July 2015
 
 

NICHE Hospital Advances and Resources Update: Long Term Care


During transitions between settings, the older adult patient population is particularly vulnerable to experiencing poor care quality and problems of care fragmentation. The following is an excerpt from Fidelindo, L., Foust, J., and Van Cleave, J. Transitional Care. In: M Boltz, E Capezuti, T Fulmer, & D Zwicker. (eds.) Evidence-Based Geriatric Nursing Protocols for Best Practice (4th ed.). New York: Springer Publishing.

 

Nursing staff shortages have forced an increasing number of acute hospitals to divert patients to other facilities where a completely new set of clinicians, who often do not have timely access to the patients' prior medical records, manages them. Long term care staff are overwhelmed and do not have the time or initiative to request necessary information. Also, clinicians do not verbally communicate patient information to one another across care settings. 

 

Following is an approach developed at a NICHE Hospital related to patients and families.  
 

Innovations 

 

Care Model Transformation: Changing
the Long Term Care Experience

 

Authors: Cindy MacQuarrie, MN, RN, Marie McPhee, & Dawn McLaine, RN, BScN, Cape Breton District Health Authority, Sydney, Nova Scotia, Canada.

 

The aim of this project was to understand the effect of implementing a Collaborative Care Model on five performance indicators: provider satisfaction, patient/family satisfaction, fall rates, urinary tract infections (UTIs), and aggression rates on three long term care units.

 

The model enabled healthcare providers to make the best use of their skills by using efficient processes, information, and technology to improve patient safety. It also encouraged patient/family involvement in the plan of care.

 

Three data collection methods were used:

  • Provider Survey: completed pre- and post-care model redesign
  • Resident/Family Survey: completed pre- and post-care model redesign
  • Key Performance Indicators: real-time monitoring of fall rates, UTI, and aggression rates.
Results suggest that the model redesign had positive results, making a difference for patients, families, and healthcare providers. It also fostered patient/family involvement in care while providing interventions known to reduce avoidable harm. 

 

NICHE-related Resources

Full access to some of the resources referenced here is only available to NICHE member hospitals. 

Geriatric Resource Nurse (GRN) Curriculum
GRN Function Slide

Designed for use by NICHE members who educate nurses in best practices for older hospitalized adults.


Geriatric Institutional Assessment Profile for Long Term Care

For use in assessing staff knowledge, perceptions of care practices, professional issues, as well as the care environment for nurses, certified nursing assistants, and other staff specific to the long term care and skilled nursing facility settings.

Need to Know BY NICHE Series

Dementia Transition Series: Hospital to Long Term Care (LTC) or Rehabilitation


NICHE for Patient+Family mobile app helps prepare older adult patients and their caregivers for the realities of hospitalization and transitions between home, hospitals, and nursing homes.




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