side Rails in Acute and Critical Care Settings

Cheryl M. Bradas, Satinderpal K. Sandhu, and Lorraine C. Mion

Educational Objectives

Overview

Background and Legal Issues

Prevalence and Rationale of Staff

Ethical Issues in the Use of Physical Restraint

Administrative Responsibilities

Interventions and Care Strategies

Alternatives to Physical Restraints

24. Preventing Pressure Ulcers and Skin Tears

Elizabeth A. Ayello and R. Gary Sibbald

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Does Race Make a Difference?

Interventions and Care Strategies

Skin Tears

25. Mealtime Difficulties in Dementia

Melissa Batchelor-Murphy and Sarah Crowgey

Educational Objectives

Overview

Background and Statement of Problem

C3P Model for Assessment and Care Strategies

26. Excessive Sleepiness

Grace E. Dean, Michelle L. Klimpt, Jonna Lee Morris, and Eileen R. Chasens

Educational Objectives

Overview

Background and Statement of Problem

Consequences of Excessive Sleepiness

Physiological Changes in Sleep That Accompany Aging

Primary Causes of Excessive Daytime Sleepiness

Secondary Causes of Excessive Daytime Sleepiness

Assessment of the Problem

Interventions and Care Strategies

27. The Frail Hospitalized Older Adult

Stewart M. Bond, Rebecca Bolton, and Marie Boltz

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

PART IV. INTERVENTIONS IN SPECIALTY PRACTICE

28. Substance Misuse and Alcohol Use Disorders

Madeline A. Naegle and Donna McCabe

Educational Objectives

Overview

Background and Statement of Problem

Assessment of Substance Use Disorders

Assessment of Substance Use

Interventions and Care Strategies

29. Comprehensive Assessment and Management of the Critically Ill

Michele C. Balas, Colleen M. Casey, Lauren Crozier, and Mary Beth Happ

Educational Objectives

Overview

Background and Statement of Problem

Assessment of Problem and Nursing Care Strategies

30. Fluid Overload: Identifying and Managing Heart Failure Patients at Risk of Hospital Readmission

Judith E. Schipper

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Interventions and Care Strategies

31. Cancer Assessment and Intervention Strategies

Janine Overcash

Educational Objectives

Overview

Assessment of the Older Hospitalized Patient

Developing a Comprehensive Geriatric Assessment for Hospitalized Patients

Medical Emergencies Associated With Cancer and Cancer Treatment

32. Perioperative Care of the Older Adult

Fidelindo Lim and Larry Z. Slater

Educational Objectives

Overview

Background and Statement of Problem

Assessment of Problem and Nursing Care Strategies

Postanesthesia Care Unit Considerations

General Perioperative Considerations

33. General Surgical Care of the Older Adult

Larry Z. Slater and Fidelindo Lim

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem and Nursing Care Strategies

34. Care of the Older Adult With Fragility Hip Fracture

Anita J. Meehan, Ami Hommel, Karen Hertz, Valerie MacDonald, and Ann Butler Maher

Educational Objectives

Overview

Background and Statement of Problem

Definition of Fragility Hip Fracture

Surgical Repair of Hip Fracture

Pathophysiology

Common Complications and Evidence-Based Nursing Care Strategies

Pain: Significance in Hip-Fracture Patients

Delirium: Significance in Hip-Fracture Patients

Malnutrition: Significance in Hip-Fracture Patients

Fluid and Electrolyte Imbalance: Significance in Hip-Fracture Patients

Pressure Ulcer: Significance in Hip-Fracture Patients

VTE: Significance in Hip-Fracture Patients

Catheter-Associated Urinary Tract Infection: Significance in Hip-Fracture Patients

Functional Decline: Significance in Hip-Fracture Patients

Loss, Grief, and Depression: Significance in Hip-Fracture Patients

Care Transitions: Significance in Hip-Fracture Patients

Secondary Prevention: Significance in Hip-Fracture Patients

PART V. MODELS OF CARE

35. Acute Care Models

Elizabeth Capezuti, Ana Julia Parks, Marie Boltz, Michael L. Malone, and Robert M. Palmer

Educational Objectives

Overview

Objectives of Geriatric Acute Care Models

Types of Acute Care Models

36. Transitional Care

Fidelindo Lim, Janice B. Foust, and Janet H. Van Cleave

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Problem

Interventions and Care Strategies

37. Palliative Care Models

Constance Dahlin

Educational Objectives

Overview

Current State of Palliative Care

Quality and Palliative Care

Outcomes

Models Across Health Care Venues

Appendix

38. Care of the Older Adult in the Emergency Department

Marie Boltz and Amala Sooklal

Educational Objectives

Overview

Background and Statement of Problem

Assessment of the Older Adult in the ED

Nursing Interventions

Transitions From the ED

39. Advance Care Planning

Linda Farber Post and Marie Boltz

Educational Objectives

Overview

Background

Types of Advance Directives

Advance Directives and Decision Making

Other Types of ACP

Decisional Capacity to Engage in ACP

Cultural Perspectives on ACP

Nurses’ Roles in ACP

ACP Interventions and Strategies

Index

Editorial Reviews

Reviewer: Katy T Nguyen, MSN, RN (MU Sinclair School of Nursing)
Description: This geriatric nursing book is organized into five parts that address the incorporation of evidence into practice, nursing assessments, clinical interventions, specialty practice, and the models of care.
Purpose: The purpose is to provide references and evidence-based protocols for geriatric care in any setting. The clinical decision-making based on research evidence that is explained in 39 clinical topics meets the objectives of enhancing the levels of evidence supporting gerontological nursing practice.
Audience: The audience includes gerontological nurses, geriatric practitioners, and/or any healthcare providers who are interested in geriatric care. The authors and contributors are clinical experts in gerontological nursing.
Features: This is an excellent resource for gerontological nurses. It emphasizes evidence-based practice from research, addresses the systematic approaches, and delivers the current clinical practice guidelines to improve quality of care and best outcomes. The best features are the many case studies with each chapter that illustrate common problems in the geriatric population and the discussion that helps guide decision-making.
Assessment: The book is well organized in a logical flow of information. As a clinical educator and a gerontological nurse consultant, I appreciate the evidence-based protocols that help guide the decision-making, intervention strategies, and implementation process. This is a great tool for nursing education and practice. I often use it for teaching and managing nursing care delivery.

Doody's Review Service