The Portal of Geriatrics Online Education

Patient Safety

Infusing Geropsychiatric Nursing into Curricula - Resources for Teaching Key Concept IV.A. (Promotes Safety and Risk Factor Reduction)

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

Nurses play a key role in optimizing patient safety and reducing risk factors that may result in mental illness and/or contribute to poor outcomes in older adults with existing mental health issues. From a community or population-based level, nurses work with others to promote mental health and reduce risk of psychiatric disorders in late life, including those risk factors that contribute to decline in physical functioning, impaired quality of life, social isolation, excess disability in older adults, and psychiatric and behavioral symptoms.

This product contains resources that address the following:

  • Medication management
  • Nursing home care
  • Older driver safety
  • Diabetes
  • Dementia
  • Restraints
Educational objectives: 
  • Increase awareness of safety issues and risk factors that contribute to vulnerability for mental illness in older adults. with mental health issues.
  • Identify population-based interventions that can help reduce risks and promote mental health in older adults.
Additional information/Special implementation requirements or guidelines: 

Each of the 27 products based on the Key Concepts provides access to curriculum/teaching materials to assist faculty to infuse the geropsychiatric nursing competency enhancements into course objectives, teaching strategies, didactic content, and/or clinical experiences of relevant educational programs. These include entry level and advanced practice nursing programs in psychiatric-mental health, adult/gerontological, family, women’s health or acute care, or stand-alone geropsychiatric nursing or continuing education courses. The resources may be adapted for use with a range of learners, as indicated in each description. Each resource has been identified as appropriate to teaching the Key Concept and is described in detail.

Date posted: 
Sun, 01/01/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 01/12/2012
Contact Person/Corresponding Author:



Suggested Citation:
Infusing Geropsychiatric Nursing into Curricula - Resources for Teaching Key Concept IV.A. (Promotes Safety and Risk Factor Reduction). POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/1089

Evolving Case Study: Delirium Superimposed on Dementia

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

This is an evolving case study on dementia/delirium (delirium superimposed on dementia).  The case centers around Mr. Wilson, who is an 82 year old widowed male admitted to the unit for treatment of an ulcer on his right leg. He currently lives alone in his own home.

Educational objectives: 

Upon completion of this course, the student will be able to:

1. Apply critical thinking skills necessary to assess patient and determine next level of treatment

2. Communicate with family members and assist with next treatment/living options

3. Identify own response to changing situations

Date posted: 
Wed, 04/04/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 04/04/2012
Contact Person/Corresponding Author:



Suggested Citation:
Evolving Case Study: Delirium Superimposed on Dementia. POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/1089

Infusing Geropsychiatric Nursing into Curricula - Resources for Teaching Key Concept II.G. (Management: Ethical/Legal and Socioeconomic Factors)

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

The Geropsychiatric Nursing Collaborative has developed Geropsychiatric Nursing Competency Enhancements and 27 associated Key Concepts (see POGOe Product 20660) to draw attention to the special mental health issues of older adults and assist faculty to address them. The key concepts are organized into four domains: assessment, management, approach to older adults, and role. This product provides an index of resources addressing Key Concept II.G. -- Management: Ethical/legal and socioeconomic factors.

Clinicians caring for patients with mental health issues often find that there are ethical and legal factors that must be addressed. Ethical questions arise when desire for autonomy (the patient's ability to make informed decisions) conflicts with safety concerns, for example, balancing the independence of driving for patients with dementia while considering the safety of the patient and public. Likewise, older adults with dementia or other mental health issues are at special risk for self neglect as well as elder abuse and mistreatment. Patients’ desires to protect perpetrators post ethical/legal concerns for providers. Other important elements to protect older adults with mental health issues and/or cognitive impairment include providing for a durable power of attorney or the appointment of a guardian. Finally, older adults’ potentially limited  socioeconomic resources and health care insurance status must be considered when recommending treatment strategies.

This product contains resources that address the following:

  • Caregiving
  • Elder Mistreatment
  • Elder Abuse
  • Domestic Violence
  • Advance Care Planning
  • Dementia
Educational objectives: 

Increase knowledge about ethical, legal and socioeconomic issues affecting care recommendations, decision making, and adherence.

Additional information/Special implementation requirements or guidelines: 

Each of the 27 products based on the Key Concepts provides access to curriculum/teaching materials to assist faculty to infuse the geropsychiatric nursing competency enhancements into course objectives, teaching strategies, didactic content, and/or clinical experiences of relevant educational programs. These include entry level and advanced practice nursing programs in psychiatric-mental health, adult/gerontological, family, women’s health or acute care, or stand-alone geropsychiatric nursing or continuing education courses. The resources may be adapted for use with a range of learners, as indicated in each description. Each resource has been identified as appropriate to teaching the Key Concept and is described in detail.

Date posted: 
Wed, 04/04/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 04/04/2012
Contact Person/Corresponding Author:



Suggested Citation:
Infusing Geropsychiatric Nursing into Curricula - Resources for Teaching Key Concept II.G. (Management: Ethical/Legal and Socioeconomic Factors). POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/1089

Computer Based Learning Workbook, Third Edition

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

The Computer Based Learning (CBL) workbook provides a structured self-study curriculum that is comprised of 10 modules. Each module has Learning Objectives, a Clinical Case, Educational Tasks, and Board-Style Questions. The modules are also crosswalked with our Basics in Geriatrics ("BIG") 10 Principles and designed to be completed with resource material at our publically available Emory website (access the link to the right under the workbook). Some resource material within the workbook is located on the website and some material links to excellent products developed by other programs.

The modules are on Delirium, Dementia, Falls, Incontinence, Medication Use, Pain Management, Hazards of Hospitalization, Adult Failure to Thrive and Malnutrition, Transitions of Care for Older Patients, and Palliative Care. Each module is divided into three parts. The first is a clinical vignette illustrative of the topic. This is followed by a set of tasks that include reading a general overview of the subject, and working with several educational tools. Finally, each module ends with a post-test with at least three “boards-style” multiple choice questions that will test your knowledge of the topic.  Each module takes an estimated 60 minutes of uninterrupted time. The materials are targeted at the training level of an Internal Medicine resident.

There is also a Facilitator’s Guide and Answer Key included.

Educational objectives: 

The general objectives for this workbook are:

  1. Identify key topics in geriatric medicine and increase your knowledge through a case-based format.
  2. Describe the extent to which iatrogenic issues are part of the management of geriatric syndromes.
  3. Describe the multifactorial nature of most geriatric problems.

Delirium Objectives:

  1. Discuss the diagnosis, etiology, management and prognosis for delirium.
  2. Identify the 4 features of the CAM diagnostic algorithm and the criteria for diagnosing delirium.
  3. Identify the risk factors for delirium.
  4. List interventions to treat and prevent delirium.

Dementia Objectives:

  1. Identify subtypes of dementia.
  2. Discuss effective assessment of dementia.
  3. Utilize the most common dementia assessment tools.
  4. Develop management plans for dementia that include pharmacologic and psychosocial modalities.

Falls Objectives:

  1. Identify risk factors for falls in the elderly.
  2. Describe the key components of a gait assessment.
  3. Develop management strategies for a patient with falls.

Incontinence Objectives:

  1. Identify potentially reversible conditions that can cause or contribute to urinary incontinence.
  2. Utilize appropriate diagnostic tools for the different subtypes of incontinence.
  3. Apply non-pharmacologic and drug treatments for incontinence.

Medication Use Objectives:

  1. Identify which medications are considered inappropriate for use in elderly patients.
  2. Recognize the risks of polypharmacy in the elderly and learn the principals of evaluating and reducing these risks.

Pain Management Objectives:

  1. Recognize the spectrum of severity of pain, and understand the appropriate setting for different types of pain medication.
  2. Demonstrate knowledge of dosing conversions between different types of opioids.
  3. Differentiate between various categories of pain.
  4. Learn to recognize and treat the side effects of various types of pain medication.

Hazards of Hospitalization Objectives:

  1. Identify the predispositions of the older patient for injury or adverse event during hospitalization.
  2. Identify common complications of hospitalization in the elderly.
  3. Develop preventative strategies for the hazards of hospitalization of the elderly.
  4. Recognize early warning signs of complications.
  5. Develop treatment for those complications

Adult Failure to Thrive and Manutrition Objectives:

  1. Identify the disease processes that present as the historical diagnosis “Adult Failure To Thrive” (AFTT).
  2. Develop an approach to the systematic evaluation of social, physical and functional processes that lead to AFTT.
  3. Identify the role of the interdisciplinary team in the treatment of the AFTT syndrome.
  4. Identify the special nutritional needs of the older patient and the risk factors for malnutrition.
  5. Be able to perform nutrition screening using the Mini Nutritional Assessment (MNA).

Transitions of Care for Older Patients Objectives:

  1. Recognize that older patients are more likely to require multiple settings of care in the recovery from serious illness.
  2. Identify several settings of care and the skilled services provided in each setting.
  3. Identify a patient’s skilled needs and match them to an alternate setting of care.
  4. Incorporate transitions of care into discharge planning of the older patient.

Palliative Care Objectives

  1. Identify and describe key components of a Family Meeting.
  2. Describe management strategies for common symptoms at the End-Of-Life.
  3. Understand and explain basics of Medicare Hospice Benefit.
Date posted: 
Fri, 01/13/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 07/29/2014
Contact Person/Corresponding Author:



Suggested Citation:
, , , and . Computer Based Learning Workbook, Third Edition. POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/1089

Integration of Elder Abuse and Neglect into a Domestic Violence Curriculum

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

This product can be integrated into an interclerkship for third year medical students, through lecture and a standardized patient (SP) experience. The PowerPoint lecture presentation focuses on screening and identification of elder abuse and discusses decision making capacity. Following the lecture, students practice inteviewing an older SP using a case concerning elder abuse.  After the interview, students receive feedback from the SP, peers and faculty in small groups.

Educational objectives: 

During this course student dyads practice and receive feedback on communication and interviewing skills.

Upon completion of the course, the third year medical student should be able to:

  1. Articulate the types of elder abuse and neglect
  2. Identify elders at risk for abuse
  3. Discuss screening for elder abuse
  4. Briefly describe decision making capacity
Additional information/Special implementation requirements or guidelines: 

This product contains two versions of the lecture: a Powerpoint file and a PDF of the slides. It also contains a profile for the Standardized Patient.

The one day domestic violence interclerkship is required for third year medical students at UMMS. The interclerkship includes topics such as screening for intimate partner violence; lesbian, gay, bisexual and transgender domestic violence; and community resources.  Elder abuse was added to the clerkship with a 30 minute PowerPoint presentation discussing screening and interviewing skills. The lecture presentation also focused on neglect, self-neglect and decision making capacity.

During the interclerkship students practice communication and interviewing skills with elder standardized patients. Student-standardized patient dyads role-play the elder interview in small group. A standardized patient (SP) case, developed for the elder abuse exercise, involves an elder who is undergoing neglect and financial abuse by a family member. Prior to the interclerkship, the SPs undergo a training session about the developed case, and faculty are given a guide that discusses domestic violence and the simulated patient case. The domestic violence interview for the elder case is formative; there is no checklist. Following the SP experience, working in groups of four, the students are given feedback about their communication skills and interaction with the SP from their peers, the SP, and the small group faculty  leader.

Additional materials for the students included a recent JAMA article and patient handout about elder abuse for further infomation on the topic.

Date posted: 
Mon, 08/27/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 08/27/2012
Contact Person/Corresponding Author:



Suggested Citation:
, , , , and . Integration of Elder Abuse and Neglect into a Domestic Violence Curriculum. POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/1089

Obtaining a Functional History: Geriatrics and Aging through Transitional Environments (GATE) Curriculum for MS 1

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

"Obtaining a Functional History" is a curriculum for first year medical students consisting of a 1.5 hr didactic session on geriatric history-taking and includes a visit by an older adult community member who fields questions about his/her life story. Following the lecture, pairs of students visit an assigned "trained patient" living in an independent senior building that is part of a retirement community. The students conduct a geriatric functional history and home safety assessment (1.5 hrs.). (Volunteer "trained patients" were recruited for this project and participated in a 2 hr. training session to prepare them for this role. Sample training packet, training video and user's guide are included.) Students' interviewing skills are rated by "trained patients" and oral feedback is given to them as well. Students also complete a knowledge test and attitudes assessment pre and post-course, and write a 250 word reflective essay about their interviewing experience. Materials provided here include:  the lecture with speaker's notes, pre and post-tests, geriatric history-taking form, "trained patient" evaluation, and a sample "trained patient" training materials. An answer key is available upon request from Editor@POGOe.org.

Educational objectives: 

"Obtaining a Functional History"  addresses the AAMC Competencies below and teaches first year medical students how to:

1.  Assess and describe baseline and current functinal abilities (instumental activities of daily living, activities of daily living, and special senses) in an older paitent by collecting historical data from multiple sources and performing a confirmatory physical examination. (AAMC Competency #9)

2. Identify and assess safety risks in the home environment, and make recommendations to mitigate these. (AAMC Competency #11)

Additional information/Special implementation requirements or guidelines: 

To provide students the opportunity to interview geriatric trained patients, arrangements were made with a local retirement community granting permission for independent senior to be recruited for this voluntary, medical student education training program. Residents participated in an on-site, 2-hour training session, led by the authors/geriatricians, on how to evaluate students' interviewing skills. A sample training packet is provided.

Piloted in Spring 2011 at the University of Chicago Pritzker School of Medicine, GATE ("Geriatrics and Aging through Transitional Environments") is a longitudinal, competency-based curriculum for medical students. The M2 curriculum is an introduction to geriatric assessments; the M3 curriculum addresses geriatric care in the hospital; and M4 training examines care in the nursing home setting.  GATE includes a comprehensive and integrated evaluation process measuring knowledge, attitudes and skills. Supplemental materials developed by other Reynolds grantee institutions and available on POGOe are incorporated in the GATE M3 and M4 curricula.

Date posted: 
Fri, 06/08/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 06/08/2012
Contact Person/Corresponding Author:



Suggested Citation:
, , and . Obtaining a Functional History: Geriatrics and Aging through Transitional Environments (GATE) Curriculum for MS 1. POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/1089

Updating Tennessee Services: Helping Adults with Disabilities and Seniors Stay in the Community

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

This one hour video lecture with accompanying PowerPoint slides describes resources for disabled persons and caregivers. During this lecture, both Medicare and Medicaid services are discussed. The target audience is Interdisciplinary health Care Professionals.

Educational objectives: 
  1. Recall where to find Area Agency on Aging and Disability offices in Tennessee and/or resources to locate these offices
  2. Define the vision and mission of the Greater Nashville Regional Council (GNRC)
  3. Recognize the history of the Older Americans Act and what it is set up to accomplish
  4. Identify State and Community programs and available services


  5.  
Additional information/Special implementation requirements or guidelines: 

You will need to install the Microsoft Silverlight plugin to view this video. The video may take a while to load based on your connection. Please wait a few minutes if it doesn't appear right away.

Date posted: 
Wed, 08/01/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 08/01/2012
Contact Person/Corresponding Author:



Suggested Citation:
Updating Tennessee Services: Helping Adults with Disabilities and Seniors Stay in the Community. POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/1089

The VA Tennessee Valley Healthcare System Homeless Veterans Program

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

This one hour lecture with accompanying PowerPoint slides describes the VA Homeless Program services and outcomes. The target audience is Interdisciplinary Health Care Professionals.

Educational objectives: 
  • Describe types of outreach provided to our homeless veterans
  • Describe types of healthcare options for our homeless veterans
  • List housing options for our homeless veterans including future plans
  • List community resources to be used to find out more information

 

Additional information/Special implementation requirements or guidelines: 

You will need to install the Microsoft Silverlight plugin to view this video. The video may take a while to load based on your connection. Please wait a few minutes if it doesn't appear right away.

Date posted: 
Wed, 08/01/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 08/01/2012
Contact Person/Corresponding Author:



Suggested Citation:
The VA Tennessee Valley Healthcare System Homeless Veterans Program. POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/1089

Geriatric Emergency Medicine Online Curriculum (GEM-OC) 4 - Assessing Falls and ADLs

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

This is Module Four of an online five-module curriculum. The modules, which are based on national geriatric emergency medicine competencies, cover a broad range of geriatric topics through an interactive teaching format. They require learners to review and analyze patient information, interpersonal interactions, laboratory and imaging results, diagnoses and treatment plans. This module teaches about assessing falls and activities of daily living (ADLs).

Educational objectives: 

At the end of this Module, you will be able to:

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

2) Ask all patients >65 years of age, or their caregivers, about falls in the last year, watch the patient rise from a chair and walk (or transfer), then record or interpret the findings.

3) Communicate the key components of a safe discharge plan (e.g., accurate medication list, plan for follow-up), including comparing/contrasting potential sites for discharge.

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

5) Understand the role of physical and occupational therapy services for elderly patients with falls. Emphasize and encourage interdisciplinary patient care.

Additional information/Special implementation requirements or guidelines: 

For best viewing results, please:

  • Set your monitor resolution to 1024x768
  • Launch in either Internet Explorer 6 or higher, Firefox 2 or higher or Safari 3.2.1 or higher
  • Avoid using browser navigation. Use only the navigation provided within the course.

 

Date posted: 
Mon, 10/24/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/24/2011
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , and . Geriatric Emergency Medicine Online Curriculum (GEM-OC) 4 - Assessing Falls and ADLs. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/1089

Restraint Use in the Elderly

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

Management of the agitated elderly patient represents one of the greatest challenges in geriatric medicine. Historically, the use of both physical and chemical restraints was widespread. In more recent years, legislation has been passed to encourage alternative means of management as restraint use may lead to increase morbidity and mortality. The following three cases are common scenarios where restraints may be considered. The cases and accompanying questions are intended to be used by faculty to lead a discussion on this topic.

Educational objectives: 

After using this educational tool learners should be able to:

1. Describe what constitutes a physical or chemical restraint.

2. Differentiate when it is and is not appropriate to use a physical or chemical restraint in an elderly patient.

3. List alternatives to physical and chemical restraints.

4. Explain the dangers of physical and chemical restraints.

Date posted: 
Mon, 12/12/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 12/12/2011
Contact Person/Corresponding Author:



Suggested Citation:
Restraint Use in the Elderly. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/1089

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