Cadth 2015 d6 rn np cadth srna (2)
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Transcript of Cadth 2015 d6 rn np cadth srna (2)
How evidence Informs NP practice- Regina Lutheran Home Experience.
Leah Clement BSN RN
Director of Care/Leader for Elder Services
Maureen Klenk MHs (APN) RN(NP)
Nurse Practitioner
Eden Philosophy
Mission – to improve the well-being of Elders and those who care for them by transforming the communities in which they live and work
Vision – to eliminate the 3 plagues Loneliness, helplessness, boredom – bulk of suffering for
those living in LTC
Eden Care Philosophy Guided by 10 Principles
1. Human habitat
2. Loving relationships
3. Give and receive care
4. Loving companionship
5. Spontaneity
6. Meaningful activity
7. Medicine the servant not the master
8. Elder centered care – autonomy in decision making
9. Human growth
10.Wise leadership
How to build an Eden Care LTC facility?
Dream a Dream
Create the Vision
• A HOME in which all Elders have an opportunity to have timely access to a primary care provider
• Elders have the best possible opportunity for a healthy quality of life so they can grow and flourish
• Add an RN(NP) to the staffing complement as a ‘best fit’.
• RN(NP)s are evidenced based providers with a holistic philosophy of care.
Implementing RN NP in LTC
Steps in the Process:
• Plant the seeds with physicians, nursing team, pharmacist, others
• Advertise & Recruit
• Plant more seeds and warm the soil
• Hire
• Muddle through………..
Nurse Practitioners in Long-Term Care Facilities: Clinical and Cost-Effectiveness and Guidelines – CADTH (2012)
RESEARCH QUESTIONS
1. What is the clinical effectiveness of having nurse practitioners in long-term care facilities? .
2. What is the cost effectiveness of having nurse practitioners in long-term care facilities?
3. What are the evidence-based guidelines for having nurse practitioners in long-term care facilities?
Nurse Practitioners in Long-Term Care Facilities: Clinical and Cost-Effectiveness and Guidelines – CADTH (2012)
KEY MESSAGE
The evidence identified suggests that the implementation of nurse practitioners in long-term care facilities may result in an increase in family satisfaction and improved health services.
NP care improves Elder Care
Present –Monday to Friday
Able to observe Elders first hand.
Raises the ‘bar’ for assessment and learning for all staff.
Lowers the cost to the system, the facility and the elder.
NP utilize evidence to improve outcomes
Reduce adverse events by reducing pill burden
Reduce antibiotic resistance by decreasing the use of antibiotics – less UTI
Reduce fall rates-decrease use of antipsychotic and BEERS list medications
Reduce levels of pain- provide consistent analgesia
Still to work toward
Improve Incontinence by increasing fluid intake
Improve mental status by improving sleep- do elders need q2h turning?
“Younger’ Elders are coming under how care- how can we improve the social need for this age group.
Outcomes
Falls
Antipsychotic use
Pain control
Pressure ulcers
Elders with 8 prescriptive medications or less
Less visits to ER/Hospital admissions
Survey results-
Elder
Family
Care Team
Physicians
Implementing RN NP in LTC
Final Thoughts:
• PERSERVERE!!!! • Innovation is hard!• “How will this contribute to the quality
of life to Elders I serve?”