Faculty Bibliography

BACKGROUND:Elder mistreatment is common and has serious social and medical consequences for victims. Though programs to combat this mistreatment have been developed and implemented for more than three decades, previous systematic literature reviews have found few successful ones. OBJECTIVE:To conduct a more comprehensive examination of programs to improve elder mistreatment identification, intervention, or prevention, including those that had not undergone evaluation. DESIGN:Systematic review. SETTING:Ovid MEDLINE, Ovid EMBASE, Cochrane Library, PsycINFO Elton B. Stephens Co. (EBSCO), AgeLine, CINAHL. MEASUREMENTS:We abstracted key information about each program and categorized programs into 14 types and 9 subtypes. For programs that reported an impact evaluation, we systematically assessed the study quality. We also systematically examined the potential for programs to be successfully implemented in environments with limited resources available. RESULTS:We found 116 articles describing 115 elder mistreatment programs. Of these articles, 43% focused on improving prevention, 50% focused on identification, and 95% focused on intervention, with 66% having multiple foci. The most common types of program were: educational (53%), multidisciplinary team (MDT) (21%), psychoeducation/therapy/counseling (15%), and legal services/support (8%). Of the programs, 13% integrated an acute-care hospital, 43% had high potential to work in low-resource environments, and 57% reported an attempt to evaluate program impact, but only 2% used a high-quality study design. CONCLUSION:Many programs to combat elder mistreatment have been developed and implemented, with the majority focusing on education and MDT development. Though more than half reported evaluation of program impact, few used high-quality study design. Many have the potential to work in low-resource environments. Acute-care hospitals were infrequently integrated into programs.

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.].

Multimorbidity occurs in adults of all ages, but the number and complexity of comorbid conditions commonly increase with advancing age such that cardiovascular disease (CVD) in older adults typically occurs in a context of multimorbidity. Current clinical practice and research mainly target single disease-specific care that does not embrace the complexities imposed by concurrent conditions. In this paper, emerging concepts regarding CVD in combination with multimorbidity are reviewed, including recommendations for incorporating multimorbidity into clinical decision making, critical knowledge gaps, and research priorities to optimize care of complex older patients.

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/OBJECTIVE: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/CONCLUSIONS: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.

The Institute of Medicine identified interprofessional education (IPE) as a key innovation for achieving the triple aim of better care, better outcomes and reduced health care 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.

Oral health inequities for older adults warrant new models of interprofessional education and collaborative practice. The Innovations in Interprofessional Oral Health: Technology, Instruction, Practice and Service curricular model at Bouve College of Health Sciences aims to transform health professions education and primary care practice to meet global and local oral health challenges. Innovations in simulation and experiential learning help to advance interprofessional education and integrate oral health care as an essential component of comprehensive primary health care. The Program of All-Inclusive Care for the Elderly clinic is an exemplary model of patient-centeredness and interprofessional collaborative practice for addressing unmet oral health needs of its patient population.

In this clinical practice exchange, we discuss how faculty at the New York University College of Nursing (NYUCN) and nurse executives at NYU Langone Medical Center (NYULMC) partnered with staff nurses to implement an attending nurse model and further describe how the model facilitates collaboration as well as clinical knowledge development in practicing nurses. The attending nurse model hastens the experiential learning essential for practice development by having faculty and nurse executives provide situated learning, teaching and coaching to advanced beginner and competent practicing nurses. The model supports the fact that learning in the patient care setting is inextricably linked to the delivery of patient care and shows how faculty can contribute to effective outcomes for patients. By modeling professional comportment, helping nurses to put language to salient issues, and coaching nurses about how to participate in interdisciplinary rounds, attending nurses help young clinical staff become active participants in interprofessional dialogue. Nurse executives recognize this model as an innovative and cost efficient way to help clinical staff gain essential knowledge and skill of the practice. For faculty, teaching is enhanced by engagement in actual patient situations which are richer and more complex than theoretical models and serve as a reminder of the centrality of the nurse-patient relationship in both the work of the discipline and the organization