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NICHE (Nurses Improving Care for Healthsystem Elders) Solutions Series

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

The "Solutions" Series is designed to provide the NICHE (Nurses Improving Healthsystem Care for Elders) community and other interested audiences with the latest "success stories" related to elder care. The stories are based on the successful application of best practice solutions related to NICHE Clinical Improvement Models and other NICHE resources.  Some of the success stories include ways to best care for geriatric surgical patients, methods to avoid medication errors, rapid response for dementia and behavioral issues, reducing delirium, and many others. 

Additional information/Special implementation requirements or guidelines: 

A program of the Hartford Institute for Geriatric Nursing at New York University College of Nursing, the goal of NICHE is to achieve systematic nursing change that will benefit hospitalized older patients. The vision of NICHE is for all patients 65 and over to be given sensitive and exemplary care. The mission of NICHE is to provide principles and tools to stimulate a change in the culture of healthcare facilities to achieve patient-centered care for older adults.

NICHE is unlike other programs in that it does not prescribe how institutions should modify geriatric care; rather, it provides the materials and services necessary to stimulate and support the planning and implementation process.

The focus of NICHE is on programs and protocols that are dominantly under the control of nursing practice; in other words, areas where nursing interventions have a substantive and positive impact on patient care.

For more information, visit http://nicheprogram.org/.

Date posted: 
Wed, 10/05/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/05/2011
Contact Person/Corresponding Author:



Suggested Citation:
NICHE (Nurses Improving Care for Healthsystem Elders) Solutions Series. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/255

Health Literacy and Patient Safety: Help Patients Understand

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
3
Abstract: 

This manual reviews the problem of health literacy, its consequences for the health care system, and the likelihood that a clinician’s practice includes patients with limited literacy. The manual then provides practical tips for clinicians to use in making their office practices more “user friendly” to patients with limited literacy, and gives suggestions for improving interpersonal communication between clinicians and patients. Finally, the manual concludes with several “case discussions” based on vignettes in the accompanying instructional video.

Educational objectives: 

MANUAL FOR PHYSICIANS
The enclosed materials will enable physicians to:

  • Define the scope of the health literacy problem.
  • Recognize health system barriers faced by patients with low literacy.
  • Implement improved methods of verbal and written communication.
  • Incorporate practical strategies to create a shame-free environment.

REDUCING THE RISK
The activity will enable physicians to:

  • Define the scope of patient safety problems caused by low health literacy and the need to manage the risk they present
  • Recognize the ethical and legal foundations for safe medical practices and patient-centered care
  • Explain patient safety concepts and approaches utilized in designing safer practice environments
  • Identify patient safety practices that reduce the risk of miscommunication and optimize the patient’s ability to safely manage their own care
  • Determine steps toward establishing a climate for change
  • Identify tools and resources for creating safer practice environments
  • Demonstrate how to utilize and implement these tools in a practice environment
Additional information/Special implementation requirements or guidelines: 

Communication is essential for the effective delivery of health care, and is one of the most powerful tools in a clinician’s arsenal. Unfortunately, there is often a mismatch between a clinician’s level of communication and a patient’s level of comprehension. In fact, evidence shows that patients often misinterpret or do not understand much of the information given to them by clinicians. This lack of understanding can lead to medication errors, missed appointments, adverse medical outcomes, and even malpractice lawsuits. Clinicians can most readily improve what patients know about their health care by confirming that patients understand what they need to know and by adopting a more patient-friendly communication style that encourages questions.

Date posted: 
Tue, 09/21/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/21/2010
Contact Person/Corresponding Author:



Suggested Citation:
, and . Health Literacy and Patient Safety: Help Patients Understand. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/255

The Physician's Role in Medication Reconciliation: Issues, Strategies, and Safety Principles

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
2
Abstract: 

In “The physician’s role in medication reconciliation,” the panel aims to heighten physician awareness of the integral role of reconciliation in the safe use of medications and to provide a framework for physicians to understand their personal roles and responsibilities in this often difficult process of care.

The essence of medication reconciliation is making sense of a patient’s medications and resolving conflicts between different sources of information to minimize harm and to maximize therapeutic effects. It is an ongoing, dynamic, episodic and team-based process that should be led by and is the responsibility of the patient’s attending or personal physician in collaboration with other health care professionals. Medication reconciliation is essential to optimize the safe and effective use of medications.

Educational objectives: 

After completing this activity, participants should be able to:

  • Describe medication reconciliation principles and processes
  • Distinguish the physician's role in the medication reconciliation process
  • Integrate patient-centric aspects of medication reconciliation into practice
  • Create a medication management plan with your patients
  • Integrate principles and processes into practice in all settings of care
  • Identify appropriate medication reconciliation team in all settings of care
  • Identify proper delegation of clinical and nonclinical medication reconciliation responsibilities
  • Lead your organization's efforts to support medication reconciliation
Additional information/Special implementation requirements or guidelines: 

This monograph first provides background on medication issues, including: medication errors and adverse drug events, communication problems and medication reconciliation’s relationship to patient safety. It then presents an overview, including the steps of medication reconciliation, the underlying principles of medication reconciliation for deeper understanding of the physician’s leadership role and obligations, and guidance for effective achievement of medication reconciliation. This is followed by strategies for two particularly important areas of medication reconciliation: taking a medication history and promoting patient understanding of their medication regimen. Case study examples illustrate medication reconciliation failures and can be the basis for discussions physicians may have with their medical team and with their patients.

Recognizing that ultimately all health care safety and factors affecting medication reconciliation must be customized to the particular patient and practicing setting, this monograph does not offer rigid prescriptions, but rather general principles that physicians and their teams may adapt to their specific circumstances and needs. Because medication reconciliation represents an integral part of the patient safety effort, this monograph offers guidelines and information on developing support for medication reconciliation in the context of core safety principles. It provides useful information for physicians’ use in local improvement efforts and in advocacy for medication safety.

Finally, this monograph discusses important special topics critical to effective medication reconciliation: information technology, coordination of care and vulnerable populations. Information technology has tremendous potential, but it also poses significant challenges. This discussion highlights some of those issues. It also reviews a key issue in medication reconciliation—coordination of care—and sketches a directly related effort to address this concern (i.e., medical homes). In addition to enhancing coordination of care, medical homes may provide important benefits to older and minority populations—groups that are disproportionately affected by ineffective medication reconciliation. Lastly and significantly, the monograph discusses vulnerable patient populations, including older adults and minorities, and provides examples and potential strategies to improve medication reconciliation for these patients.

For information on receiving CME credit, go to http://www.ama-assn.org/ama/no-index/physician-resources/medication-reconciliation.shtml.

Date posted: 
Tue, 09/07/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/07/2010
Contact Person/Corresponding Author:



Suggested Citation:
, , and . The Physician's Role in Medication Reconciliation: Issues, Strategies, and Safety Principles. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/255

Effective Clinical Partnerships between Primary Care Medical Practices and Public Health Agencies

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
2
Abstract: 

The purposes of the study reported in this monograph were:

  • To identify partnerships between public health and medicine that increase the effectiveness and efficiency of clinical care, with a particular emphasis on the aging population; and
  • Through a careful examination of current models, to identify themes and lessons that would be useful in the expansion, replication, and broader application of such partnerships.
Additional information/Special implementation requirements or guidelines: 

The monograph is divided into four sections. The introduction reviews the literature on primary care/public health partnerships. The methods used in our research are described in the second section. The third section describes the 48 programs we identified and profiled, thereby providing an inventory of the wide range of partnerships currently in operation. The fourth section presents the results of qualitative analyses of in-depth interviews we conducted with key participants in a selection of 16 programs. The final section presents our conclusions and recommendations.

Our research methods included conducting a national scan to identify successful ongoing programs, gathering detailed information from a sample of the identified programs, and analyzing the data to identify themes and lessons that could be drawn from the experiences of these pioneers.

We believe that the U.S. health care system would benefit greatly from more integration between population-oriented and individual patient care systems. This monograph is intended to foster movement in that direction.

Date posted: 
Tue, 09/07/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/07/2010
Contact Person/Corresponding Author:



Suggested Citation:
and . Effective Clinical Partnerships between Primary Care Medical Practices and Public Health Agencies. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/255

Promoting Preventive Services for Adults 50-64: Community and Clinical Partnerships

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
2
Abstract: 

Promoting Preventive Services for Adults 50-64: Community and Clinical Partnerships is a landmark document intended to help promote lifesaving clinical preventive services for adults aged 50 to 64. As the first in a series, this innovative resource identifies a set of recommended preventive services, provides indicators and data at national, state, and selected local levels with which to monitor progress, and promotes successful strategies to facilitate adoption and use. It is hoped that this information will spark vigorous and sustained collaborations that make effective screening, counseling, vaccinations, and other recommended services a routine part of prevention for the nation's adults. 

Educational objectives: 

Much national attention has been paid to the impact of longer life spans on the health of older adults in their 70s, 80s and beyond. Just one generation behind them is a group equally worthy of note. In 2007, Americans between the ages of 50 and 64 numbered nearly 55 million. By 2015, the aging of baby boomers will boost this group of adults to 63 million strong – nearly 20 percent of the population. This report delineates science-based strategies and highlights "calls to action" that build on linkages between clinical and community efforts to facilitate the delivery of multiple preventive services.

Additional information/Special implementation requirements or guidelines: 

For more information on this topic, please visit http://apps.nccd.cdc.gov/DACH_PPS/Default/Default.aspx.

Date posted: 
Tue, 09/07/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/07/2010
Contact Person/Corresponding Author:



Suggested Citation:
, , and . Promoting Preventive Services for Adults 50-64: Community and Clinical Partnerships. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/255

An Interprofessional Approach to Chronic Conditions 5: Caregiver and Family Support in Managing Chronic Conditions

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

Caregiving can be rewarding and yet a challenge. The stress and strain of caregiving can be detrimental to the care provider’s health. The complexity of transitioning into the role of caregiver to identifying adequate resources for both the care recipient and care provider can be laborious. However, when proper resources have been identified for those involved it can make the process of caregving run smoothly. Furthermore, being an active member of the interprofessional healthcare team has its benefits. The concept of this module is to give healthcare professionals and students an understanding of the caregiver role while utilizing an interprofessional approach to care.  It also includes pre-test, post-test and exercises. A certificate of completion is awarded, after completing the module in its entirety.

Educational objectives: 

Upon completion of this module, the participant will be able to:

  • Provide information regarding transitioning to the caregiver role.
  • Provide guidelines to assess caregiver parameters.
  • Identify caregiver concerns and current social supports.
  • Discuss the role of the interprofessional team in supporting older adults and families experiencing caregiver roles.
  • Promote understanding of the caregiver role and identification of care recipient resources.
Additional information/Special implementation requirements or guidelines: 

Technical Requirements and Notes: This learning module uses Adobe Flash media and may require you to add a browser "plug-in" in order to display properly. Most computers already have this free plug-in installed. But, if yours does not, it is very easy to download and install. Try the module first because the software is "smart" enough to detect the Flash player. If the module doesn't begin, you will be automatically prompted to download the plug-in. The module contains links to external websites which will open in a new browser window. Your browser's back button will not return to the module, so these new windows should be closed.

In order to track your progress, you must create an account and fill out a brief demographic profile. Once the profile has been created, you can log directly into the course.

Date posted: 
Tue, 09/21/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 12/03/2012
Product Viewing Instructions: 
You must create an account to use this product.
Contact Person/Corresponding Author:



Suggested Citation:
An Interprofessional Approach to Chronic Conditions 5: Caregiver and Family Support in Managing Chronic Conditions. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/255

Elder Care: A Resource for Interprofessional Providers: Low Vision Aids

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Sponsors: 
Product Information
Estimated time to complete: 
1
Abstract: 

Aids for Patients with Low Vision is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites,  they are useful for students and health care professionals from many fields and across a very broad range of health care settings.

Educational objectives: 
  1. Name five vision aids for people with impaired vision
  2. List a principal advantage and disadvantage of each of those five vision aids
  3. State whether or not most insurance plans provide coverage for low-vision aids
Additional information/Special implementation requirements or guidelines: 
Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as
(1) content is not changed, 
(2) no one is charged a fee to use or read the publication, 
(3) authors and their affiliated institutions are noted without change, and 
(4) the reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatric Education Center."
Publications from, presentations from, and/or citations to this product: 
The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.

Date posted: 
Thu, 08/02/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 05/21/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care: A Resource for Interprofessional Providers: Low Vision Aids. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/255

Finding Community Resources for Older Adults and Their Families

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 
This component consists of brief scenarios describing the needs of older adults, older patients, and their families. Each student is assigned a scenario. By searching print and internet sources, he/she identifies the community services that are available to address these needs. Then, he/she reports the findings to the small group. In that way, the group can compile a listing of specific community resources along with contact information. The component contains a general list of resources and useful web sites on community services that students can search. CME credit is available for this product. For more information, please contact the author. Format: Self-directed Learning; Community Resources; Discussion
Educational objectives: 
The goals are: 1.) To gain a detailed understanding of the community resources that are available to address the full-range of needs of older adults. 2.) To learn how to locate community resources. Learners should: 1.) Be able to specify what community resources are available for a specific set of needs of older adults. (For example, learners should be able to say specifically what resources are available to transport older adults without their own means of transportation to various sites such as physicians' offices, groceries stores, etc.) 2.) Acquire search strategies to identify community resources for older adults.
Additional information/Special implementation requirements or guidelines: 
After receiving a scenario describing an older adult with a need that must be met, each student identifies community resources that can meet that need. The resources can then be catalogued, merged, and put onto a web-site for use by students and even by older adults (if there is a way to maintain and update the list of resources and contact information for those resources).
Date posted: 
Fri, 12/01/2006
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sat, 05/08/2010
Contact Person/Corresponding Author:



Suggested Citation:
and . Finding Community Resources for Older Adults and Their Families. POGOe - Portal of Geriatrics Online Education; 2006 Available from: https://pogoe.org/taxonomy/term/255

Environmental Geriatrics

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Abstract: 

Our 3D animated course gives providers the necessary tools to incorporate Environmental Geriatrics as an essential component of chronic disease management. Using sound, text and moving images, the learner witnesses virtual patients who have reduced visual, hearing, mobility, and memory skills, struggling to accomplish daily tasks of living, i.e., bathing, eating, ambulating, and taking medications. The second half of the animation identifies specific assistive devices and environmental features that improve patients’ ADL/IADL functioning while reducing injury.

Educational objectives: 

Learners should be able to: 1. Identify risk factors associated with falls and burns in elderly patients 2. Identify specific assistive devices and environmental features that improve patients’ ADL/IADL functioning while reducing injury risk 3. List specific assessment tools for the geriatric patient 4. Learn about reimbursement mechanisms and national resources for home modifications and assistive technologies Using state-of-the-art 3D software that combines sound, text and moving images, our educational animation allows medical students, physicians, and other health care professionals: 1. To make a virtual home visit with an older patient who has reduced visual, hearing, mobility, and memory skills 2. Witness virtual patients unnecessarily struggling to accomplish daily tasks of living (e.g., bathing, eating, ambulating, and taking medications) 3. Observe patients encountering remediable environmental hazards that increase fall and burn risk, which are not usually observable in practice 4. Experience virtually the effect of visual impairments, such as macular degeneration or glaucoma, while interacting with the environment (e.g., descending stairs) 5. Identify interventions that improve patients’ ADL/IADL functioning while reducing injury risk

Additional information/Special implementation requirements or guidelines: 

55 third-year medical students at the Weill Medical College of Cornell University. This course takes about 45 minutes to an hour to complete. Students can view all three sections at once, or a facilitator can engage the students in a group discussion after each section. After all three sections are completed, a facilitator can break the class up into small groups of 4 to 6 and have the students engage in a solving a case. For example, you might present the following: "An 85-year-old woman with mild dementia and low vision (glaucoma) was admitted to the hospital with a fractured hip and is now getting ready for discharge. You are about to meet with both the patient and her daughter, who is very worried about her mother returning home. What issues do you need to consider, and what possible suggestions could you offer, so the patient can return home to an environment that will maximize her function and safety?"

Date posted: 
Thu, 10/05/2006
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/01/2012
Contact Person/Corresponding Author:



Suggested Citation:
, , , , and . Environmental Geriatrics. POGOe - Portal of Geriatrics Online Education; 2006 Available from: https://pogoe.org/taxonomy/term/255

Geriatric Health Maintenance: Cancer Screening

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

A presentation for geriatricians to educate seniors on the importance of cancer screening.

Educational objectives: 

To educate seniors on the importance of cancer screening. Learners should be able to 1.) discuss with their physician the risks and benefits of cancer screening. 2.) identify the different methods of screening for cancer.

Date posted: 
Wed, 11/01/2006
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 11/06/2006
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Health Maintenance: Cancer Screening. POGOe - Portal of Geriatrics Online Education; 2006 Available from: https://pogoe.org/taxonomy/term/255

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