Greetings!

Welcome to the Hartford Institute for Geriatric Nursing's November 2009 eNewsletter featuring articles, reference materials, useful links, calendar of events and other best practice information on the care of older adults.

This eNewsletter is sponsored by ConsultGeriRN.org.

ConsultGeriRN.org is the authoritative geriatric clinical nursing website of the Hartford Institute for Geriatric Nursing, New York University College of Nursing and the NICHE (Nurses Improving Care for Healthsystem Elders) program, (www.NICHEProgram.org). ConsultGeriRN.org contains evidence-based protocols and topics for nurses and other healthcare professionals on the care of older adults. Content is updated regularly.

Hartford Institute Evidence Based Protocols on Federal Healthcare Web Site

The goals of cognitive assessment are to determine an individual's cognitive abilities by: recognizing early the presence of an impairment in cognitive functioning, and monitoring an individual's cognitive response to various treatments. Undetected impairment in cognition is associated with greater morbidity and mortality, and assessing cognitive function is the foundation for early detection and prompt treatment of impairment. Conditions in which cognitive functioning is impaired include delirium, dementia, and depression.
Learn more about "Assessing Cognitive Function" with references and assessment tools by visiting ConsultGeriRN.org.

The vision statement emphasizes that, with the rapid increase in the population of U.S. older-adults, the nurse workforce must become equipped to meet their changing and specific health care needs. Older adults constitute the largest group of health care users across all settings, and virtually all nurses care for older adults in their subspecialties. The Statement is currently endorsed and supported by 25 Specialty Nursing organizations and 7 geriatric organizations, representing more than 320,000 nurses. "This is a major shift and a major commitment on part of the organizations that have signed the statement," said Mathy Mezey, EdD, RN, FAAN, director of the Hartford Institute. "Just as we know that care of older adults by geriatric nurses is better care, specialty nurses who have had geriatric preparation or who use geriatric instruments will also improve patient care."
To view the full editorial visit and register with the Geriatric Nursing website

The Hartford Institute will be exhibiting at the Nursing Organizations Alliance's 2009 Fall Summit, held November 19-21, 2009 in Louisville, Kentucky, and will be presenting the Specialty Nursing Association Global Vision Statement on Care of Older Adults to conference attendees. The statement emphasizes that, with the rapid increase in the population of U.S. older-adults, the nurse workforce must become equipped to meet their changing and specific health care needs. Older adults constitute the largest group of health care users across all settings, and virtually all nurses care for older adults in their subspecialties.

The purpose of the 2009 Fall Summit is to provide a forum for identification, education, and collaboration building on issues of common interest to advance the nursing profession. The Fall Summit is designed for the chief elected officers and chief staff officers of The Alliance member organizations. In presenting the Global Vision Statement, the Hartford Institute will be soliciting endorsements of the Global Vision Statements in order to meet our goal of having the statement endorsed by no fewer than 44 Nursing Organizations.

Learn more about the Specialty Nursing Association Global Vision Statement and follow along as new endorsements heat things up!

By: Kimberly T. Hall, MSN, FNP-BC and Deborah A. Chyun, PhD, RN, FAHA, FAAN
New York University, College of Nursing

Chronic diseases, such as cancer, diabetes, and cardiovascular disease (coronary heart disease, hypertension and dyslipidemia), disproportionately affect older adults and are associated with disability and diminished quality of life. These conditions share many of the same common, modifiable risk factors, including obesity and physical inactivity. Today, about 80% of older adults have at least one chronic condition, and 50% have at least two. Identification of chronic disease risk factors and early disease detection, through screening, may decrease the burden of chronic disease and protect and promote the health of older adults.

View Try This Issue 27 - General Screening Recommendations for Chronic Disease and Risk Factors in Older Adults

The three-year-old Advancing Excellence in America's Nursing Homes Campaign is moving to a new phase this month with the launching of a new and revised goals and an improved website www.nhqualitycampaign.org to provide nursing home leaders with new resources and other materials to help advance quality improvement activities.
To learn more, read the message from Mary Jane Koren, MD. MPH, Chair of the Advancing Excellence Campaign.

Fall 2009 Webinar Series:

Unit Design and Capital Equipment in U.S. Hospitals

2010 Annual NICHE Conference

Collaborate! Interdisciplinary Paths to Improved Geriatric Care

New Pathways to Excellence!

Deborah A. Chyun, PhD, RN, FAHA
Associate Director
Hartford Institute for Geriatric Nursing
New York University College of Nursing

A recent article looking at the comparative effectiveness of minimally invasive radical prostatectomy (MIRP) versus open retropubic radical prostatectomy (RRP) highlighted the fact that while MIRP was associated with a shorter length of stay, fewer blood transfusions, and lower rates of respiratory or miscellaneous surgical complications, genitourinary complications were more common with MIRP, as were incontinence and erectile dysfunction.¹ Equally important, the use of MIRP has increased dramatically from 2003 to 2007, accounting for 43% of the total number of prostatectomies. The authors raise an important warning about early adoption of new therapies despite a lack of proven benefit over another, established procedure. They further question the role of society and a health care system eager to embrace expensive new technologies. Given the reluctance of many providers to adopt other well-established, evidence-based therapies, the early and perhaps premature adoption of certain therapies perceived to be beneficial is problematic. Reality is what should be guiding practice and helping our patients make informed decisions.

1 Hu, JC, Gu, X, Lipsitzm SR, D'Amico, AV, Weinberg, AC, and Keating, NL. (2009). Comparative effectiveness of minimally invasive vs open radical prostatectomy. JAMA, 302:1557-64.

What are your thoughts and ideas on this subject? Let us know by answering our poll or responding directly to the author on the Hartford Institute forums!