The Faculty Nurse Attending Model at the Mount Sinai Hospital.

The ongoing nursing shortage and the ravages of the COVID-19 pandemic have further challenged nursing staff with devastating shortages. This article describes the Faculty Nurse Attending Model, an innovative approach incorporating nursing faculty into staffing and the ongoing interdisciplinary rounds at the Mount Sinai Hospital in New York City. The Mount Sinai Phillips School of Nursing faculty actively participates in the pilot unit to support nursing practice and ensure that the curricula address contemporary practice.

Expanding Public Health Practice to Address Older Adult Health and Well-being.

CONTEXT: The older adult population in the United States is experiencing unprecedented growth and is accompanied by a parallel increase in the health challenges of these individuals. Public health has, historically, not played a large role in older adult health, but given its contributions to longevity, it makes sense for public health to now prioritize the health of this population. PROGRAM: With the goal of public health prioritization of healthy aging, Trust for America's Health, with support from The John A. Hartford Foundation, launched an initiative to demonstrate the crucial roles public health departments can play to improve the health of older adults. IMPLEMENTATION: An Age-Friendly Public Health Systems (AFPHS) Learning and Action Network was created to provide local health departments in Florida with training and technical assistance through in-person and virtual activities, as well as access to events, opportunities, and resources to increase expertise and capacity to address healthy aging. AFPHS Network participants attended monthly learning activities to enhance their capacity around data analysis, health equity, partnerships and collaboration, social determinants of health, and other age-friendly initiatives. EVALUATION: Network participants are being tracked on 13 key indicators to improve the health and well-being of older adults, including data collection and dissemination; ensuring emergency preparedness plans target older adults; and targeting older adult health needs in community health assessments. DISCUSSION: Trust for America's Health's AFPHS initiative demonstrates that state and local public health departments have crucial roles to play to improve the health and well-being of older adults through data collection and analysis, collaboration with aging sector stakeholders, and adapting policies and programs to become age-friendly.

Advancing Gerontological Nursing at the Intersection of Age-Friendly Communities, Health Systems, and Public Health.

Mounting efforts to improve care and promote healthy aging throughout society and across the care continuum have created unique opportunities for gerontological nursing practice. Population aging has invoked a multitude of responses among all levels of international and national organizations, foundations, health care, and government to meet the needs and promote preferences of older adults. Large-scale programs by the World Health Organization, The John A. Hartford Foundation, Institute for Health-care Improvement, and Trust for America's Health have galvanized to advance the momentum of age-friendly communities, health care, and public health. Gerontological nurses can leverage this growing interest in aging by enhancing their knowledge about age-friendly movements, influencing these movements with their expertise in evidence-based practices, and advancing their own competencies in caring for older adults in any setting. [Journal of Gerontological Nursing, 47(3), 13-17.].

Developing a tool to assess and monitor institutional readiness to address elder mistreatment in hospital emergency departments.

Hospital emergency departments (EDs) lack the tools and processes required to facilitate consistent screening and intervention in cases of elder abuse and neglect. To address this need, the National Collaboratory to Address Elder Mistreatment has developed a clinical care model that ED's can implement to improve screening, referral, and linkage to coordinated care and support services for older adults who are at risk of mistreatment. To gauge ED readiness to change and facilitate adoption of the care model, we developed an organizational assessment tool, the Elder Mistreatment Emergency Department Assessment Profile (EM-EDAP). Development included a phased approach in which we reviewed evidence on best practice; consulted with multidisciplinary experts; and sought input from ED staff. Based on this formative research, we developed a tool that can be used to guide EDs in focusing on practice improvements for addressing elder mistreatment that are most responsive to local needs and opportunities.

A retrospective/prospective on the future of geriatric nursing.

This paper will describe the exciting progress in geriatric nursing practice over the past 40 years and pay tribute to the leadership in the field, the progress in our programs of research and our commitment to ensuring our older patients get the reliable, high value, evidenced-based care they deserve. A brief synopsis of the literature related to the future of geriatric nursing and the field of geriatrics, describing themes from the literature in the context of the papers contained herein. Themes include: shortage of trained geriatric healthcare professionals, shortage of faculty, paucity of research funding, interdisciplinary care is required, meaningful use and integration of technology, lack of research funding and lack of interest in geriatrics as a specialty. The rapidly accelerating demand for geriatric nurse experts and care for older adults positions the nursing profession as principal agent in bridging care-gap needs for older persons, families, and their communities.

Screening for elder mistreatment in emergency departments: current progress and recommendations for next steps.

Emergency Department (ED) visits provide an important but seldom realized opportunity to identify elder mistreatment. Many screening tools exist, including several that are brief and may be effective, but few have been specifically designed for or tested in EDs. In addition to the absence of validated tools, other challenges with implementing ED elder mistreatment screening include difficulty integrating anything longer than a few questions into a busy clinical encounter and resources required to respond to positive screens. The Electronic Health Record (EHR) offers a critical tool to facilitate elder mistreatment screening through required data entry and real-time monitoring of compliance and results. We describe current work in the field and recommend next steps including design and testing of a two-step screening process, implementation research to accelerate adoption, development of ED-based interventions and referral protocols for positive cases, and consideration of the important role of pre-hospital providers in case identification.

NUCare: Advancing research on technological integration for self-management in the aging population.

BACKGROUND: The Center for Technology in Support of Self-Management and Health (NUCare) is an exploratory research center funded by the National Institute of Nursing Research's P20 mechanism positioned to conduct rigorous research on the integration of technology in the self-management of the older adult population. PURPOSE: The purpose of this paper is to describe the development and application of an evaluation plan and preliminary evaluation results from the first year of implementation. METHODS: This evaluation plan is derived from and is consistent with Dorsey et al.'s (2014) logic model. Dorsey's model provided guidelines for evaluating sustainability, leveraging of resources, and interdisciplinary collaboration within the center. DISCUSSION: Preliminary results and strategies for addressing findings from the first year of evaluation are discussed. A secondary aim of this paper is to showcase the relevance of this center to the advancement and maintenance of health in the aging population.

Resident-to-Resident Mistreatment: Evaluation of a Staff Training Program in the Reduction of Falls and Injuries.

Resident-to-resident elder mistreatment (R-REM) occurs frequently in long-term services and support settings. The purpose of the current study was to evaluate the effect of a R-REM training program for nursing and other frontline staff on resident falls and injuries in a cluster randomized trial of units within four nursing homes. Interview and observational data from a sample of 1,201 residents (n = 600 and n = 601 in the usual care and intervention groups, respectively) and staff were collected at baseline and 6 and 12 months. A generalized linear model was used to model the falls/injuries outcome. The net reduction in falls and injuries was 5%, translating to 10 saved events per year in an averagesized facility. Although the result did not reach statistical significance due to low power, the findings of fall prevention associated with implementing the intervention in long-term care facilities is clinically important. [Journal of Gerontological Nursing, 44(6), 15-23.].

E-Learning with virtual teammates: A novel approach to interprofessional education.

The Institute of Medicine identified interprofessional education (IPE) as a key innovation for achieving the triple aim of better care, better outcomes, and reduced healthcare costs. Yet, a shortage of qualified faculty and difficulty with aligning learners' schedules often prevent sustainable and scalable IPE. A virtual IPE intervention was developed to circumvent these barriers and compared to a blended-learning IPE intervention. We used a pre-test and post-test design with two comparison interventions to test the effects of these IPE interventions on changes in teamwork knowledge, skills, and attitudes. The interventions were delivered to pre-licensure learners at a large, metropolitan medical and a nursing school. We used one-sample and independent-sample t-tests to analyze data from 220 learners who received the blended-learning intervention in 2011 and 540 learners who received the virtual learning intervention in 2012. The students in the blended-learning intervention did not significantly (p < 0.05) outperform the students in the virtual learning intervention for any of the measured outcomes, except for medical students' attitudes around team value. Virtual IPE learning is an effective, scalable, and sustainable solution for imparting foundational teamwork knowledge in health profession students.

Verbal mistreatment of the elderly.

Elder mistreatment is expected to rise with the aging of the American population. To date, the association between specific forms of mistreatment and decreased quality of life is poorly understood. The aim of the present study was to explore the association between verbal mistreatment among elderly individuals and depression and quality of life. A sample of 142 older adults (40% male) aged 65 or over was enrolled from a large medical practice and academic dental practice, mean (SD) age = 74.88 (6.98) years. Thirty-eight percent of the sample reported verbal mistreatment. Controlling for sociodemographic characteristics and depression, verbal mistreatment was a significant predictor of social functioning (r = -.28, p < .001), mental health (r = -.25, p < .001), and role limitations OR = 3.02, 95% CI [1.34-6.77]. The present findings highlight the prevalence of verbal mistreatment of elderly individuals.

Optimizing delirium care in the era of Age-Friendly Health System.

Delirium is a significant geriatric condition associated with adverse clinical and economic outcomes. The cause of delirium is usually multifactorial, and person-centered multicomponent approaches for proper delirium management are required. In 2017, the John A. Hartford Foundation and the Institute for Healthcare Improvement (IHI) launched a national initiative, Age-Friendly Health System (AFHS), promoting the use of a framework called 4Ms (what matters, medication, mentation, and mobility). The 4Ms framework's primary goal is to provide comprehensive and practical person-centered care for older adults and it aligns with the core concepts of optimal delirium management. In this special article, we demonstrate how a traditional delirium prevention and management model can be assessed from the perspective of AFHS. An example is the crosswalk with the Hospital Elder Life Program (HELP) Core Interventions and the 4MS, which demonstrates alignment in delirium management. We also introduce useful tools to create an AFHS environment in delirium management. Although much has been written about delirium management, there is a need to identify the critical steps in advancing the overall delirium care in the context of the AFHS. In this article, we suggest future directions, including the need for more prospective and comprehensive research to assess the impact of AFHS on delirium care, the need for more innovative and sustainable education platforms, fundamental changes in the healthcare payment system for proper adoption of AFHS in any healthcare setting, and application of AFHS in the community for continuity of care for older adults with delirium.

Influencing collaborative leadership: an interview with Dean Terry Fulmer. Interview by Jeffrey M. Adams.

This department highlights nursing leaders who have demonstrated a commitment to innovation and patient care leadership in practice, policy, research, education and theory. This interview profiles Terry Fulmer, PhD, RN, FAAN, chairperson of the Robert Wood Johnson Executive Nurse Fellows Advisory Committee and dean of the Bouvé College of Health Sciences at Northeastern University.

Age-Friendly Ecosystems: Expert Voices from the Field.

(1) Background: With the growth of the age-friendly movement, age-friendly ecosystems (AFE) garnered more attention. The successful development of an AFE is contingent on unified efforts across different stakeholders; however, limited efforts were made to help create a common understanding of the necessary components of an AFE. (2) Methodology: In response, The John A. Hartford Foundation and The Age-Friendly Institute hosted a series of convenings of international experts to identify a working definition of the characteristics composing an AFE. The goal of these convenings was to provide a foundation on which to unite cross-sector age-friendly work. (3) Results: This paper discussed the findings of the convenings and provided a framework from which future age-friendly work must draw upon. (4) Conclusions: This paper presented a necessary change in how we conceive AFEs.

Identifying unaddressed systemic health conditions at dental visits: patients who visited dental practices but not general health care providers in 2008.

We assessed the proportion and characteristics of patients who do not regularly visit general health care providers but do visit dentists and whose unaddressed systemic health conditions could therefore be identified by their dentist. Of the 26.0% of children and 24.1% of adults that did not access general outpatient health care in 2008, 34.7% and 23.1%, respectively, visited a dentist. They varied by census region, family income, and sociodemographics. Dental practices can serve as alternate sites of opportunity to identify health concerns among diverse groups of US patients.