Integrating the ELNEC undergraduate curriculum into Nursing Education: Lessons learned.

Nurses are called to lead and transform palliative care, compelling nurse educators to provide the requisite education to do so. All nursing students need to learn primary palliative care to be prepared to care for the growing number of patients with serious illness and their families. The American Association of Colleges of Nursing (AACN) Competencies And Recommendations for Educating nursing Students (CARES) document outlines 17 palliative care competencies to be attained by graduation from their pre-licensure programs. Integrating standardized primary palliative care education into curriculum remains a challenge for nurse educators. The End of Life Nursing Education Consortium (ELNEC) Undergraduate online modules represent one educational strategy that supports faculty and students in meeting AACN competencies as well as other national guidelines for palliative care education. Despite its ease of use, only about 25% of all undergraduate programs are incorporating these into their programs. Faculty continue to report barriers to implementing palliative care education, including saturated curricula, limited content expertise, and cost. This paper describes lessons learned from palliative care champion nursing schools to help overcome these barriers.

Development of a Long-Term Care Nurse Residency Program.

Nurses working in the long-term care (LTC) setting provide increasingly complex patient care, often without formal training on the specific needs of LTC patients, which can lead to burnout and high turnover rates. Nurse residency programs (NRPs) have been used effectively to orient novice RNs to their work setting, address transition-to-practice challenges, and promote retention, yet few LTC NRPs have been developed. The University of Utah Geriatric Education Consortium Geriatric Workforce Enhancement Program created an online LTC NRP to provide LTC nurses with the knowledge and skills to succeed in the LTC environment. RNs with <1 year of LTC experience were paired with experienced nurse mentors working within the same LTC facility. Synchronous and asynchronous curricular modules addressed leadership and communication, caring for older adult patients, quality improvement, and the LTC regulatory environment. A distance-based LTC NRP allows nurses flexibility in gaining gerontological nursing and leadership expertise that supports their professional goals. [Journal of Gerontological Nursing, 47(2), 37-43.].

The Impact of the End-of-Life Nurse Education Consortium on Attitudes of Undergraduate Nursing Students Toward Care of Dying Patients.

This mixed methods study explored the impact of the End-of-Life Nursing Education Consortium (ELNEC)-Undergraduate Curriculum on perceived preparedness of undergraduate nursing students in the care of dying patients and the relationship between personal loss experience and undergraduate nursing students' attitudes regarding the ELNEC-Undergraduate Curriculum. Of the 36 undergraduate nursing students who completed ELNEC, 24 reported a personal loss of a close family member or friend to death and 12 reported no loss. Findings confirmed the overall positive impact and acceptability of ELNEC, but this effect was observed differently between students with and without previous loss. Students with personal loss were more aware of the challenges of end-of-life care before taking ELNEC and incorporated the content into a greater sense of preparedness. Study recommendations include placing ELNEC within didactic instruction by well-prepared faculty, creating simulation debrief groups composed of both students with and without loss, and faculty attention to the loss experiences of students.

Summary of factors contributing to falls in older adults and nursing implications.

Falls are a common cause of serious injury and injury-related death in the older adult population, and may be associated with multiple risks such as age, history of falls, impaired mobility, balance and gait problems, and medications. Sensory and environmental factors as well as the fear of falling may also increase the risk of falls. The purpose of this article is to review current best practice on screening fall risks and fear of falling, fall prevention strategies, and fall prevention resources to assist gerontological nurses in reducing falls by their older adult clients.

Strategic planning for organizational effectiveness during dynamic change.

The leadership of a professional association is charged with developing a strategic plan to operationalize the organization's goals, tactics, and progress. Within the context of its values and goals, a strategic plan steers the organization toward its mission. While there are a variety of models and approaches used in strategic planning, the National Gerontological Nursing Association (NGNA) has historically used goal-based methodology. This method is congruent with the organization's leadership preferences, consistent with the mission-driven culture of the organization, and collaborative in its approach. In 2009 the NGNA Board of Directors initiated a plan for the organization's transformation to a more dynamic and member-driven association through a deliberate process. This article addresses the process used to arrive at the 2010­2011 NGNA strategic initiatives, including a discussion of pertinent data revealed in the 2011 needs assessment survey and NGNA's future initiatives focused on networking, communication, and membership benefits. This process is relevant for all organizations and groups seeking improvement in serving their constituents.

Review of current conceptual models and frameworks to guide transitions of care in older adults.

Older adults are at high risk for gaps in care as they move between health care providers and settings during the course of illness, such as following hospital discharge. These gaps in care may result in unnecessary re-hospitalization and even death. Nurses can assist older adults to achieve successful transitions of care by taking a systematic approach and individualizing care to meet patient and family health literacy, cognitive, and sensory needs. This article reviews trends in transitions of care, models, partnerships, and health literacy. Models described include the Transitional Care Model, Care Transitions Program, Project BOOST (Better Outcomes for Older adults through Safe Transitions), Project RED (Re-engineered Discharge), Chronic Care Model, and INTERACT(II) (Interventions to Reduce Acute Care Transfers). Approaches to transitions of care are discussed, and resources for geriatric nurses are provided.

The role of information technology in translating educational interventions into practice: an analysis using the PRECEDE/PROCEED model.

OBJECTIVE: The evidence base for information technology (IT) has been criticized, especially with the current emphasis on translational science. The purpose of this paper is to present an analysis of the role of IT in the implementation of a geriatric education and quality improvement (QI) intervention. DESIGN: A mixed-method three-group comparative design was used. The PRECEDE/PROCEED implementation model was used to qualitatively identify key factors in the implementation process. These results were further explored in a quantitative analysis. METHOD: Thirty-three primary care clinics at three institutions (Intermountain Healthcare, VA Salt Lake City Health Care System, and University of Utah) participated. The program consisted of an onsite, didactic session, QI planning and 6 months of intense implementation support. RESULTS: Completion rate was 82% with an average improvement rate of 21%. Important predisposing factors for success included an established electronic record and a culture of quality. The reinforcing and enabling factors included free continuing medical education credits, feedback, IT access, and flexible support. The relationship between IT and QI emerged as a central factor. Quantitative analysis found significant differences between institutions for pre-post changes even after the number and category of implementation strategies had been controlled for. CONCLUSIONS: The analysis illustrates the complex dependence between IT interventions, institutional characteristics, and implementation practices. Access to IT tools and data by individual clinicians may be a key factor for the success of QI projects. Institutions vary widely in the degree of access to IT tools and support. This article suggests that more attention be paid to the QI and IT department relationship.