Development of Gerontological Learning Objectives to Enhance Nursing Educational Curricula.

BACKGROUND: Many nursing schools are challenged to provide adequate gerontological education to students despite the enormous benefits to students' careers and society. This project developed student learning objectives to be used by nursing faculty to facilitate enriched gerontology courses and program curricula. METHOD: The project team drafted a comprehensive list of nursing student learning objectives based on the 2020 Canadian Gerontological Nursing Association Standards of Practice and Competencies and included relevant supportive references. Subsequently, 20 gerontological nurse experts reviewed the learning objectives through a modified Delphi process via online Qualtrics surveys (two rounds). RESULTS: A total of 176 learning objectives were rated in round one for importance, measurability, feasibility, and interpretability; these were amalgamated to 47 learning objectives for review in round two. CONCLUSION: Thirty-three learning objectives were identified and validated that can be used by nursing schools to offer increased opportunities for gerontological learning. [J Nurs Educ. 2024;63(4):256-260.].

Effective Chronic Disease Interventions in Nursing Homes: A Scoping Review Based on the Knowledge-to-Action Framework.

Objectives: The purpose of this scoping review was two-fold: 1) to identify effective intervention studies addressing chronic disease for seniors living in nursing homes (e.x. chronic heart failure, diabetes, dementia, etc.), and 2) to describe how consistently the studies' reported their stages of the Knowledge-to-Action framework (2006).Methods: This scoping review involved a systematic search of CINAHL, EMBASE, PubMed and Scopus of intervention studies, published in English and French between 1997 and 2018, that focused on the development, implementation and/or evaluation of a chronic disease management guideline or best practice for older adults 65+ residing within a nursing home (NH). Authors abstracted information specific to the seven stages of the Knowledge-to-Action framework (identifying problem, tailoring to local context, barriers and facilitators to intervention delivery, implementation, monitoring, outcome criteria, and sustainability).Results: Six studies met the inclusion criteria. Procedures for monitoring knowledge use and outcome evaluation were thoroughly described. Other stages of the Knowledge-to-Action framework were not consistently reported, including problem identification related to older adults' needs and within the context of NHs, intervention implementation, evaluation, and sustainability. Of the six studies included, only two met all the pre-defined evaluation outcomes.Conclusions: Given the need for chronic disease management in NHs, researchers are encouraged to report on intervention studies using the Knowledge-to-Action framework to optimize the likelihood that interventions will be suitable for the context of their delivery and introduce sustainable change.Clinical implications: To answer what interventions should be introduced to residents in long-term care, research must clearly demonstrate efficacy, provide enough detail for methods to be reproducible in applied contexts, and consider strategies for sustainability and the holistic needs of residents.

InterRAI Acute Care Instrument for Seniors in Canadian Hospitals: Findings of an Inter-Rater Reliability Pilot Study.

BACKGROUND: Older adults are the biggest users of emergency departments and hospitals. However, healthcare professionals are often ill equipped to conduct comprehensive geriatric assessments causing missed opportunities for preventing adverse outcomes. PURPOSE: To evaluate the inter-rater reliability of the interRAI Acute Care (AC) instrument for hospitalized older adults in two acute care hospitals in Ontario, Canada. METHODS: This descriptive study focused on evaluating the interRAI AC instrument, which was designed to facilitate a comprehensive nursing assessment for hospitalized seniors. Sample characteristics were described, and Cohen's Kappa was calculated to derive the inter-rater reliability. Assessment times to complete the instrument were collected as well. RESULTS: The Cohen's Kappa score for the instrument was 0.96. Many older adults who were interviewed had several challenges, including multimorbidity, polypharmacy, and lack of home support. The average time required for nurses to complete the interRAI AC instrument was 22 min. CONCLUSIONS: The interRAI AC instrument is reliable for use by trained nurses to conduct a comprehensive assessment. This instrument offers a standardized and efficient approach to assess for care and intervention priorities and could prevent adverse outcomes in hospitalized older adults.

La nécessité des approches interdisciplinaires et collaboratives pour évaluer l'impact de la COVID-19 sur les personnes âgées et le vieillissement: déclaration conjointe de l'ACG / CAG et de la RCV / CJA.

La pandémie de la COVID-19 et l'état d'urgence publique qui en a découlé ont eu des répercussions significatives sur les personnes âgées au Canada et à travers le monde. Il est impératif que le domaine de la gérontologie réponde efficacement à cette situation. Dans la présente déclaration, les membres du conseil d'administration de l'Association canadienne de gérontologie/Canadian Association on Gerontology (ACG/CAG) et ceux du comité de rédaction de La Revue canadienne du vieillissement/Canadian Journal on Aging (RCV/CJA) reconnaissent la contribution des membres de l'ACG/CAG et des lecteurs de la RCV/CJA. Les auteurs exposent les voies complexes par lesquelles la COVID-19 affecte les personnes âgées, allant du niveau individuel au niveau populationnel. Ils préconisent une approche impliquant des équipes collaboratives pluridisciplinaires, regroupant divers champs de compétences, et différentes perspectives et méthodes d'évaluation de l'impact de la COVID-19.

Profiling the Characteristics of People Who Are Comatose in Long-term and Complex Continuing Care Settings.

OBJECTIVES: To describe the sociodemographic, clinical, and treatment characteristics of people who are comatose in Canadian complex continuing care (CCC) and long-term care (LTC) settings, and to make recommendations to promote comprehensive care planning for this population. DESIGN: Retrospective, cross-sectional analysis of population data. SETTING AND PARTICIPANTS: All residents in the Canadian provinces of Alberta, Ontario, British Columbia, Manitoba, Nova Scotia, Newfoundland, Saskatchewan, and the territory of Yukon with data available from the fiscal year 2015 (April 1, 2015, to March 31, 2016). MEASURES: Demographic, clinical, and treatment variables were extracted from the Resident Assessment Instrument-Minimum Data Set (MDS 2.0) and were reported using descriptive statistics. RESULTS: Of the LTC and CCC populations, 0.07% and 3.5% were identified as comatose, respectively. Overall, people who are comatose in both CCC or LTC settings are younger and have a longer length of stay than those who are not comatose. A higher proportion of people who are comatose experience active infections and irregular bowel elimination patterns, and those who are comatose were more likely to have a feeding tube and require oxygen therapy or suctioning than those who were not comatose. However, a lower proportion of people who were comatose had documented pain. In LTC, one-quarter of people who are comatose are expected to die within 6 months. CONCLUSION/IMPLICATIONS: Although the prevalence of people who are comatose in LTC and CCC settings is low, this population is complex and has significant care needs that require comprehensive assessment and care planning.