The Portal of Geriatrics Online Education

Nephrology

The branch of medicine that deals with the physiology and diseases of the kidneys.

Elder Care A Resource for Interprofessional Providers: Urinary Tract Infections in Long-Term Care

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

Urinary Tract Infections in Long-Term Care​ is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites, they are useful for students and health care professionals from many fields and across a very broad range of health care settings.

Educational objectives: 

After reading this issue of Elder Care, you should be able to…

  1. List the criteria for diagnosis of urinary tract infection (UTI)
  2. Define asymptomatic bacteriuria
  3. Appropriately manage common clinical situations that are often misdiagnosed at UTI
Additional information/Special implementation requirements or guidelines: 

Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as:

  1. Content is not changed,
  2. No one is charged a fee to use or read the publication,
  3. Authors and their affiliated institutions are noted without change, and
  4. The reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatrics Workforce Enhancement Program”.
Publications from, presentations from, and/or citations to this product: 

The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.

Date posted: 
Mon, 08/06/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 08/01/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Urinary Tract Infections in Long-Term Care. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/211

Elder Care A Resource for Interprofessional Providers: Dialysis in the Older Adult - Practical Considerations

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

Elder Care A Resource for Interprofessional Providers: Dialysis in the Older Adult - Practical Considerations is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites, they are useful for students and health care professionals from many fields and across a very broad range of health care settings.

Educational objectives: 

After reading this issue of Elder Care, you should be able to…

  1. Explain why older adults on dialysis have higher mortality rates than younger adults on dialysis
  2. Explain the role of a trial of dialysis
  3. Identify older adults with end-stage rental disease who are unlikely to benefit from dialysis
Additional information/Special implementation requirements or guidelines: 

Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as:

  1. Content is not changed,
  2. No one is charged a fee to use or read the publication,
  3. Authors and their affiliated institutions are noted without change, and

The reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatrics Workforce Enhancement Program”. 

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

The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.

Date posted: 
Thu, 03/29/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 03/19/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Dialysis in the Older Adult - Practical Considerations. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/211

Elder Care A Resource for Interprofessional Providers: Hyponatremia in Older Adults - Therapeutic Considerations

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

Elder Care A Resource for Interprofessional Providers: Hyponatremia in Older Adults - Therapeutic Considerations is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites, they are useful for students and health care professionals from many fields and across a very broad range of health care settings.

Educational objectives: 

After reading this issue of Elder Care, you should be able to…

  1. Explain why free water restriction is sometimes difficult for older adults
  2. Describe the approach to correcting sodium levels in chronic hyponatremia
  3. Describe the approach to correcting sodium levels in severe acute hyponatremia
Additional information/Special implementation requirements or guidelines: 

Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as:

  1. Content is not changed,
  2. No one is charged a fee to use or read the publication,
  3. Authors and their affiliated institutions are noted without change, and
  4. The reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatrics Workforce Enhancement Program”.
Publications from, presentations from, and/or citations to this product: 

The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.

Date posted: 
Thu, 03/29/2018
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 03/19/2018
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Hyponatremia in Older Adults - Therapeutic Considerations. POGOe - Portal of Geriatrics Online Education; 2018 Available from: https://pogoe.org/taxonomy/term/211

Elder Care A Resource for Interprofessional Providers: Chronic Kidney Disease in Older Adults

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

Chronic Kidney Disease in Older Adults is one of a continuing series of practical, evidence based, Provider Fact Sheets which summarize key geriatric topics and provide clinically useful assessments and interventions. Initially developed for remote, rural clinical sites, they are useful for students and health care professionals from many fields and across a very broad range of health care settings.

Educational objectives: 

After reading this issue of Elder Care, you should be able to…

  1. Identify the age after which renal function declines most steeply
  2. Explain why equations that use cystatin C for estimating glomerular filtration rate are more accurate than the traditional Cockroft-Gualt equation
  3. State the glomerular filtration rate below which a patient should be referred to a nephrologist
Additional information/Special implementation requirements or guidelines: 

Subscribers to POGOe are free to reprint Elder Care on their own stationery or in other publications without obtaining specific permission, so long as:

  1. Content is not changed,
  2. No one is charged a fee to use or read the publication,
  3. Authors and their affiliated institutions are noted without change, and
  4. The reprint includes the following statement: “Reprinted courtesy of the Arizona Reynolds Program of Applied Geriatrics and the Arizona Geriatrics Workforce Enhancement Program”. 
Publications from, presentations from, and/or citations to this product: 

The Elder Care provider sheets are occasionally published in the Arizona Geriatrics Society Journal, which is published twice yearly.

Nelson, D. and Medina-Walpole, A. (2010, December), Elder care provider fact sheets. Journal of the American Geriatrics Society, 58(12), 2414-2415. Also available online.               

Date posted: 
Mon, 06/12/2017
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 06/12/2017
Contact Person/Corresponding Author:



Suggested Citation:
Elder Care A Resource for Interprofessional Providers: Chronic Kidney Disease in Older Adults. POGOe - Portal of Geriatrics Online Education; 2017 Available from: https://pogoe.org/taxonomy/term/211

Goals of Care Conversation Curriculum (GOCCC) Training

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

We developed a 3-part curriculum for teaching the basics of communication about goals of care (GOC) in older persons targeted towards medical students, residents, fellows, and faculty. There are 3 modules: 

1. Communicating Serious News - identifies strategies for effective communication and especially communicating serious news to patients or family members and improving our ability to transmit this news in an empathic and effective manner.

2. Goals of Care Discussion -focuses on the essential components of a GOC discussion; initiation, understanding the patient and family perspective, surrogate decision making, and concluding remarks clarifying and summarizing key discussion points and areas of understanding.

3. Managing conflict with patients and families - focuses on how to address frustrated and perhaps angry patients or family members who sometimes don’t feel that they are being listened to.  As providers, we are often put in this situation with few resources or skills to help guide us on how to deal with the patient’s and family’s emotions as well as our own.  Each module contains a didactic lecture (45-60 minutes), examples of faculty role play (10-15 minutes), instructions for participant role play activities focused around a clinical case scenario done in dyads (30 minutes), and a sample evaluation form. Each module is best done in 2-hour sessions and in small groups (10-20 participants) but can be modified for 1-hour sessions. The content is applicable to a range of learners although the participant role play will likely be more meaningful for the more advanced learners.

Educational objectives: 

At the end of Module 1: Discussing Serious News, students, residents, and faculty will be able to:        

a.      Use curiosity and good listening skills to understand patient coping styles

b.      Describe empathic and effective approaches to discussing serious news

c.       Identify strategies for discussing prognosis

At the end of Module 2: Basic GOC, students, residents, and faculty will be able to:

a.       Be comfortable and effective talking with patients and families about goals of care for patients with serious life-threatening, or chronic conditions

b.      Describe goals of care discussions as an essential component of the practice of medicine accepted within the mainstream of legal, moral, and ethical principles

c.       Articulate the complexity and subtleties of surrogate decision-making, in particular the concept of substituted judgment

d.      Practice the key components of goals of care discussions in a simulation as a way to gain competence and confidence in conducting GOC conversations

At the end of Module 3: Managing Conflict, students, residents, and faculty will be able to:

a.       Manage conflict in an effective and empathic manner to de-escalate anger and frustration experienced by patients and families during serious illness

b.      Recognize that in life-threatening situations, anger is a common response

c.       Describe communication techniques for diffusing anger

d.      Apply recommended skills to manage conflict and guide patients’ families and other clinicians through difficult decisions

Date posted: 
Mon, 06/20/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 06/20/2016
Contact Person/Corresponding Author:



Suggested Citation:
Goals of Care Conversation Curriculum (GOCCC) Training. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/211

Geriatric Fast Facts Quizzes

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
0
Abstract: 

Geriatric Fast Facts (GFFs) [www.geriatricfastfacts.com] is a mobile enabled website which contains 1-2 page concise, peer-reviewed evidence-based educational summaries on key geriatrics topics to increase medical knowledge.

GFF Quizzes are quick, online assessment tools paired with GFF content, to be used by learners at the point of care to assess knowledge of geriatric content aligned with ACGME Milestones.  Design elements include quiz content searchable by topic, links to corresponding GFFs, MCQ/ short answer question formats and ability to include images. Learners enter brief demographic information to start (institution, email of self and up to 1 other) allowing annotated score results, displayed immediately after quiz completion, to be sent to themselves and one other individual (faculty, program director). These quick quizzes, available on hand held mobile devices at the point of care, linked to GFF content provide learners and program directors information of learner knowledge assessment linked to ACGME Milestones.

Educational objectives: 

The Geriatric Fast Fact (GFF) quizzes, available on hand held mobile devices at the point of care, linked to GFF content will provide learners and program directors information of learner knowledge assessment linked to ACGME Milestones.

Additional information/Special implementation requirements or guidelines: 

The Geriatric Fast Facts (GFF) and GFF Quizzes may be viewed and accessed by the URL address geriatricfastfacts.com. The site may be then saved to the home screen to allow functionality as an "app".

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

Quick Quizzes:  Geriatrics Right in Your Hand & at the Point of Care.  Denson K, Simpson D, Padua K, and the GET Collaboratives at the Medical College of Wisconsin & Aurora Health Care, American Geriatrics Society Annual Meeting, Baltimore, MD, 05/2015

Date posted: 
Thu, 10/08/2015
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 10/08/2015
Product Viewing Instructions: 
The Geriatric Fast Facts (GFF) and GFF Quizzes may be viewed by the URL address geriatricfastfacts.com. The site may be then saved to the home screen to allow functionality as an "app"
Contact Person/Corresponding Author:



Suggested Citation:
Geriatric Fast Facts Quizzes. POGOe - Portal of Geriatrics Online Education; 2015 Available from: https://pogoe.org/taxonomy/term/211

"TMI"... (Too Many Interpretations): Mr. Moore's Medication Misadventures!

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

This two hour interprofessional curriculum brings together fourth year medical students and third year pharmacy students in a hands-on, interactive small group session. Learners are given a guide briefly describing the case and delineating five health care members and their roles and expertise in Mr. Moore's healthcare team (Mr. Moore's partner, the outpatient pharmacist, the inpatient intern, etc). A pair of interprofessional facilitators guide learners through the case, utilizing different healthcare team members' roles and expertise to explore methods of medication organization and systemic barriers to accurate and safe discharge medication reconciliation. Learners discover and discuss discrepancies in high-risk medications, gain an appreciation of systems hurdles for patients and healthcare providers during transitions of care, complete an exercise in writing discharge medication instructions, and brainstorm action items to personally employ to overcome systemic hurdles for safer discharge medication reconciliation.

Educational objectives: 

By the end of the two-hour session, learners will work collaboratively to:

  1. Describe the roles and expertise of three health professions that can collaborate to reconcile medications and enhance safety of medication orders at the time of hospital discharge. 
  2. List three potential communication barriers between health professionals involved in discharge planning that contribute to medication errors in vulnerable older adults.
  3. Identify key components of discharge medication lists and instructions to communicate information safely to patients, caregivers, primary care providers and others on the healthcare team.
Date posted: 
Tue, 08/30/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 08/30/2016
Contact Person/Corresponding Author:



Suggested Citation:
"TMI"... (Too Many Interpretations): Mr. Moore's Medication Misadventures!. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/211

Interprofessional Collaborator Mini-Course

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

Physicians (and other health professionals) are often expected to participate with teams of health professionals; however, postgraduate training infrequently includes interprofessional (IP) or team training.  Thus, this curriculum was developed to teach and demonstrate the knowledge, skills and attitudes which lead to successful IP collaboration.  While created for an audience of in-training physicians, it may be used with other health professional audiences.

During a four-week geriatrics rotation, medicine interns complete a fifty-minute, in-person, multimedia lecture to introduce the IP collaborator concept and the Canadian and American IP competency frameworks. The IP pocket card is demonstrated and interns complete a guided, team-meeting video observation exercise. Using a SurveyMonkey, narrative reporting tool, interns analyze team competencies that they observe or initiate during geriatrics team meetings during the rotation. They report on two interactions. They complete a closing SurveyMonkey questionnaire and have an in-person debriefing.

Educational objectives: 

Given opportunity to work with interprofessional teams for patient care on the Geriatrics Block Rotation:

  • Learner will recognize interprofessional competencies.
  • Learner will understand the role of interprofessional collaborator.
  • Learner will observe and demonstrate the knowledge, skills and attitudes necessary to be an interprofessional collaborator according to CIHC and IPEC competencies
Publications from, presentations from, and/or citations to this product: 
Poster Presentation: Interprofessional Collaborator Curriculum
InterProfessional Care for the 21st Century
Redefining Education & Practice
Jefferson University, Philadelphia, PA
October 2014
Date posted: 
Tue, 06/14/2016
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 04/03/2019
Contact Person/Corresponding Author:



Suggested Citation:
Interprofessional Collaborator Mini-Course. POGOe - Portal of Geriatrics Online Education; 2016 Available from: https://pogoe.org/taxonomy/term/211

SAGE Intrinsic Aging: A Histological Perspective: Urinary System Module

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

This module demonstrates the normal age-related changes in the urinary system and its clinical implications. A highlight of these modules are side by side comparison of young and aged tissues with interactive slides and summary drawings which reinforce the main points on the histology slides. The curriculum is appealing to clinical learners as it is anchored in showing clinically relevant changes and the implications of these changes in older patients. The main audience is the pre-clinical first or second year medical student, but these could be used by other trainees to teach the basic science of aging.

Educational objectives: 

Learning Objectives for Urinary System module:

Identify the major aging associated changes in each of the following and describe the clinical implications of these changes on the:

  1. Kidney
  2. Ureter
  3. Urethra - female
  4. Nerves
  5. Urethra - male
Additional information/Special implementation requirements or guidelines: 

Southwestern Aging and Geriatrics Education (SAGE) Program

Lead Author: Judith R. Head, PhD

Medical Illustrator: Lindsay Oksenberg, MA

Geriatrician:  Amit Shah, MD

Special thanks to histology technician: Brie Thaden Pirkle and Tasha Buxton

Date posted: 
Thu, 12/18/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Thu, 12/18/2014
Contact Person/Corresponding Author:



Suggested Citation:
SAGE Intrinsic Aging: A Histological Perspective: Urinary System Module. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/211

Powerpoint: Medicare, Medicaid and Discharge Planning

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

This is a Powerpoint presentation designed to provide the backbone for a talk to primary care or specialty residents responsible for discharging hospitalized Medicare patients to another level of care. It reviews the available post-acute options (LTACH, AIR, SNF, LTC, home health) and provides just the information on Medicare and Medicaid that are critical to understanding the patient’s options. The presentation includes Medicare financial information and criteria for coverage specific to 2014, and Medicaid information specific to NC, so some modification and updating may be necessary for use in other venues or later years. The presentation can be accomplished in 45 minutes leaving room for questions in a one-hour time block. A decision-tree diagram is included as a handout that can be provided with the talk and provides a succinct summary for future reference.

Educational objectives: 

1. Review a few key elements of Medicare and Medicaid eligibility and benefits

2. Distinguish between Inpatient and Observation status for Medicare patients

3. Be able to clearly state a patient’s discharge needs

4. Know the various discharge options and the key differences between them

5. Apply the criteria for Medicare coverage of various discharge options

Date posted: 
Fri, 10/03/2014
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 10/03/2014
Contact Person/Corresponding Author:



Suggested Citation:
Powerpoint: Medicare, Medicaid and Discharge Planning. POGOe - Portal of Geriatrics Online Education; 2014 Available from: https://pogoe.org/taxonomy/term/211

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