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GEC Partner Programs >> NYU

Visiting Nurse Service of New York

Geriatric Nursing in Home Care: A Clinical Training Program at the Visiting Nurse Service of New York (VNSNY)

Geriatric Nursing Competency in Home Care: A Clinical Training Program at the Visiting Nurse Service of New York (VNSNY)

Problem to be addressed:
Of all sectors of health care delivery, home care is the fastest growing. Irrespective of physical or functional decline, older people prefer to remain in their own home. As the largest, not-for-profit, non-governmental home care agency in the US, the Visiting Nurse Service of New York (VNSNY) delivers care to 30,000 patients daily throughout the five boroughs of New York City. Sixty four percent of these patients are over the age of 65, with the average age of patients at 73. The VNSNY offers an array of clinical programs to meet the complex and diverse needs of patients for acute, long-term and palliative care services at home.

The 2,560 Registered Nurses employed by VNSNY deliver direct care to patients, work closely with other professional staff (e.g. physical therapists and social workers), and supervise over 6,000 home health aides. It is imperative that these nurses be competent in care of older patients. Yet, within VNSNY, only a handful of nurses are certified in geriatrics. With this initiative and new initiatives subsequently added to the VNSNY program in geriatric training and education, VNSNY is working to assure geriatric competency in their nursing workforce and to increase the number of nurses certified in geriatrics.

The VNSNY/Hartford Institute Project:
In 2008, VNSNY and the Hartford Institute for Geriatric Nursing at the NYU College of Nursing (Hartford Institute) (with partial funding from the NY City Department for the Aging and the Fan Fox and Leslie R. Samuels Foundation) began to collaborate on a pilot project to assure that VNSNY nurses were prepared in geriatrics. In the project's first phase, in 2009, VNSNY educated 20 nurses working in the VNSNY Long Term Home Health Care Program (LTHHCP), the “Lombardi” program. The LTHHCP program, with over 3,000 patients enrolled, enables patients with chronic illness or disabilities to live at home instead of in a nursing home facility.

The goals for this pilot phase of the program (2009 and Spring, 2010) are to prepare 40 nurses from the >90 nurses in the Queens office of the VNSNY LTHHCP program (patient case load 1,509) in best practices in care of older adults. RNs completing the educational module will sit for the ANCC Gerontological Certification Exam. An evaluation plan is in place to evaluate the program effectiveness. Participants completing the 40 hours of the educational program receive Certificates of Completion from the Consortium of New York Geriatric Education Centers (CNYGEC).

Project Evaluation:

Program evaluation includes querying nurse trainees using two instruments:

1) Assessment of Geriatric Capacity in Home Care that assesses trainee attitudes and perceptions related to the care of older adults (a modification of an instrument used by NICHE hospitals)

2) a knowledge test of geriatric care. Trainees will complete both instruments before and after training. The number of VNSNY nurses participating in each training session and those sitting for the ANCC Certification Course will be recorded. The Nurse Administrator of the VNSNY LTHHCP is an active member of the Steering Committee for this project and will give feedback throughout the project. Participants also complete all of the evaluation instruments of the CNYGEC.

Training for VNSNY LTHHC nurses in best-practices in geriatric nursing:
The project that VNSNY and the Hartford Institute have developed and begun to implement builds on the nationally recognized training and clinical materials and models developed by the Hartford Institute (www.ConsultGeriRN.org; www.HartfordIGN.org), and the Hartford Institute NICHE program (Nurses Improving Care to Healthsystems Elders), specifically an evaluation tool of nurses perception of the environment to support competence in geriatric nursing care, and the Geriatric Resource Nurse (GRN) model which trains nurses in geriatrics who in turn become resources for units within the hospital.

The VNSNY program provides both traditional face-to-face synchronous training and asynchronous internet training to VNSNY nurses using nationally recognized evidence-based best practices training materials on the care of older adults developed by the Hartford Institute.

This training focuses on the major nursing needs of older adults in home care, including assessment and management of geriatric conditions and syndromes. Nurses will apply electronic resources accessible through portable tablet technology. The trainings use a blended approach of face-to-face live teaching and materials on the Hartford Institute clinical nursing website www.ConsultGeriRN.org.

Training for nurses to sit for the ANCC Gerontological Nursing Certification:
The American Nurses Credentialing Center (ANCC) offers a Gerontological Nursing Certification examination that is open to all RNs who successfully complete an examination and meet practice hour requirements. VNSNY will prepare 40 nurses from the LTHHC program to sit for this exam in 2 classes of 20, one in Spring and one in Fall 2008. VNSNY will conduct face-to-face trainings (2 hours /week over 12 weeks) with the last class focused on completing the ANCC application to sit for certification. VNSNY will reimburse nurses for the application fee to sit for the exam. The web-based certification review course available on www.ConsultGeriRN, will supplement the face-to-face trainings. Nurses will receive 40 hours of CEUs: 24 from the class and 16 from web materials.

Project Impact:

We anticipate that the project will have a substantial impact on the geriatric capacity of the nurse workforce at VNSNY. For the individual nurse exposed to geriatric best practices, the project should improve care by greater use of assessment and protocols for older adults. These nurses should more easily identify “abnormal” behavior or symptoms and thus make more timely referrals and head off untoward events.

Contact Information

Program Director: Mary Jo Vetter, RN, MS, NP-C, Director of New Clinical Product Development, Visiting Nurse Service of New York (VNSNY); 212 609-6358; 212 290-2167; maryjo.vetter@vnsny.org

Health and Hospital Corporation

Enhancing Nurse Competence in Care of Older Adults at New York City Health and Hospital Corporation

In 2010, HHC employees have a special opportunity to take the Geriatric Scholar Certificate Program for $100 or $30 per individual training.

Pilot Project Summary

In 2009, the Hartford Institute for Geriatric Nursing (Hartford Institute), in conjunction with the Corporate Nursing Department, New York City Health and Hospital Corporation (HHC-Nursing) conducted a Pilot Project to enhance competence in care of older adults of nurses working in HHC facilities. This Pilot project was partially funded by the New York City Department for the Aging, and by the Fan Fox and Leslie R. Samuels Foundation.

Background

The 21 acute care hospitals, clinics, and nursing home facilities of the New York City, the Health and Hospitals Corporation (HHC) care for 1.3 million of the city's poorest citizens and its legal and illegal immigrants. It also assumes a large burden of health care for New York's older adults. In Fiscal Year 2009, to date, HHC has cared for 176,000+ patients 60 years of age and over, of whom 49% were 70 and over.

In HHC facilities, 8,000 RNs that are in the forefront of this care, whether chronic or acute, in ambulatory or inpatient settings. RNs at HHC are highly interested in expanding their knowledge and expertise in the care of the older adults. Yet, almost non of these nurses have had specific training and education in care of older adults. This mirrors national data that <1% of RNs are certified in geriatrics.

Pilot Project Details

Pilot Project Program; The Pilot project offered eight (8) full day geriatric education programs that conformed to the NYCGEC requirements of core and elective courses.

  • Educational programs were focused on clinical issues of concern to nurses, e.g. falls, urinary incontinence, pressure ulcers (content of the educational program appended in the Evaluation Report).
  • Classes focused on content that would prepare nurses to sit for the examination of the American Nurses Credentialing Center for Certification in Gerontological Nursing.
  • Nurses completing five educational programs (50 hours of training) were eligible for the Certificate of Completion from the NYGEC

Pilot Project Attendance by HHC nurses: The Pilot programs were completed with 154 unique nursing participants.

Forty eight (48) program participants completed 5 or more sessions, and received a Certificate of Completion from the NYCGEC.

All of the 11 HHC hospitals and 4 HHC nursing homes sent nurses for full participation in the program. This required financial commitment from the facilities to provide “back-fill” nursing coverage to allow these nurses to be released from their day-to-day clinical responsibilities.

The preference for a cohort of nurses rather than random attendance at events represents a shift of emphasis on the part of HHC from our original plan, and represents a strong commitment on the part of corporate nursing to provide in-depth training to nurses in the hope of having them share information back at their facilities and perhaps to encourage the nurses to sit for the nursing certification exam. This works well within the concept of the project as a Pilot Program.

HHC committed significant administrative staff who helped organize, facilitate registration, and attend the events, duplicating many resource materials, providing continuing education credits and breakfast and lunches.

Pilot Project Evaluation Report:

The evaluation, including focus groups with nurses as to the clinical relevance of the educational program and resources, has been completed (see appended Evaluation Report).

Phase I

Following the Pilot Program, the Hartford Institute for Geriatric Nursing collaborated specifically with the HHC Office of Patient Centered Care and 3 HHC hospitals – Harlem Hospital, North Central Bronx Network (NCBN), and Queens Hospital - to implement a program called NICHE (Nurses Improving Care to Healthsystem Elders) in order to create an elder-friendly environment with enhanced geriatric expertise of staff and enhanced outcomes for the older adult patients at these hospitals. The emphasis was that each HHC NICHE hospital is unique and needed to tailor its NICHE project in accordance with the facility culture and priorities.

During the 24 months of this initiative, approximately 2000 Patients or Clients over age 65 were impacted on the NICHE units in the 3 HHC hospitals; 165.5 (Geriatric Resource Nurses: 83) professionals on NICHE Units in the 3 HHC hospitals participated

Project initiative included:

Interdisciplinary NICHE Steering Committees
Hospital Nurse Leadership Training and Action Plans
Designated NICHE Project Units
Geriatric Training in designated NICHE Units
Encouragement of Gerontological Nursing Certification
Participation in National NICHE Conference
HHC Intranet dissemination of resources
NICHE Clinical Consultant

Phase II

Started in September, 2012, Phase II continues this initiative and expands the program to four additional HHC facilities, Jacobi, Lincoln, Elmhurst and Coney Island Hospitals, with “Phase II Expansion: Enhancing HHC Competencies to Care for Older Adults.”

Institutions and Project Investigator
Hartford Institute for Geriatric Nursing
College of Nursing, New York University

Tara Cortes, PhD, RN, FAAN, PI

Geriatric Interdisciplinary Team Training (GITT)

Geriatric Interdisciplinary Team Training (GITT)

Overview

GITT is a national initiative to train health care professionals to work on interdisciplinary teams to care for older adults. Patients with multiple conditions rely on health care professionals from a variety of disciplines. This is often the case with older adults. Studies show that complex patients manage better when their doctors, nurses, gerontologists, pharmacists—every health professional involved in their care (including the patient!)—work together as a team to develop a smart plan of care.

In May 1995, the John A. Hartford Foundation, Inc., of New York created this innovative program. Recognizing that health trainees receive little, if any, explicit instruction on teamwork, the Foundation's trustees sought to develop prototypes of geriatric team training that could be tested and then disseminated throughout the country. The GITT program continues the Foundation's tradition of reshaping health professionals' training to meet the demographic imperatives of the 21st century.

For more information about the GITT please contact Malvina Kluger at mk17@nyu.edu or visit the GITT Program website: www.GITTProgram.org

Hartford Institute for Geriatric Nursing Elder Mistreatment

Overview

Health professionals and allied health workers need to know and recognize the clinical indicators of Elder Mistreatment (EM) and need to know what actions to take if they suspect EM. Yet many healthcare workers have no idea that EM even exists, and few are actually trained to screen and assess for EM. Understanding cultural competency is essential to any EM training. Different cultures perceive aging and caregiving differently and this has important implications for how EM is viewed, gets assessed and gets treated.

Trainees We Want to Reach

  • Clergy
  • Health Services Administrators
  • Nurses
  • Physicians
  • Psychologists
  • Pharmacists
  • Rehabilitation Therapists
  • Social Workers
  • Community Practitioners and Care Providers

Core Program

Activities

Lectures

  • Concepts of Elder Mistreatment
  • Clinical Recognition of Elder Mistreatment
  • Research on Elder Mistreatment
  • Legal Aspects of Elder Mistreatment
  • The Care Continuum and Elder Mistreatment
  • Contemporary Elder Mistreatment Theories
  • Clinical Documentation of EM
  • The Impact of Elder Neglect on Clinical Care

Interdisciplinary Teams

  • Geriatric Interdisciplinary Team Training (GITT) - A train-the-trainers program for exercising effective leadership in complex social environments.
  • Models for Clinical Team Practice
  • Dynamics of Multidisciplinary Clinical Teams

Interactive Workshops

  • Case Studies in Elder Mistreatment
  • Team Assessment of Elder Mistreatment
  • The Elder Assessment Instrument (EAI) in Practice

To take course, please go to: http://www.hartfordign.org/continuing_ed/elder_mistreatment/

Gerontological Nursing Certification Review Course

The Hartford Institute for Geriatric Nursing, New York University (NYU) College of Nursing, Gerontological Nursing Certification Review Course has been updated in both content and format. The purpose of this Review Course is to help nurses prepare to sit for the American Nurses Credentialing Center's (ANCC) Gerontological Nurse Certification Exmaination. The Review Course offers a summary of current key clinical information and issues central to caring for the highly specialized needs of older adults. It also reviews the current financial, social, political, and cultural issues that affect nursing care for the elderly. This course reflects the current test content outline of the ANCC Gerontological Nurse Certification Examination.

This course has been revised based on a two-day Gerontological Nursing Certification Review Workshop created by Sharon Stahl Wexler, PhD, RN, BC.

Why Certification in Gerontological Nursing?

Certification in gerontological nursing will:

  • assure competent care for elders
  • validate you as a credible geriatric resource for your supervisors, physicians, and colleagues
  • provide you with competence that is portable wherever you choose to work
  • provide opportunity for professional advancement and compensation

Prepare for Certification and enhance your geriatric competence!

In addition to those nurses who intend to sit for the certification examination, this course is useful to any practicing nurse, nurse faculty, or student wanting to acquire fundamental knowledge of geriatric nursing care.

This course reflects the current test content outline of the American Nurses Credentialing Center's (ANCC) Gerontological Nurse Certification Examination. View the outline on the ANCC site!

  • Learn the basics of gerontological nursing
  • Prepare to be certified in gerontological nursing
  • Cost is $150.00 for 10 Contact Hours!
  • 9 Module Design: The course is organized to be consistent with the topics included in the current ANCC Gerontological Nurse Certification Examination test content outline.

Module 1: Epidemiology, theories of aging, financial, political, social, legal and ethical issues

Module 2: Nursing theories, models of gerontological care, standards and scopes of practice, research, quality improvement

Module 3: Health promotion, age-related changes, and Health issues: integumentary and sensory disorders

Module 4: Health issues: cardiovascular, respiratory

Module 5: Health issues: endocrine, immunological, hematological

Module 6: Health issues: gastrointestinal, genitourinary

Module 7: Health issues: neurological, musculoskeletal

Module 8: Nutrition, pain, end-of-life, care, elder mistreatment

Module 9: Medication issues, patient education, communication

  • Self-Paced Study: The course provides self-study (asynchronous) instruction that is online and interactive. Estimated time for completion is 10 hours. Incremental use is encouraged.

  • Simple Computer Requirements: You need a Pentium 233 MHz processor or better with at least 64 MB of memory and a 56K or faster connection. Mimimum screen resolution is 640 x 480. You must use a javascript enabled web browser. You should be able to view the course using most modern web browsers; however, it is important to note that the course has been tested on Mozilla Firefox 3, Opera 9, and Internet Explorer 5.5 and up.

Questions or Commments? Send them to: CertReview@HartfordIGN.org

Co-sponsored by The John A. Hartford Foundation Institute for geriatric Nursing, www.hartfordign.org.

Click here for details.

Primary Care for Older Adults 

Primary Care for Older Adults

The Primary Care for Older Adults (or PCOA) program is a HRSA funded project that aims to build the capacity of the healthcare workforce in geriatrics. This project, administered by the Hartford Institute for Geriatric Nursing (HIGN) at New York University College of Nursing, in coordination with the Consortium of New York Geriatric Education Centers (CNYGEC) at the Mount Sinai School of Medicine (MSSM) and the National Nurses Care Consortium (NNCC) aims to:

Nursing Student Programs - New York University College of Nursing

Nursing Student Programs - New York University College of Nursing

NYU College of Nursing offers a Bachelor of Science (15-month accelerated and traditional four-year), Master of Science and Post-Master's Advanced Certificate programs, a Doctor of Nursing Practice (DNP), and a Doctor of Philosophy in Research Theory and Development (PhD). The curriculum incorporates evidence-based classroom and clinical learning to prepare nurses at the undergraduate and graduate levels.

HIGN/NGNA Webinar Series

HIGN/NGNA Webinar Series

The Hartford Institute for Geriatric Nursing, NYU College of Nursing and the National Gerontological Nursing Association (NGNA) have joined together to launch a new webinar series to improve nursing care for older adults. The one-hour webinars will be held every month, and then archived on the Hartford Institute e-Learning center. The webinars, presented by expert faculty from NGNA and HIGN, will present clinical topics relevant to improving the delivery of healthcare to older adults, covering topics such as patient- and family-centered care approach to delirium, fall prevention, medication management, and diabetes management.

The Try This:® Series and How to Try This Assessment Series

The Try This:® Series and How to Try This Assessment Series

The Try This:® Assessment Series which consists of a General Practice, Specialty Practice and Dementia Series, offers assessment tools on a variety of topics relevant to the care of older adults. The How to Try This series, developed in partnership with the American Journal of Nursing AJN, is an accompanying collection, comprised of articles and videos presenting cases studies demonstrating the use of the Try This:® series. Additionally, there is a mobile reference that provides information and tools to treat common problems encountered in the health care of older adults called ConsultGeriRN iPad App

ConsultGeriRN.org esta encantado de ofrecer recursos de enfermeria en Español

ConsultGeriRN.org esta encantado de ofrecer recursos de enfermeria en Español

Primary Care for our Aging Population-Free Webinars

Primary Care for our Aging Population-Free Webinars

Hartford Institute for Geriatric Nursing, New York University College of Nursing, is partnering with Community Health Partners for Sustainability and the National Center for Health and the Aging to present a free, three-part webinar series, Primary Care for our Aging Population, to improve the geriatric health workforce in community health centers. As the population ages, more and more older adults are requiring community based services that reflect evidence based, age specific quality care. Part 1 focuses on primary prevention tools. Part 2 focuses on common screenings for older adults. Part 3 looks at important cancer screenings for older adults. This project is funded by a HRSA/ Comprehensive Geriatric Education Program grant.

Patient and Family Centered Care: An Approach to Delirium

Patient and Family Centered Care: An Approach to Delirium

The Hartford Institute has developed two modules that address a patient family centered care approach to delirium. They are available on the Hartford Institute e-learning center. Registration with the Center is required.

Core Values of Patient Family Centered Care

Dignity and Respect - patient and family ideas, values, beliefs and cultural backgrounds
Information Sharing - communicate and share complete and unbiased information with patients and families
Involvement - encourage and support patients and families in care and decision making
Collaboration - invite patients and family members to work together with health care staff

Module 1: Delirium Overview, Assessment, and Intervention: An Inter Professional Delirium Protocol across Health Care Transitions
Module 2: The Patient and Family Centered Care Approach to Delirium: Tips for practitioners to help families manage patients with delirium across health care transitions

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