The Portal of Geriatrics Online Education

13 FBG: Construct diagnosis and evaluation plan for fallen patient

13. In a patient who has fallen, conduct a gait assessment and construct a differential diagnosis and evaluation plan that addresses the multiple etiologies identified by history, physical examination and functional assessment.

Simulation Curriculum for Geriatric Medicine Fellows

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
999
Abstract: 

This material consists of a suite of nine simulated clinical cases, divided into three separate sessions of three cases each, intended to be conducted in a simulation center with simulated patients.  Cases are designed to teach geriatric medicine fellows and other appropriate learners basic geriatric assessment skills (Session one), how to navigate difficult situations in long-term care (Session two), and high-level communication skills in palliative and end-of-life care (Session three).  Each case consists of a multi-page document outlining scripts for the learner as well as the roles (patient, family member, facility staff, etc) portrayed by actors, necessary props and supporting materials, and instructions for evaluating and debriefing the learner.  Also contained in each document are Entrustable Professional Activities (EPA), Curricular Milestones (CM), and Reporting Milestones (RM) relevant to the case.

Educational objectives: 

- Efficiently and effectively assess and manage common geriatric syndromes in a variety of clinical settings.

- Demonstrate the ability to navigate difficult communication scenarios in a long-term care environment, while providing leadership, mediating conflict between interdisciplinary team members and/or family members, and providing high quality care.

- Provide compassionsate, patient-centered care at the end of life, using high-level communication strategies.

Additional information/Special implementation requirements or guidelines: 

n/a

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

None, though plans to present this at AGS/ADGAP in 2019.

Date posted: 
Mon, 11/12/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 08/08/2018
Contact Person/Corresponding Author:



Suggested Citation:
Simulation Curriculum for Geriatric Medicine Fellows. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/107

Where's the Fall Risk?

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

One in four older adults have a fall or fall-related injury every year. “Where’s the Fall Risk?” is an interactive educational game that allows learners to discuss falls prevention in the home environment and think of potential solutions. Learners will be in groups of 2-6 people and use the provided picture to circle the fall risk areas in the given amount of time. The teams will then present the total number of areas by room and propose solutions for each fall risk area. A point will be given for each circled area and solution. The discussion portion of the game provides learners the ability to identify and fix high fall risk areas in the home. 

 

Educational objectives: 
  1. Understand what aspects of the home environment are considered fall risks
  2. Think of creative solutions to fix these fall risk areas
  3. At the end of the game, be able to have an active discussion with patients regarding falls prevention in the home environment
Additional information/Special implementation requirements or guidelines: 
Materials:
The game is best played in a group setting with teams composed of about 2-6 people.
  • Diagram of the home environment (PowerPoint provided)
  • Pen/Marker to circle fall risk areas
  • Timer
  • White board to keep track of points
Instructions:
Please print the provided diagram of the home environment. Groups of 2-6 people with a minimum of 2 groups.
Identification Phase:
  1. Set timer for 2 minutes and provide groups with the home diagram
  2. Start timer and have groups circle areas in the home that are considered fall risks. Suggestion to groups: it is easier to go room by room
  3. Once time is up, set pens to the side.
Solution Phase:
  1. Set timer for 2 minutes and provide groups with a sheet of paper.
  2. Start timer and have groups discuss why they circled the area as a fall risk and think of a solution for the fall risk area (of note, groups may not use “get rid of the item” as a solution).
  3. Once time is up, set pens to the side.
Discussion Phase:
  1. On white board, create a grid with group names at the top and rooms on the side (“Outside”, “Living Room”, “Kitchen”, “Dining”, “Bedroom”, “Bathroom”)
    1. Depending on how much time you have, it may be faster to discuss some rooms together: Outside & Living Room, Kitchen & Dining, Bedroom & Bathroom
  2. Start the discussion by going from room to room. Each team will get 1 point if they can identify a fall risk area and provide a solution. Of note, this is a key opportunity to discuss and talk about these high fall risk areas. You may propose other solutions and open it up to discussion with other groups as well.
  3. The winning team has the most points at the end of the game. 
Date posted: 
Wed, 07/25/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Sat, 05/26/2018
Contact Person/Corresponding Author:



Suggested Citation:
Where's the Fall Risk?. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/107

ACUTE MANAGEMENT OF OLDER ADULT FOUND DOWN WITH ALTERED MENTAL STATUS

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Estimated time to complete: 
2
Abstract: 

This case study was developed for use in academic coursework and as a standalone training for health care providers (MDs, ARNP, Pharmacists, Social Workers, Nurses). This unfolding case study about the management of an older adult in the midst of a health crisis. This case is a composite of many actual cases seen in Emergency Departments. During the course of this case study, learners are presented with information as the providers learn of the patient’s emergent and ongoing health concerns – from her Emergency Department admission through her Intensive Care Unit stay. Learners are asked to make decisions and use their best judgment about how to care for this patient.

Educational objectives: 

 

  • Apply knowledge of evidence-based care provision to an older adult found with altered mental status after a ground level fall
  • Describe the contributions of the interprofessional team to care management
  • Demonstrate effective communication during handoffs in care
Publications from, presentations from, and/or citations to this product: 

Citations are listed at the bottom of the screen throughout the case study.

Date posted: 
Fri, 07/27/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 05/22/2018
Contact Person/Corresponding Author:



Suggested Citation:
ACUTE MANAGEMENT OF OLDER ADULT FOUND DOWN WITH ALTERED MENTAL STATUS. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/107

Mobility Clinical Evaluation Exercise (Mini-CEX)

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

This mobility Clinical Evaluation Exercise (Mini-CEX) is designed to use with a learner during an actual patient encounter. The leaner first views the Center for Disease Control and Prevention (CDC) videos on the Timed Up and Go Test, 30 Second Chair Stand and 4 Stage Balance tests and handouts prior to the administration of the Mini-CEX. The teacher observes the learner during the patient encounter and completes the Mini-CEX. The teacher reviews the form with the learner and provides feedback of what skill was observed, partially observed, not observed, not applicable and comments about the encounter.

Educational objectives: 

Learners who are administered this mobility Mini-CEX will:

1)acquire knowedgle about various tests for mobiilty, strength and balance.

2)be observed assessing mobility during a patient encounter.

3)receive feedback about their communcation and professionalism skills in assessing mobility.

Date posted: 
Mon, 01/23/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 01/23/2017
Product Viewing Instructions: 
Learner views videos prior to Mini-CEX
Contact Person/Corresponding Author:



Suggested Citation:
Mobility Clinical Evaluation Exercise (Mini-CEX). POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/107

Your Role After a Fall: Assessment and Communication - An Interdisciplinary Approach

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

This educational module is intended for an interdisciplinary audience of staff who work with older patients in hospitals or long term care facilities.  The emphasis is on the importance of an interdisciplinary approach to care of the older patient and ensuring each team member understands his or her own role in communicating once a fall has taken place. Providers, nurses, C.N.A.s, social workers, rehabilitation therapists, housekeeping, transport, and any other person who comes into contact with an older patient is considered part of the interdisciplinary team.  All team members understanding common concepts and a shared model on how to communicate (use of SBAR) promotes better care of the patient who has fallen.  The 30 minute video is clear and concise. 

Educational objectives: 

- Understand the signficance of falls and their consequences in acute patient care

- Learn the role specific post-fall assessment techniques

- Define your role on an interdisciplinary team in caring for patients after a fall

- Learn how to communicate effectively about falls using "SBAR" (Situaion, Background, Assessment,        Request/Recommendation)

Date posted: 
Mon, 10/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
Your Role After a Fall: Assessment and Communication - An Interdisciplinary Approach. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/107

Barney Smith - A Progressive Palliative Care Standardized Patient

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Intended Learner Audiences: 
Product Information
Abstract: 

This six part progressive standardized patent serves re train medical students to care for an older adult with a life limiting condition, including making the diagnosis of multiple myeloma, breaking bad news, transitions of care from the hospital to home and curative care to palliation, through advance directiive discussions, and eventually into hospice and his death. The six encounters occur from Year 2 through Year 4 of the medical school curriculum , with a scripted five year span of patient care. Educational modalities include standandized patients, simulation, web-based modules, and small group discussions. 

Educational objectives: 

1) Provide medical care for an older adult with a life limiting condition from their diagnosis through their death

2) Understand the roles of the medical provider and other health care disciplines, as individual providers and as a team, in caring for an older adult with a life limiting diagnosis as they transition from the hospital to home and from curative care to palliation

3) Assist family caregivers in identifying caregiver responsibilities and potential caregiver burden

Date posted: 
Mon, 10/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
Barney Smith - A Progressive Palliative Care Standardized Patient. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/107

Barney Smith 3 - A Transitions of Care Interprofessional Education Standardized Patient

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Intended Learner Audiences: 
Product Information
Abstract: 

This transitions of care Interprofessional education standardized patient serves to train Year 3 medical students and graduate students from physical, occupational and speech therapy in the transition of care of a frail older adult from the hospital to home. It is the third of a six part progressive standarized patient encounter on palliative care. This clinical simulation is an encounter with Barney as a hospitalized patient with newly acquired functional decline. Learners gain experience in the interprofessional team assessment of a hopsitalized older adult's functional status and the team management of that patient's transition of care from the hospital to home. Educational modalities include web-based instruction , the simulation, and a small group discussion of the interprofessional set of learners immediately following the encounter facilitated by interprofessional faculty.  

Educational objectives: 

1) Perform an interprofessional, comprehensive team assessment of a hospitalized older adult's functional assessment and the team mangement of that patient's transition of care from the hospital to home. 

2) Understand the role that individual discpliness play in conducting  a comprehesive assessment of an older adult's functinal status 

3) Assess specific risks and barriers to older adult safety as they transition from the hospital to home 

4) Assist family caregivers in identfying caregiver responsibilities and potential caregiver burden 

Date posted: 
Mon, 10/17/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/17/2016
Contact Person/Corresponding Author:



Suggested Citation:
Barney Smith 3 - A Transitions of Care Interprofessional Education Standardized Patient. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/107

The Hospitalized Older Adult

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
999
Abstract: 

Older adults are exposed to multiple hazards during hospitalization resulting in multiple complications that limit their return to their functional and cognitive baseline. It is critical that healthcare providers are trained on best practices in the care of hospitalized older adults. This product is a monthlong module for M4 students during their Sub I rotation, that focuses on educating them on the hazards of hospitalization, best practices in the care of hospitalized older adults, issues that occur during transitions of care and best practices to ensure optimal transitions across care settings. The module starts with an initial lecture on hazards of hospitalization and best practices in the care of older adults. This is followed by assignments in which students are assigned older aduts to care for. Using a checklist, they evaluate the care that these patients have received and also implement best practices in the care of their patient. They also participate in an interdisciplinary team meeting that focuses on these aspects of care.  This is followed by another assignment in which they are involved in deciding on the most appropriate discharge care setting their patient. They subsequently place a post discharge call to their patient to identify any issues thay may have encountered post discharge and assist them in resolving some of these issues. Through the month, students share their experiences on blackboard, outlining hazards they identified in their patients,  challenges in implementing best practices, choice of discharge care setting and reasons for their choices along with care transitions issues identified in their patients. Additionally they are required to review educational materials and published articles posted on blackboard, focused on hazards of hospitalization, best practices in care, settings of care and transitions of care.  A final class is held with the students at the end of the month discussing the rotation and their experiences, with a focus on settings of care and best practices in transitions of care.

Educational objectives: 

At the end of this course, each participant will be able to:

1. Describe the hazards of hospitalization of older adults.

2. Evaluate the care and implement best practices in the management of a hospitalized older adult.

3. Enumerate the discharge options available in a particular case scenario.

4. Compare and contrast the problematic elements of care transition with those of an ideal care transition.

Date posted: 
Tue, 10/25/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 10/25/2016
Contact Person/Corresponding Author:



Suggested Citation:
The Hospitalized Older Adult. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/107

Family Medicine Resident and Geriatric Fellow Longitudinal Home Visit Curriculum

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

With an aging population, the need to train primary care residents and geriatric fellows in home-based care continues to grow. A needs assessment of family medicine residents and geriatric fellows' attitudes and knowledge was performed to guide a novel, longitudinal home care curriculum based out of a Home-Based Primary Care practice within the Family Medicine Center.

Fellows are assigned a panel of two home visit patients from the Family Medicine Center's Home-Based Primary Care practice. Fellows follow these patients monthly and manage their care between visits.  In today’s rapidly changing clinical environment, primary care physicains and geriatricians must be adapt at analyzing systems and processes they work under and making changes to improve patient care. A new home visit program is a natural venue for a specific, achievable quality improvement intervention with support from faculty, the Home Based Primary Care practice team and the Family Medicine Center Patient and Family Advisory Council. 

The longitudinal family medicine resident curriculum is based on graded autonomy and focused objectives for each level with the ultimate goal of residents feeling empowered to include home visits in their future practice. After home visit sessions, residents complete personal, written reflections after each visit to optimize learning and retention, as well as for giving a venue for processing potentially challenging situations. Sample reflections are included. Third-year residents facilitate an interdisciplinary case conference to address various social determinants of health, home safety issues and medication concerns. By residency graduation, residents will complete 10-14 home visits. 

 
Educational objectives: 
  1. Describe challenges and opportunities unique to patient care in the home environment.  
  2. Review medication use and adherence while identifying medications that are no longer effective, are duplicative or carry greater burden than benefit.  Identify medications that you would recommend stopping and create a schedule for stopping these medications.
  3. Develop and implement a safety plan to make the patient’s home environment safer.
  4. Develop a personal plan to integrate home visits into your future practice.

Fellow-specific objectives:

  1. Develop, document and manage patient- and family-centered care plans related to patient’s health conditions and expected trajectory with emphasis on personal goals of care in collaboration with an interprofessional health care team and community service providers.
  2. Implement a process improvement as part of the Home Based Primary Care team.  

 

Date posted: 
Wed, 10/19/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 10/19/2016
Contact Person/Corresponding Author:



Suggested Citation:
Family Medicine Resident and Geriatric Fellow Longitudinal Home Visit Curriculum. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/107

VirginiaGeriatrics.Org

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Intended Learner Audiences: 
Product Information
Estimated time to complete: 
2
Abstract: 

The VirginiaGeriatrics.Org website consists of 6 primary resources and a secondary list of resources for further research. These primary resources include a video archive of the geriatric grand round lecture series, interactive pre-clinical basic science geriatric case studies for medical students, more advanced geriatric case studies for clinical residents, a quick consult guide for geriatric consults, an "ask the expert" discussion resource, and various educational materials related to the Virginia Geriatrics Society Conference. Additionally, spread through the website are external educational resources to complement the core material. Finally, there are some resources for patients and families that may be interested in contacting clinics and/or geriatricians.

Educational objectives: 

Listed through 6 primary education sections (Grand Rounds, Med Student Materials, Resident Materials, Quick Consults, Ask the Expert, etc)

Date posted: 
Thu, 09/22/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 09/22/2016
Contact Person/Corresponding Author:



Suggested Citation:
VirginiaGeriatrics.Org. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/107

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