- Email: [email protected]
Care Coordination Improves Outcomes and Reduces Cost
2009 AAN Poster Abstracts continued From the AAN Annual Meeting and Conference
courses per semester. Start-up cost to student for technology is about $300 plus the cost of an up-to-date computer and high speed internet The greatest cost of the program is the use of bridge technology, which costs about $300,000, to support the videoconferencing. Findings: 47 students from 22 states have been admitted to the distance PhD program in oncology, gerontology, and non-specialty cohorts. Racial and ethnic diversity of the cohorts ranges from 15-45%. Average time to graduation was 3.7 years compared to 5.8 years for traditional students. Students have secured an unprecedented number of fellowships, awards, and research grants. Student and faculty satisfaction is also higher. Summary Concluding Statement: Technology-based education supports development of competent nurse scientists and culturally competent educators. (2009 AAN Poster of Distinction)
The WV Rural Health Research Center Cynthia Armstrong Persily, PhD, RN, FAAN, Michael Hendryx, PhD, and Joel Halverson, PhD
Background: The West Virginia Rural Health Research Center (WVRHRC), funded in 2008 by the US DHHS Office of Rural Health Policy, has a unique interdisciplinary research team, blending the strengths of the WVU Schools of Nursing, Medicine and Pharmacy, the WV Institute for Health Policy Research, and the Office of Rural Health to focus on the impact of environmental risks on the health of rural communities. Purpose: Areas of the environment considered to impact health include the built environment, food, air, water, and land use. These environmental features may include direct pollution sources but also include the larger social, economic or built environment that differentially places rural populations at greater risk for poor health outcomes. These problems are of concern given the limited information about environmental risks faced by rural populations. Methodology: The WVRHRC conducts studies to analyze environmental risks and their relationship to national health. In year 1, studies included development of 1 a rural environmental hazards inventory 2 a rural socioeconomic risk and resiliency inventory and 3 key environmental health competencies for rural primary care providers. Future studies include analysis of rural environmental health workforce needs, targeted analyses of environmental hazards, and an analysis of health implications of food security and availability in rural areas. Findings: Findings and policy briefs for each Year 1 study will be shared during the poster session. Year 2 studies will be abstracted and preliminary findings will be discussed. Summary Concluding Statement: The interdisciplinary research of the WVRHRC will ensure that providers
serving rural communities are supported with the latest data and information on the health and healthcare needs of rural populations exposed to environmental risks, and will inform policy makers of the important impact of the environment on the health of rural communities.
The Massachusetts School Nurse Research Network Joyce Pulcini, PhD, RN, FAAN, Anne Sheetz, RN, MPH, CNAA, and Marie DeSisto, RN, MSN, NCSN
Background: The Massachusetts School Nurse Research Network (MASNRN) was established in 2004 as a joint venture of the Boston College Connell School of Nursing, the Massachusetts School Nurse Organization, and the Massachusetts Department of Public Health (MDPH), School Health Unit. The three organizations recognized the need to integrate current research into school nursing practice to (a) meet the profession’s obligation for accountability, (b) build a knowledge base specific to this subspecialty area of nursing and (c) meet children’s health care needs most effectively. Purpose: To describe this innovative collaboration as a model for promoting nursing research, building nursing research leaders in school health for the future, and improving child health outcomes. Methodology: The accomplishments of this unique organization will be displayed including research grants, publications, presentations, and educational opportunities. Results of a focus group and survey of members will also be presented. Findings: This organization, which has over 100 school nurse members, has generated in its five years: 7 funded grants, 3 journal articles plus 3 in progress; at least 17 presentations, 4 poster presentations and 7 continuing education programs on research. A logic model for evaluating this organization’s progress will also be presented along with qualitative survey and focus group findings. Summary Concluding Statement: In order to promote nursing research, new models for reaching out to nurses and to improve child health outcomes can be developed through innovative collaborative efforts between universities and community partners.
Care Coordination Improves Outcomes and Reduces Cost Marilyn J. Rantz, PhD, RN, FAAN, Lorraine Phillips, PhD, RN, Myra Aud, PhD, RN, Karen Marek, PhD, MBA, RN, FAAN, Isabella Zaniletti, and Steven J. Miller
Background: Older adults want to live independently at home and postpone or avoid nursing home placement Long term care expenses are expected to more than double between 2000 and 2040. To address these concerns, M
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2009 AAN Poster Abstracts continued From the AAN Annual Meeting and Conference
Methodology: We conducted focus groups (n¼59) and surveyed 304 older adults (OA) (M age 75, SD 8) and community stakeholders (CS) (M age 48, SD 15), stratified by ethnicity and NORC population using a 9item demographic form, 24-item Social Provisions Scale (SPS) (a 093) and 24-item Perceptions of Community (POC) scale (a 088). Findings: Phase I results provide the context for reporting Phase II results. Transportation, walkability (safety, lack of sidewalks, vehicular speed) and lack of health care services (providers, pharmacy, clinics) were major concerns. OA and CS differed significantly (p<05) on SPS total and five SPS subscales; NORCs differed significantly on two SPS subscales, POC total and four POC subscales. Summary Concluding Statement: These results highlight the economic, health care, housing, community and family resource challenges in increasing livable communities that enable older adults to remain in their homes as they age. Creating an agenda for a healthy aging society in livable communities supports the highest quality of life for residents of all ages.
a new model of care using registered nurse (RN) care coordination coupled with in-home services was developed based on prior research helping older adults age in place. Built and operated by Americare, a leading long-term care provider, TigerPlace, an independent senior living facility, was designed as a demonstration site for the aging in place model. The Sinclair School of Nursing developed a home health agency to provide RN care coordination and home care services to TigerPlace and the surrounding community. Personal care, skilled nursing and hospice services are arranged to assist residents and health promotion activities are provided to maintain independence enabling aging in place. Purpose: Assess the impact of the aging in place model of care on costs and outcomes. Methodology: A semi-annual comprehensive health assessment including the mini-mental state exam, geriatric depression scale, minimum data set, fall risk assessment and SF-12 health survey was completed on all of the residents of TigerPlace (n¼66) from 2005 to 2008. Adverse events and costs of services provided were also tracked. Statistical summaries were prepared about the clinical and cost data. Findings: RN care coordination reduces adverse health events, improves outcomes, reduces nursing home utilization and is cost effective. The cost for any resident (both care and housing) has never approached or exceeded the cost of nursing home care (average annual cost for care in 2008 was $3,594 plus housing costs). Summary Concluding Statement: RN care coordination coupled with in-home services can be a viable option for long term care while saving money and allowing older adults to remain independent in a pleasing, private apartment, congregate housing setting.
Adolescents’ Approaches to Genetic Testing Lynn Rew EdD, RN, FAAN, Michael Mackert, and Daniel Bonevac
Background: Direct-to-consumer advertising of genetic testing via the Internet poses potential risks to individuals with limited knowledge about the human genome and without benefit of genetic counseling to make decisions about testing. Adolescents can be both targeted and tempted by such advertising, but we know little about their approach to such opportunities. Purpose: To determine what adolescents know, what information and resources they would use to make decisions about genetic testing, and how these factors differ by age group (middle¼14-17 v late¼18-21 year-old adolescents). Methodology: A qualitative descriptive design was used. A multi-ethnic sample of 22 middle (n¼11) and late (n¼11) adolescents were interviewed and responded to hypothetical scenarios involving genetic testing. Audio-tapes were transcribed and coded for manifest and latent content. Findings: Both groups of adolescents had limited knowledge of the human genome and the risks involved in genetic testing. Younger adolescents were more likely than older adolescents to seek additional information from their parents, but both groups identified physicians and the Internet as resources for additional information Both groups would seek more information about how and why genetic testing is done, including its history and benefits. Older adolescents would also consider
Healthy Aging in Livable Communities Veronica F. Rempusheski, PhD, RN, FAAN, Becky Laster, MSW, Susan R. Getman, and James Thornton
Background: Aging in place and the in-migration of retirees can form a Naturally Occurring Retirement Community (NORC) – a geographic area within which a significant number of older adults reside, although not planned as such. The percentage of persons age 65+ is projected to increase by 104% in the US by 2030, and to almost 2 billion worldwide by 2050, when for the first time in history the population of older adults will outnumber the population of children. Purpose: The goal of this project is to enhance the livability in three NORCs in NE USA The study objective for phase II of the project was to assess the perceptions of availability of and access to resources and services for older adults within three NORCs defined by postal code. e26
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courses per semester. Start-up cost to student for technology is about $300 plus the cost of an up-to-date computer and high speed internet The greatest cost of the program is the use of bridge technology, which costs about $300,000, to support the videoconferencing. Findings: 47 students from 22 states have been admitted to the distance PhD program in oncology, gerontology, and non-specialty cohorts. Racial and ethnic diversity of the cohorts ranges from 15-45%. Average time to graduation was 3.7 years compared to 5.8 years for traditional students. Students have secured an unprecedented number of fellowships, awards, and research grants. Student and faculty satisfaction is also higher. Summary Concluding Statement: Technology-based education supports development of competent nurse scientists and culturally competent educators. (2009 AAN Poster of Distinction)
The WV Rural Health Research Center Cynthia Armstrong Persily, PhD, RN, FAAN, Michael Hendryx, PhD, and Joel Halverson, PhD
Background: The West Virginia Rural Health Research Center (WVRHRC), funded in 2008 by the US DHHS Office of Rural Health Policy, has a unique interdisciplinary research team, blending the strengths of the WVU Schools of Nursing, Medicine and Pharmacy, the WV Institute for Health Policy Research, and the Office of Rural Health to focus on the impact of environmental risks on the health of rural communities. Purpose: Areas of the environment considered to impact health include the built environment, food, air, water, and land use. These environmental features may include direct pollution sources but also include the larger social, economic or built environment that differentially places rural populations at greater risk for poor health outcomes. These problems are of concern given the limited information about environmental risks faced by rural populations. Methodology: The WVRHRC conducts studies to analyze environmental risks and their relationship to national health. In year 1, studies included development of 1 a rural environmental hazards inventory 2 a rural socioeconomic risk and resiliency inventory and 3 key environmental health competencies for rural primary care providers. Future studies include analysis of rural environmental health workforce needs, targeted analyses of environmental hazards, and an analysis of health implications of food security and availability in rural areas. Findings: Findings and policy briefs for each Year 1 study will be shared during the poster session. Year 2 studies will be abstracted and preliminary findings will be discussed. Summary Concluding Statement: The interdisciplinary research of the WVRHRC will ensure that providers
serving rural communities are supported with the latest data and information on the health and healthcare needs of rural populations exposed to environmental risks, and will inform policy makers of the important impact of the environment on the health of rural communities.
The Massachusetts School Nurse Research Network Joyce Pulcini, PhD, RN, FAAN, Anne Sheetz, RN, MPH, CNAA, and Marie DeSisto, RN, MSN, NCSN
Background: The Massachusetts School Nurse Research Network (MASNRN) was established in 2004 as a joint venture of the Boston College Connell School of Nursing, the Massachusetts School Nurse Organization, and the Massachusetts Department of Public Health (MDPH), School Health Unit. The three organizations recognized the need to integrate current research into school nursing practice to (a) meet the profession’s obligation for accountability, (b) build a knowledge base specific to this subspecialty area of nursing and (c) meet children’s health care needs most effectively. Purpose: To describe this innovative collaboration as a model for promoting nursing research, building nursing research leaders in school health for the future, and improving child health outcomes. Methodology: The accomplishments of this unique organization will be displayed including research grants, publications, presentations, and educational opportunities. Results of a focus group and survey of members will also be presented. Findings: This organization, which has over 100 school nurse members, has generated in its five years: 7 funded grants, 3 journal articles plus 3 in progress; at least 17 presentations, 4 poster presentations and 7 continuing education programs on research. A logic model for evaluating this organization’s progress will also be presented along with qualitative survey and focus group findings. Summary Concluding Statement: In order to promote nursing research, new models for reaching out to nurses and to improve child health outcomes can be developed through innovative collaborative efforts between universities and community partners.
Care Coordination Improves Outcomes and Reduces Cost Marilyn J. Rantz, PhD, RN, FAAN, Lorraine Phillips, PhD, RN, Myra Aud, PhD, RN, Karen Marek, PhD, MBA, RN, FAAN, Isabella Zaniletti, and Steven J. Miller
Background: Older adults want to live independently at home and postpone or avoid nursing home placement Long term care expenses are expected to more than double between 2000 and 2040. To address these concerns, M
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2009 AAN Poster Abstracts continued From the AAN Annual Meeting and Conference
Methodology: We conducted focus groups (n¼59) and surveyed 304 older adults (OA) (M age 75, SD 8) and community stakeholders (CS) (M age 48, SD 15), stratified by ethnicity and NORC population using a 9item demographic form, 24-item Social Provisions Scale (SPS) (a 093) and 24-item Perceptions of Community (POC) scale (a 088). Findings: Phase I results provide the context for reporting Phase II results. Transportation, walkability (safety, lack of sidewalks, vehicular speed) and lack of health care services (providers, pharmacy, clinics) were major concerns. OA and CS differed significantly (p<05) on SPS total and five SPS subscales; NORCs differed significantly on two SPS subscales, POC total and four POC subscales. Summary Concluding Statement: These results highlight the economic, health care, housing, community and family resource challenges in increasing livable communities that enable older adults to remain in their homes as they age. Creating an agenda for a healthy aging society in livable communities supports the highest quality of life for residents of all ages.
a new model of care using registered nurse (RN) care coordination coupled with in-home services was developed based on prior research helping older adults age in place. Built and operated by Americare, a leading long-term care provider, TigerPlace, an independent senior living facility, was designed as a demonstration site for the aging in place model. The Sinclair School of Nursing developed a home health agency to provide RN care coordination and home care services to TigerPlace and the surrounding community. Personal care, skilled nursing and hospice services are arranged to assist residents and health promotion activities are provided to maintain independence enabling aging in place. Purpose: Assess the impact of the aging in place model of care on costs and outcomes. Methodology: A semi-annual comprehensive health assessment including the mini-mental state exam, geriatric depression scale, minimum data set, fall risk assessment and SF-12 health survey was completed on all of the residents of TigerPlace (n¼66) from 2005 to 2008. Adverse events and costs of services provided were also tracked. Statistical summaries were prepared about the clinical and cost data. Findings: RN care coordination reduces adverse health events, improves outcomes, reduces nursing home utilization and is cost effective. The cost for any resident (both care and housing) has never approached or exceeded the cost of nursing home care (average annual cost for care in 2008 was $3,594 plus housing costs). Summary Concluding Statement: RN care coordination coupled with in-home services can be a viable option for long term care while saving money and allowing older adults to remain independent in a pleasing, private apartment, congregate housing setting.
Adolescents’ Approaches to Genetic Testing Lynn Rew EdD, RN, FAAN, Michael Mackert, and Daniel Bonevac
Background: Direct-to-consumer advertising of genetic testing via the Internet poses potential risks to individuals with limited knowledge about the human genome and without benefit of genetic counseling to make decisions about testing. Adolescents can be both targeted and tempted by such advertising, but we know little about their approach to such opportunities. Purpose: To determine what adolescents know, what information and resources they would use to make decisions about genetic testing, and how these factors differ by age group (middle¼14-17 v late¼18-21 year-old adolescents). Methodology: A qualitative descriptive design was used. A multi-ethnic sample of 22 middle (n¼11) and late (n¼11) adolescents were interviewed and responded to hypothetical scenarios involving genetic testing. Audio-tapes were transcribed and coded for manifest and latent content. Findings: Both groups of adolescents had limited knowledge of the human genome and the risks involved in genetic testing. Younger adolescents were more likely than older adolescents to seek additional information from their parents, but both groups identified physicians and the Internet as resources for additional information Both groups would seek more information about how and why genetic testing is done, including its history and benefits. Older adolescents would also consider
Healthy Aging in Livable Communities Veronica F. Rempusheski, PhD, RN, FAAN, Becky Laster, MSW, Susan R. Getman, and James Thornton
Background: Aging in place and the in-migration of retirees can form a Naturally Occurring Retirement Community (NORC) – a geographic area within which a significant number of older adults reside, although not planned as such. The percentage of persons age 65+ is projected to increase by 104% in the US by 2030, and to almost 2 billion worldwide by 2050, when for the first time in history the population of older adults will outnumber the population of children. Purpose: The goal of this project is to enhance the livability in three NORCs in NE USA The study objective for phase II of the project was to assess the perceptions of availability of and access to resources and services for older adults within three NORCs defined by postal code. e26
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