Gerontological Nurse Practitioner Research Articles

Nurses’ perceptions of gerontological nurse practitioner programme curricula: A qualitative descriptive study

Purpose: This study aimed to describe nurses’ perceptions of gerontological nurse practitioner (GNP) programme curricula, especially positive and negative aspects of the curricula and suggestions to improve the curricula. Methods: Twenty-one certified GNPs attended one or two interviews and the data obtained were analysed using a conventional content analytic method. Results: The analysis revealed seven categories and 18 subcategories. The main positive aspects of the GNP programme curricula were “Acquiring knowledge and skills to elder care through the GNP programme” and “Application of gerontological nursing-related knowledge and skills attained from the GNP programme.” The negative aspects included “Didactic education insufficient for the development of expertise in gerontological nursing” and “Ineffective and suboptimal operation of clinical practice curriculum.” Suggestions to improve the GNP programme curricula were “Enhancement of education in core courses,” “Strengthening the contents of gerontological nursing didactic courses,” and “Quality improvement of clinical practice.” Conclusion: The findings indicate that educators, policymakers, and other stakeholders should re-examine the current GNP programme curricula to provide GNP students with quality education and training pertinent to professional healthcare for older adults in various healthcare settings.

Experiences of Advanced Health Assessment Simulation Based on the Education Needs of Gerontological Nurse Practitioner Students.

There is an insufficient exploration of how simulation educational approaches improve the job performance of students in gerontological nurse practitioner (GNP) courses. To increase the effectiveness of simulation education in GNP courses, it is necessary to explore the advanced health assessment simulation curriculum. This study aimed to investigate GNP students' educational experiences with the advanced health assessment simulation program by reflecting the needs of GNPs. A qualitative study design was employed for this study; focus group interviews were conducted among eight GNP students who participated in this simulation program. The focus group interview identified three theme clusters: 'a high-fidelity simulator that reproduces a real-life setting', 'experience with standardized patients as a reference for normal older people', and 'application in the clinical field'. Through simulation education, GNP students were able to safely demonstrate knowledge and use what they learned for clinical practice. The development and utilization of simulation education for the GNP program would help to enhance the clinical competency of students.

Building APRN Gerontology Workforce Capacity Through New APRN Gerontological Specialist Certification

Building APRN Gerontology Workforce Capacity Through New APRN Gerontological Specialist Certification

Gerontological nurse practitioners (GNPs) for the first time in Israel: Physicians' and nurses' attitudes.

Nurse practitioners (NPs) have recently been partially introduced by the Israel Ministry of Health. This study examines the attitudes among gerontological physicians and nurses toward the scope of practice and effects on healthcare quality of the new role of gerontological NPs (GNPs). A descriptive survey methodology, with a cross-sectional design, was used. According to about 50% of the respondents, GNPs would be expected to have various positive effects on health care, such as reducing the number of referrals to emergency care, as well as readmissions. Despite the overall positive attitude to the GNPs' role, nurses and physicians perceived its scope of practice somewhat differently. Implementing the NP role involves multiple challenges and provides insights into this complex new function. Especially in these early stages, identified intentions for the NP role and value of the role by healthcare teams are expected to be useful to policy makers for planning effective utilization of NPs in healthcare workforce. This role is also a new role in other countries, so these findings should be relevant beyond Israel.

The Role-expectations of Gerontological Nurse Practitioners and Performance of Gerontological Nursing by Nurses in Long Term Care Hospitals and General Hospitals

Subjects were 200 nurses; 100 nurses from long term care hospitals where as 100 nurses from general hospitals. The subjects completed a questionnaire on general characteristics, role-expectations of gerontological nurse practitioners, and performance of gerontological nursing by nurses. Data were collected from February to March 2013 and analyzed using SPSS/ WIN 18.0 version program in order to pe rform descriptive statistics, independent t-test, and one-way ANOVA.

Infusing oral health care into nursing curriculum: addressing preventive health in aging and disability.

Access to oral health care is essential for promoting and maintaining overall health and well-being, yet oral health disparities exist among vulnerable and underserved populations. While nurses make up the largest portion of the health care work force, educational preparation to address oral health needs of elders and persons with disabilities is limited across nursing curricula. This descriptive study reports on the interdisciplinary development, implementation, and testing of an oral health module that was included and infused into a graduate nursing curriculum in a three-phase plan. Phase 1 includes evaluation of a lecture presented to eight gerontological nurse practitioner (GNP) students. Phase 2 includes evaluation of GNP students' perceptions of learning, skills, and confidence following a one-time 8-hour practicum infused into 80 required practicum hours. The evaluation data show promise in preparing nurse practitioner students to assess and address preventive oral health needs of persons aging with disabilities such that further infusion and inclusion in a course for nurse practitioners across five specialties will implemented and tested in Phase 3.

Gerontological NPs as Healthcare Directors of Nursing Homes

In today's nursing home environment, with the increasing complexity of care for the older adult, collaboration among healthcare professionals is essential to ensure the best quality of care. The need exists for a clinician who can coordinate this dynamic team of professionals while synthesizing holistic care to meet the needs of older adults now and in the years to come. The role for gerontological nurse practitioner (GNP) is here, and its title is healthcare director.

More than a Prescriber: Gerontological Nurse Practitioners' Perspectives on Prescribing and Pharmaceutical Marketing

The purpose of this study was to gain understanding about nurse practitioners' (NPs') prescriptive decision making for geriatric patients with attention to pharmaceutical marketing influences. Prior research has focused on physician prescribers and identified suboptimal practices. Because the majority of medications are prescribed to older adults, NPs in geriatric practice were targeted as an information-rich group to interview about prescribing issues. Given the exploratory nature of this research, qualitative focus group methods were employed using content analysis. Fifteen NPs were recruited at an annual national geriatric NP conference. They worked in all regions of the United States, had an average of 9 years prescribing experience, and participated in 1 of the 2 focus groups. The key theme that emerged was that they were more than a prescriber. Findings revealed overwhelming consistency among the NP participants that their nursing background instilled a holistic approach that encompassed both nondrug and therapeutic drug options and skepticism about drug marketing, as well as offered a positive difference by tailoring to their patients' biophysical, psychological, and economic needs with an involvement in the interplay of geriatric care issues not typically addressed by physicians. The participants' reported approaches were in alignment with geriatric prescribing recommendations.

Managing Pain in the Older Adult, Edited by Michaelene Jansen

Managing Pain in the Older Adult Edited by Michaelene Jansen. Older adults comprise a rapidly growing segment of both society and consumers of health care. This population has a very high prevalence of persistent pain. Their pain is often undertreated or untreated because of inadequate assessment, concerns related to the harmful effects of medications, or social and economic barriers. The undertreatment of pain is recognized as a threat to the overall health and well-being of older adults and can contribute to physical harm, mental despair, and social isolation. Although much remains to be learned, there is now a growing body of literature on the topic. The book Managing Pain in the Older Adult , edited by Michaelene Jansen [1], contributes to this literature as a reference for a wide range of clinicians caring for older adults. Although Dr. Jansen, a Gerontological Nurse-Practitioner, identifies the target audience as primary-care providers; nurses, therapists, and social workers would also find the content useful. The book …

Clinical practice characteristics of gerontological nurse practitioners: A national study

To determine the clinical practice characteristics of gerontological nurse practitioners (GNPs) in the United States and ascertain whether length of employment, geographic region of practice, work setting, and educational preparation influence GNPs' delivery of advanced clinical services and clinical procedures. The Gerontological Nurse Practitioner Practice Profile was mailed to a stratified random sample of 1000 GNPs certified by the American Nurses Credentialing Center. Despite the growing demands for GNPs, of the 472 GNPs who responded to the survey, only half were working full-time as a GNP. Although the role was established over 30 years ago, 56% of the respondents indicated that they were the first GNP in the position. There was a statistically significant positive relationship between being the first GNP in his or her practice and the percent of primarily medical advanced clinical services performed. GNPs who worked in multiple clinical setting performed more advanced clinical services and medical procedures than GNPs who only worked in one setting. This study provides insight into the complex practice characteristics of GNPs. GNPs are combining the nursing skills so necessary to care for older adults with advanced clinical services and clinical procedures deemed medical acts. Various factors influence how GNPs practice, including geographic location, type of practice, and whether the GNP was the first person to be employed as a nurse practitioner at the practice.

Prescribing patterns of gerontological nurse practitioners in the United States

To identify the prescribing patterns of gerontological nurse practitioners (GNPs) as reported on the Gerontological Nurse Practitioner Practice Profile. Specifically, the study examined (a) GNPs' frequency of prescribing certain categories of medications for older adults; (b) the influence of practice, education, and experience variables on prescribing practices of GNPs; and (c) the rate of prescribing inappropriate medications for older adults based on the list of medications on the modified Beers Criteria. The study was part of a larger descriptive survey that examined the practice characteristics of GNPs using the Gerontological Nurse Practitioner Practice Profile. A stratified random sample of 1000 GNPs certified by American Nurses Credentialing Center was sent surveys; 472 usable surveys were returned. Only the 234 GNPs who indicated that they were currently practicing full time as a GNP were included in this analysis. Ninety-three percent of the respondents indicated that they had prescriptive privileges. The most commonly prescribed types of medications were analgesics, antihypertensives, cardiovascular drugs, and diabetic medications. The prescribing patterns of these GNPs were not influenced by education, years of practice, or selected practice characteristics. There was a significant difference in the prescribing of inappropriate medication among office-based GNPs and those who worked in long-term care settings. The GNPs in the ambulatory care setting had a tendency to prescribe inappropriate medications more frequently than those in long-term care facilities. Overall, self-reported prescribing of inappropriate medications among the GNPs participating in this study, however, was low. The findings of this study indicate that GNPs are prescribing medications for complex medical conditions.

Task Analysis of the Job Description of Gerontological Nurse Practitioners based on DACUM

The aim of this study was to develop and to analyze the task of gerontological nurse practitioners (GNPs) in Korea. The definition of GNP and job description was developed based on developing a curriculum (DACUM) by 7 panels who have experienced in DACUM analysis and gerontological nursing. One hundred sixty nurses who were working at long term care facilities were participated. The questionnaire included frequency, importance, and difficulty of duties, tasks, and task elements. The data were collected in November 2006, analyzed by descriptive statistics. The job description of GNPs in Korea revealed 5 duties, 23 tasks, and 86 task elements. On the all five duties, the highest duty in frequency and in importance was professional nursing care (3.25+/-0.35, 3.49+/-0.29). But the highest duty in difficulty was research (3.24+/-0.46). 'Prevent health problem (3.42+/-0.43, 3.56+/-0.33)', 'Teach other staffs (2.83+/-0.77, 3.39+/-0.43)', 'Develop the evidence-based standards (2.43+/-0.76, 3.22+/-0.43)', 'Develop the self (2.81+/-0.65, 3.26+/-0.42)', and 'Participate the team activities' were the highest score in frequency and in criticality of tasks. 'Provide emotional support to older adults and families (3.16+/-0.41)', 'Counsel older adults and their families (3.14+/-0.49)', 'Do clinical research (3.32+/-0.49)', 'Quality insurance (3.25+/-0.49)', and 'Build collaborative system (3.18+/-0.47)' were perceived the most difficult tasks. The political efforts for the legislation of role and task of GNPs were needed.

Chronic Care Management for the Elderly: An Opportunity for Gerontological Nurse Practitioners

To discuss the role that gerontological nurse practitioners (GNPs) may play in providing chronic care management for the elderly. Review of recent literature on chronic care management, personal experience of the authors in caring for older adults under the chronic care management model, and a case study. GNPs are the most appropriate practitioners to provide and coordinate chronic care management to the population that needs it most--the elderly. Demographic shifts in the United States have increased the number of people with chronic illnesses; however, the nation's healthcare delivery system has not significantly evolved to meet the changing needs of its population. As a result, many people, especially older adults, suffer needlessly, and healthcare costs continue to rise. Chronic care management may alleviate older adults' chronic health problems, reduce expenditures for their health care, and promote their satisfaction and quality of life.

Collaboration: Foundation for a Successful Practice

Barbara Resnick, PhD, CRNP, FAAN, FAANP, and Alice Bonner, APRN-BC Collaboration, by definition, is a joint and cooperative enterprise that integrates the individual perspectives and expertise of various team members. Some commonly identified themes of collaborative relationships include collegiality, teamwork, open communication, recognition of one another’s expertise, and a strong level of trust and respect. However, the development of an individual collaborative practice is unique to the practice, should optimize the skills of each party, and allow each participant to provide care within his or her scope of practice. Despite the potential benefits of a collaborative physician-nurse practitioner practice, several barriers also exist. Collaboration should be distinguished from supervision, which implies direct physician oversight of the nurse practitioner (NP) and is a requirement for nurse practitioner practice in some states. This article describes collaborative physician-nurse practitioner relationships in geriatric practice, and guidelines for implementation of a collaborative practice agreement. GERONTOLOGICAL NURSE PRACTITIONERS A gerontological NP is a registered nurse with advanced educational preparation and the skills to provide a full range of primary care services to older adults. Gerontological NPs practice under the rules and regulations of the Nurse Practice Act of the state in which they practice. In order to practice they must be nationally certified. Gerontological NPs are currently practicing in all of the 50 states, from rural communities to heavily populated areas such as major cities and retirement communities. In addition to gerontological NPs, adult and family NPs also practice in long-term care settings. ADVANTAGES OF COLLABORATIVE CARE The benefits of physician-NP collaborative practice are particularly evident in the field of geriatrics, because older adults commonly present with multiple physical as well as psychosocial needs. Moreover, physicians who participate in a collaborative practice have noted the positive aspects of this collaboration. Based on a survey of approximately 700 physi

Practice methods among nurse practitioners treating depressed women.

To determine practice methods and beliefs about degree of competence in the assessment, diagnosis, and treatment of depressive symptoms in women by nurse practitioners (NPs). A survey about the diagnosis and treatment of depressive symptoms in women was mailed to 3,000 NPs randomly selected from the membership of the American Academy of Nurse Practitioners. Family, adult, women's and gerontological NPs were included; 1,647 surveys were returned (55%). Assessment and treatment protocols used by NPs were consistent with the AHCPR guidelines and similar to the protocols used by psychiatrists and non-psychiatric physicians, yet only 65% believed their education had adequately prepared them to assess/diagnose depression and only 52% believed they had been adequately prepared to treat depression. Findings suggest areas for improvement in the formal education and continuing education of NPs.

A Clinical Practice Guideline Approach to Treating Depression in Long-term Care

The Clinical Practice Guideline (CPG) Project was initiated by the American Medical Directors Association (AMDA) in 1994 to address the need for user-friendly guidelines relevant to long-term care. The project is guided by a multidisciplinary, as well as interdisciplinary, steering committee, with representation from the long-term care field, including: American Association of Homes and Services for the Aging (AAHSA), American Health Care Association (AHCA), American Hospital Association (AHA), American Society of Consultant Pharmacists (ASCP), American College of Health Care Administrators (ACHCA), National Association of Directors of Nursing Administration (NADONA), National Conference of Gerontological Nurse Practitioners (NCGNP).

National Conference of Gerontological Nurse Practitioners seeks submissions

National Conference of Gerontological Nurse Practitioners seeks submissions

A Clinical Practice Guideline Approach to Treating Depression in Long-term Care

The Clinical Practice Guideline (CPG) Project was initiated by the American Medical Directors Association (AMDA) in 1994 to address the need for user-friendly guidelines relevant to long-term care. The project is guided by a multidisciplinary, as well as interdisciplinary, steering committee, with representation from the long-term care field, including: American Association of Homes and Services for the Aging (AAHSA), American Health Care Association (AHCA), American Hospital Association (AHA), American Society of Consultant Pharmacists (ASCP), American College of Health Care Administrators (ACHCA), National Association of Directors of Nursing Administration (NADONA), National Conference of Gerontological Nurse Practitioners (NCGNP). To date, 12 guidelines have been published. In 1996, Depression, Heart Failure, Urinary Incontinence, and Pressure Ulcers were developed using a consensus method and Agency for Health Care Policy and Research (AHCPR) documents as a starting point. The AHCPR has since been renamed the Agency for Healthcare Research and Quality (AHRQ). Then, in 1997, under a joint project conducted by AMDA and AHCA, Guideline Implementation, Pharmacotherapy Companion to the Depression Clinical Practice Guideline, Altered Mental States, Dementia, Falls and Fall Risk, and Osteoporosis were published. In 1998, AMDA resumed autonomous leadership of the CPG Project and, in 1999, published two guidelines—Chronic Pain Management in the Long-term Care Setting and Pressure Ulcer Therapy Companion to the 1996 Pressure Ulcer Clinical Practice Guideline. The mission of this project is to develop CPGs to improve the quality of care delivered to patients across the long-term care continuum. The guiding principles established by the steering committee include:

A Clinical Practice Guideline Approach to Treating Depression in Long-term Care

The Clinical Practice Guideline (CPG) Project was initiated by the American Medical Directors Association (AMDA) in 1994 to address the need for user-friendly guidelines relevant to long-term care. The project is guided by a multidisciplinary, as well as interdisciplinary, steering committee, with representation from the long-term care field, including: American Association of Homes and Services for the Aging (AAHSA), American Health Care Association (AHCA), American Hospital Association (AHA), American Society of Consultant Pharmacists (ASCP), American College of Health Care Administrators (ACHCA), National Association of Directors of Nursing Administration (NADONA), National Conference of Gerontological Nurse Practitioners (NCGNP).

Getting in touch with impaired foot sensitivity.

Gerontological Nurse Practitioner University of Southwestern Louisiana Lafayette, La. Certified Diabetes Educator Program Director Diabetes Self-Management Center Lafayette, La.