The Portal of Geriatrics Online Education

11 SCC: Identify safety risks in home

11. Identify and assess safety risks in the home environment, and make recommendations to mitigate these.

SAFE-T from Babe to Sage: Injury Related Anticipatory Guidance Across the Age Continuum

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

Given many common themes in pediatric, adult, and geriatric injury prevention, we designed an anticipatory guidance pocket card with the mnemonic SAFE-T, encompassing topic areas of supervision, abuse, falls, environment, and travel. Each topic area is subdivided into areas of high injury risk, and then preventative guidance is provided. 

Educational objectives: 

Use a single mnemonic device that is applicable across the continuum of life to teach injury-related anticipatory guidance.

Additional information/Special implementation requirements or guidelines: 

Purpose: Unintentional injury constitutes the fifth leading cause of mortality in the United States, and nineth among adults greater than 65years of age. In contrast to pediatric curricula, there is little formal training on injury anticipatory guidance for elderly and vulnerable patients in either inpatient or outpatient settings. Medical students and resident physicians are often not taught to discuss anticipatory issues other than smoke alarms, seatbelts, bike helmets, and preventative screening, nor are they taught to approach these in a disease specific way. While general injury prevention can be linked to developmental stage and age in pediatrics, the non-linear decline in health of an older patient makes generalized anticipatory guidance more difficult. 

Method: Given many common themes in pediatric, adult, and geriatric injury prevention, we designed an anticipatory guidance pocket card with the mnemonic SAFE-T, encompassing topic areas of supervision, abuse, falls, environment, and travel. Each topic area is subdivided into areas of high injury risk, and then preventative guidance is provided. Traditional pediatric guidance is done by developmental stage and age. The geriatric anticipatory guidance looks at trigger conditions (diseases, comorbidities, cognitive decline) and links these to the injury risk and preventative strategy.

The powerpoint is an instruction guide to the SAFE-T card.  Two versions of the SAFE-T card are included - a color version and a greyscale.

Publications from, presentations from, and/or citations to this product: 

Presented at the Presidential Poster Session, 2010 American Geriatrics Society National Meeting, Orlando, FL. Presented at the AGS Educator's Materials and Methods Swap, 2010 American Geriatrics Society National Meeting, Orlando, FL.

Date posted: 
Sat, 10/16/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sat, 10/16/2010
Contact Person/Corresponding Author:



Suggested Citation:
, , , and . SAFE-T from Babe to Sage: Injury Related Anticipatory Guidance Across the Age Continuum. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/102

PATCH (Palliative Access Through Care at Home) Match: Virtual Training in Geriatric Palliative Home Visits

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

PATCH Match is a competency-based, virtual training experience in geriatric palliative home care, accessible online and suitable for a wide range of health care professionals such as medical and nursing students, residents, fellows, and others. Through simulated home visits, PATCH Match aims to teach learners to recognize that visiting frail older adults in their homes provides a more comprehensive understanding of patients, and that palliative care can be delivered effectively on home visits. Learners visit up to 4 homebound elderly patients, and face decisions about assessment and treatment relating to issues in: dementia with acute agitation, dementia with pain, falls at home, and transitions of care (from hospital to home). 

Educational objectives: 

After "visiting" the PATIENT WITH DEMENTIA AND PAIN, learners should be able to:

  1. recognize atypical ways in which pain may present in patients with advanced dementia,
  2. assess pain in patients with advanced dementia,
  3. identify options for pain treatment in patients with advanced dementia, and
  4. discuss the caregivers' role in caring for patients with advanced dementia and pain.

After "visiting" the PATIENT WITH DEMENTIA AND AGITATION, learners should be able to:

  1. recognize that agitation can be a symptom of emotional or physical distress in patients with advanced dementia,
  2. explain how the environment can have a positive or negative effect on agitated patients with dementia,
  3. describe behavioral and communication strategies for managing agitation in patients with dementia.

After "visiting" the PATIENT WITH RECENT FALLS, learners should be able to:

  1. report common causes of falls at home,
  2. name components of a falls risk assessment,
  3. recognize that most falls are the result of multi-factorial causes,
  4. explain how medications may contribute significantly to falls, and
  5. identify strategies for falls prevention that maximize patients' function and minimize injury.

After "visiting" the patient recently discharged from the hospital (TRANSITION OF CARE), learners should be able to:

  1. recognize problems that occur in the transition from hospital discharge to home relating to medication use and communication about hospital care and follow up,
  2. explain the teach-back method of communicating with patients and families, and
  3. discuss how a multi-disciplinary team and social support system may be engaged during transitions from hospital to home
Date posted: 
Fri, 11/12/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 11/12/2010
Contact Person/Corresponding Author:



Suggested Citation:
, and . PATCH (Palliative Access Through Care at Home) Match: Virtual Training in Geriatric Palliative Home Visits. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/102

Texas Tech Medcast Reynolds Geriatrics Step 1 Prep Series: No. 30--The Gasping Geriatric

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

The Step 1 Test Prep Series was created by second-year students at the Texas Tech School of Medicine in Lubbock as a project of the MS2 Aging Block of Systems Disorders II. It was developed as part of the Reynolds Geriatrics Podcast series, which is supported in part by an Aging and Quality of Life grant from the D.W. Reynolds Foundation. The episodes in this series are based on questions that have geriatrics content and patient vignettes from the 2010 Step 1 Sample Exam, available from http://www.ttuhsc.edu/som/fammed/ttmedcast/gerseri...

Educational objectives: 

The second-year medical student studying for the Step 1 exam should be able to:

  • Describe physical findings associated with lobar pneumonia
  • Describe the clinical presentation in patients with lobar pneumonia
  • Differentiate diseases of the lung based on clinical presentation, onset of symptoms, and physical findings
Date posted: 
Thu, 10/07/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 01/22/2013
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , , , and . Texas Tech Medcast Reynolds Geriatrics Step 1 Prep Series: No. 30--The Gasping Geriatric. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/102

Quick Reference for Geriatric Syndromes

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

A quick reference card set of geriatric syndromes designed for bedside use, which fits in a white coat pocket.

Educational objectives: 

Identification of, assessment of, and intervention with important geriatric syndromes frequently encountered in inpatient and outpatient clinical settings.

Additional information/Special implementation requirements or guidelines: 

Content available as PDF file. Cards may be printed and bound for hard-copy reference.

Publications from, presentations from, and/or citations to this product: 

2008 Southern Group on Educational Affairs (SGEA) Conference (demonstration)

Date posted: 
Wed, 03/31/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 07/18/2012
Contact Person/Corresponding Author:



Suggested Citation:
Quick Reference for Geriatric Syndromes. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/102

Environmental Geriatrics

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Abstract: 

Our 3D animated course gives providers the necessary tools to incorporate Environmental Geriatrics as an essential component of chronic disease management. Using sound, text and moving images, the learner witnesses virtual patients who have reduced visual, hearing, mobility, and memory skills, struggling to accomplish daily tasks of living, i.e., bathing, eating, ambulating, and taking medications. The second half of the animation identifies specific assistive devices and environmental features that improve patients’ ADL/IADL functioning while reducing injury.

Educational objectives: 

Learners should be able to: 1. Identify risk factors associated with falls and burns in elderly patients 2. Identify specific assistive devices and environmental features that improve patients’ ADL/IADL functioning while reducing injury risk 3. List specific assessment tools for the geriatric patient 4. Learn about reimbursement mechanisms and national resources for home modifications and assistive technologies Using state-of-the-art 3D software that combines sound, text and moving images, our educational animation allows medical students, physicians, and other health care professionals: 1. To make a virtual home visit with an older patient who has reduced visual, hearing, mobility, and memory skills 2. Witness virtual patients unnecessarily struggling to accomplish daily tasks of living (e.g., bathing, eating, ambulating, and taking medications) 3. Observe patients encountering remediable environmental hazards that increase fall and burn risk, which are not usually observable in practice 4. Experience virtually the effect of visual impairments, such as macular degeneration or glaucoma, while interacting with the environment (e.g., descending stairs) 5. Identify interventions that improve patients’ ADL/IADL functioning while reducing injury risk

Additional information/Special implementation requirements or guidelines: 

55 third-year medical students at the Weill Medical College of Cornell University. This course takes about 45 minutes to an hour to complete. Students can view all three sections at once, or a facilitator can engage the students in a group discussion after each section. After all three sections are completed, a facilitator can break the class up into small groups of 4 to 6 and have the students engage in a solving a case. For example, you might present the following: "An 85-year-old woman with mild dementia and low vision (glaucoma) was admitted to the hospital with a fractured hip and is now getting ready for discharge. You are about to meet with both the patient and her daughter, who is very worried about her mother returning home. What issues do you need to consider, and what possible suggestions could you offer, so the patient can return home to an environment that will maximize her function and safety?"

Date posted: 
Thu, 10/05/2006
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/01/2012
Contact Person/Corresponding Author:



Suggested Citation:
, , , , and . Environmental Geriatrics. POGOe - Portal of Geriatrics Online Education; 2006 Available from: https://pogoe.org/taxonomy/term/102

Home Safety Assessment

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

The home safety assessment learning object consists of two components:

  1. An interactive multimedia tutorial that introduces the learners to basic concepts and rationale for the use of home safety assessment for older persons with special emphasis in older persons with dementia. The tutorial uses textual content enhanced by multimedia animations and graphics. 
  2. Practice Exercises consisting of simulated home environments where the learner has an opportunity to identify home safety hazards. 
Educational objectives: 

The learner will be able to identify home related fall hazards and safety concerns for patients, including patients with dementia.

Additional information/Special implementation requirements or guidelines: 

These computer-based tutorials were created as "reusable learning objects", and are available in CD ROM and web-based versions. 

This product can be used in conjunction with Eliminate Hazards in Your Home: A Safety Checklist with Recommendations, a checklist designed for medical students, primary care residents, and other healthcare trainees and professionals who participate in the evaluation of older adults in the home. It is helpful if the learner has received basic instruction on home safety evaluation as this will help them complete a more in-depth assessment. This checklist can also be used as a patient education tool.

Publications from, presentations from, and/or citations to this product: 

Rodriguez O, Ruiz JG, Phancao F. Home Safety Assessment (web-based program). GeriU, the Online Geriatrics University, Stein Gerontological Institute, 2006.

Date posted: 
Mon, 09/21/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 06/21/2012
Contact Person/Corresponding Author:



Suggested Citation:
, and . Home Safety Assessment. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/102

Fast Forward Rounds - An Innovative and Effective Transitional Care Curriculum

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

Fast Forward Rounds (FFR) is a 3 hour course created to teach medical students how to safely transition patients between different health care settings. The course combines interdisciplinary lectures, an interactive DVD with a clinical vignette, small-group discussion, and a team-based learning exercise. FFR emphasizes the use of functional assessment to identify patients at risk for poor discharge outcomes, promotes interdisciplinary collaboration to link vulnerable patients with appropriate services, reviews Medicare/Medicaid reimbursement, and teaches students to develop comprehensive care plans. The course evaluation tool assesses participants' knowledge, attitudes and behaviors within the domains of transitional care, functional assessment, interdisciplinary team, community resources, and reimbursement. For more information about the FFR course at Cornell University, go to www.cornellaging.com/medical/.

Educational objectives: 

After completing the Fast Forward Rounds course, learners should possess greater knowledge of transitional care, improved attitudes toward promoting safe transitions and increased performance transitional care behaviors. Participants will report improved understanding of: - the roles of interdisciplinary team members (nursing, social work, physical/occupational therapy) - home care and community resources - the variety of care settings and housing options for older adults - the importance of performing a thorough functional assessment - Medicare and Medicaid reimbursement policies for various home, community, and housing services Participants will report increased proficiency in: - Performance of functional assessment - Communication with physician and non-physician providers (e.g., home health care workers, nurses, and other interdisciplinary team members) - Education of patients, families and caregivers - Medication reconciliation to prevent medication errors - Management of the discharge process of complex patients

Additional information/Special implementation requirements or guidelines: 

Please see the facilitator guide for details regarding implementation requirement and guidelines.

Publications from, presentations from, and/or citations to this product: 

Citations: Ouchida, K, LoFaso V, Capello, C, Ramsaroop, R, and Reid, MC Fast Forward Rounds: An Effective Method for Teaching Medical Students to Safely Transition Patients Across Care Settings J Am Geriatr Soc 2007;55:s185 Presentations Northeast Group on Educational Affairs Annual Educational Retreat June 2007 Society of General Internal Medicine Annual Conference April 2008

Date posted: 
Thu, 09/24/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 09/17/2012
Contact Person/Corresponding Author:



Suggested Citation:
, and . Fast Forward Rounds - An Innovative and Effective Transitional Care Curriculum. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/102

"Swiss Cheese Model" approach to clinical geriatrics - Geriatric Interdisciplinary Care Summary (GICS)

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

Problems in geriatrics, also called geriatric syndromes are generally caused by a combination of many contributing problems. These problems are characteristics of the patient, activities being performed, demands of the environment and hazards, and socioeconomic barriers limiting the access to basic living needs, health care, and rehabilitation of the patient. The "Swiss Cheese" represents a patient with a geriatric syndrome and its many contributing problems which are represented by the holes in the Swiss Cheese. These problems are broken down into 8 main domains or categories. A more detailed explanation of the “Swiss Cheese Model” and Geriatric Interdisciplinary Care Summary (GICS) can be found above in the Guide to “Swiss Cheese Model of Geriatrics.” Students who are in the Geriatrics Clerkship rotation fill out the Geriatric Interdisciplinary Care Summary (GICS) for their own patients to address all these main domains of interdisciplinary care in the Swiss Cheese model. For more information about this program at the University of Florida, go to http://www.aging.ufl.edu/gericlerkship/swiss-chees....

Educational objectives: 

Students will be able to address complex medical, psychological, environmental and socioeconomic issues impinged upon rehabilitation of medically complex older adults in subacute rehabilitative settings (e.g. nursing home, acute rehabilitation hospital).

Additional information/Special implementation requirements or guidelines: 

None

Publications from, presentations from, and/or citations to this product: 

Bautista MK, Mueleman JR, Shorr RI, Beyth RJ. Description and Students' Perceptions of a Required Geriatric Clerkship in Postacute Rehabilitative Care. Journal of American Geriatrics Society 57:1685-1691, 2009.

Date posted: 
Tue, 09/29/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 09/29/2009
Contact Person/Corresponding Author:



Suggested Citation:
and . "Swiss Cheese Model" approach to clinical geriatrics - Geriatric Interdisciplinary Care Summary (GICS). POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/102

Schwartz Communication Curriculum

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Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This curriculum is designed to teach first and second year medical students to acquire and to improve their skills in effective communication with patients and family members. The developing curriculum consists of several 3-hour sessions in the 2-year Doctoring Course. The components of each session include the following: 1. Entire class: Introduction of goals of session (e.g., the importance of communication and professionalism); short videos showcasing examples of communication; demonstration of role play of physician-patient consultations 2. Small group session: 2-3 role plays of case by students followed by faculty and student feedback and further discussion of case 3. Entire class reconvenes and discusses case and experience of role play led by expert panel consisting of chaplain, hospital social worker and 1-2 faculty physicians Products associated with this curriculum consist of an introduction and description of the first program and an evaluation form used for that session, as well as a faculty guide that provides goals and guidance for presenting the curriculum. Additional products will be listed as the curriculum develops.

Educational objectives: 

<p>
The overall objective is to teach pre-clinical students the central importance of effective communication between physicians and their patients and family members.</p>

<ol>
<li>
Students learn to develop and maintain empathy through communication skills.</li>
<li>
Students develop professionalism as they learn to utilize basic and necessary components of questioning and listening skills with patients and family members.</li>
<li>
The use of role play provides effective opportunity for practice in a safe small group setting.</li>
</ol>

<p>
The faculty guide explicitly notes the teaching points to be made in the communication session. It lists questions for discussion based on the session's case, readings and videos. It also describes the components of an effective role play: how to coach each student role player to inhabit their role and play their part, and provides guidance for successful critique and discussion.</p>

Additional information/Special implementation requirements or guidelines: 

Students are assigned readings and videos related to communication principles prior to the Doctoring session. Citations for suggested reading and viewing materials:

  • Schwartz, K. B. (1995, July 16). A patient’s story. The Boston Globe.
  • Delbanco, T., & Augello, T. (2006). When things go wrong: Voices of patients and families [DVD]. Cambridge, MA: CRICO/RMF. (Available from http://www.rmf.harvard.edu/education-interventions... or contact Alison O'Brien, aobrien@rmfstrategies.com, 617.679.1500, ext. 1299.)
  • Goldman, J., & Schapira, L. (2001). One story, two voices; A candid conversation between a cancer patient and her oncologist [DVD]. Both DVDs are also available from The Schwartz Center. Contact them at (617) 724-7576 or by email: schwartzcenter@partners.org.
Publications from, presentations from, and/or citations to this product: 

ShieldR, Tong I, Tomas M, Campbell SE, Besdine RW. Compassionate care does matter: Using teachable moments with medical students, American Geriatrics Society Annual Meeting, May, 2010. Journal of the American Geriatrics Society 2010:58 (Supplement); S215.

Shield R, Tong I, Tomas M, Besdine R. Teaching communication and compassionate care skills: An innovative curriculum for pre-clerkship medical students. Medical Teacher 2011;33(8):e408-16. Available online at http://dx.doi.org/10.3109/0142159X.2011.586748

 

Date posted: 
Thu, 10/08/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 07/25/2011
Contact Person/Corresponding Author:



Suggested Citation:
, and . Schwartz Communication Curriculum. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/102

Transitions in Care Curriculum for Medical Students

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This curriculum was developed to educate medical students about how to improve hospital discharges. The curriculum is focused on peri-discharge communication with the patient and follow-up provider. Additionally, the student is expected to make a post discharge visit to the patient's home or care center to do medication reconciliation. The standardized Medication Discrepancy Tool by Eric Coleman is used as a tracking mechanism. A pre and post curriculum confidence survey helps the students and educators see what the student has learned. The students are tested on their ability to develop a discharge plan on their final exam.

Educational objectives: 

Objectives:

  1. Students will identify the critical components of care transitions and the common obstacles to quality of care in transitions from the inpatient setting.
  2. Students will identify and describe the important role of healthcare providers in assuring quality of care during transitions of care from the inpatient setting.
  3. Students will perform thorough medication reconciliation between hospital discharge and home/assisted living/skilled nursing facility.
  4. Students will gain confidence and skills in inter-provider communication necessary for quality care in transitions from the inpatient setting.
Additional information/Special implementation requirements or guidelines: 

The curriculum has been implemented within the Hospitalized Adult Care clerkship to give students the experience of discharging the patient and discovering how the patient functions at home.

Publications from, presentations from, and/or citations to this product: 

CDIM Annual Meeting 10/08

Date posted: 
Fri, 08/07/2009
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 07/02/2012
Contact Person/Corresponding Author:



Suggested Citation:
and . Transitions in Care Curriculum for Medical Students. POGOe - Portal of Geriatrics Online Education; 2009 Available from: https://pogoe.org/taxonomy/term/102

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