Geriatric Training and Education (GTE) Projects

The Geriatric Training and Education (GTE) initiative is supporting 15 different projects in the current fiscal year that are affecting Virginians in each region, from certified nursing assistants to family caregivers of relatives with dementia to long-term care staff helping elders at the end of life

It\u27s About the People

The Virginia Center on Aging celebrates 30 years and the people who have made accomplishments possible

Medical Education Digest, Vol. 6 No. 2 (March 15, 2004)

https://nsuworks.nova.edu/hpd_com_med/1070/thumbnail.jp

Interprofessional education: an overview of six initiatives across the schools of health at a single university

The benefits of interprofessional education (IPE) amongst health professionals are well documented, however, the implementation of interprofessional initiatives across the USA is inconsistent. This report describes the development and content of a number of IPE initiatives that are in the early stages of development and implementation at the University of California, Davis, USA. The article describes several important factors that were found to be necessary for the initial implementation of these IPE initiatives. Evaluation data from these initiatives, which is providing a range of positive outcomes, are also presented and discussed in relation to the wider IPE literature

Investigating the Efficacy of Pre-Licensure Clinical Interprofessional Education

Nurses are expected to work collaboratively with other health professionals after graduation; however, most have not been taught to work in teams and are ill-prepared to work in collaborative relationships. Interprofessional Education (IPE) may better prepare nursing students for teamwork. The purpose of this study was to investigate the efficacy of pre-licensure clinical IPE for nursing students. It was hypothesized that nursing students who participate in clinical IPE have more positive attitudes toward health care teams than nursing students who do not participate in clinical IPE as evidenced by higher scores on the Attitudes Toward Health Care Teams Scale (ATHCTS), Quality of Care/Process subscale and by lower scores on the ATHCTS, Physician Centrality subscale. The theoretical framework for this study was Pettigrew’s intergroup contact theory. A quasi-experimental, nonequivalent control group, after-only design was used for this study. Archived data (ATHCTS) for nursing students who had participated in clinical IPE was used for the intervention group. The ATHCTS was administered to nursing students in control group universities. An independent t test was used to compare group mean scores. There was no significant difference in Quality of Care/Process subscales between groups. Students participating in clinical IPE had lower scores on the Physician Centrality subscale than the control group. Nursing students participating in clinical IPE favored shared leadership while non-IPE participants supported physician authority. Clinical IPE did not improve student attitudes toward quality of care given by teams. However, all participants had relatively high attitudes toward quality of care provided by teams

Interventions for preventing delirium in hospitalised non-ICU patients

BACKGROUND: Delirium is a common mental disorder, which is distressing and has serious adverse outcomes in hospitalised patients. Prevention of delirium is desirable from the perspective of patients and carers, and healthcare providers. It is currently unclear, however, whether interventions for preventing delirium are effective. OBJECTIVES: To assess the effectiveness of interventions for preventing delirium in hospitalised non-Intensive Care Unit (ICU) patients. SEARCH METHODS: We searched ALOIS - the Cochrane Dementia and Cognitive Improvement Group's Specialized Register on 4 December 2015 for all randomised studies on preventing delirium. We also searched MEDLINE (Ovid SP), EMBASE (Ovid SP), PsycINFO (Ovid SP), Central (The Cochrane Library), CINAHL (EBSCOhost), LILACS (BIREME), Web of Science core collection (ISI Web of Science), ClinicalTrials.gov and the WHO meta register of trials, ICTRP. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of single and multi- component non-pharmacological and pharmacological interventions for preventing delirium in hospitalised non-ICU patients. DATA COLLECTION AND ANALYSIS: Two review authors examined titles and abstracts of citations identified by the search for eligibility and extracted data independently, with any disagreements settled by consensus. The primary outcome was incidence of delirium; secondary outcomes included duration and severity of delirium, institutional care at discharge, quality of life and healthcare costs. We used risk ratios (RRs) as measures of treatment effect for dichotomous outcomes; and between group mean differences and standard deviations for continuous outcomes. MAIN RESULTS: We included 39 trials that recruited 16,082 participants, assessing 22 different interventions or comparisons. Fourteen trials were placebo-controlled, 15 evaluated a delirium prevention intervention against usual care, and 10 compared two different interventions. Thirty-two studies were conducted in patients undergoing surgery, the majority in orthopaedic settings. Seven studies were conducted in general medical or geriatric medicine settings.We found multi-component interventions reduced the incidence of delirium compared to usual care (RR 0.69, 95% CI 0.59 to 0.81; seven studies; 1950 participants; moderate-quality evidence). Effect sizes were similar in medical (RR 0.63, 95% CI 0.43 to 0.92; four studies; 1365 participants) and surgical settings (RR 0.71, 95% CI 0.59 to 0.85; three studies; 585 participants). In the subgroup of patients with pre-existing dementia, the effect of multi-component interventions remains uncertain (RR 0.90, 95% CI 0.59 to 1.36; one study, 50 participants; low-quality evidence).There is no clear evidence that cholinesterase inhibitors are effective in preventing delirium compared to placebo (RR 0.68, 95% CI, 0.17 to 2.62; two studies, 113 participants; very low-quality evidence).Three trials provide no clear evidence of an effect of antipsychotic medications as a group on the incidence of delirium (RR 0.73, 95% CI, 0.33 to 1.59; 916 participants; very low-quality evidence). In a pre-planned subgroup analysis there was no evidence for effectiveness of a typical antipsychotic (haloperidol) (RR 1.05, 95% CI 0.69 to 1.60; two studies; 516 participants, low-quality evidence). However, delirium incidence was lower (RR 0.36, 95% CI 0.24 to 0.52; one study; 400 participants, moderate-quality evidence) for patients treated with an atypical antipsychotic (olanzapine) compared to placebo (moderate-quality evidence).There is no clear evidence that melatonin or melatonin agonists reduce delirium incidence compared to placebo (RR 0.41, 95% CI 0.09 to 1.89; three studies, 529 participants; low-quality evidence).There is moderate-quality evidence that Bispectral Index (BIS)-guided anaesthesia reduces the incidence of delirium compared to BIS-blinded anaesthesia or clinical judgement (RR 0.71, 95% CI 0.60 to 0.85; two studies; 2057 participants).It is not possible to generate robust evidence statements for a range of additional pharmacological and anaesthetic interventions due to small numbers of trials, of variable methodological quality. AUTHORS' CONCLUSIONS: There is strong evidence supporting multi-component interventions to prevent delirium in hospitalised patients. There is no clear evidence that cholinesterase inhibitors, antipsychotic medication or melatonin reduce the incidence of delirium. Using the Bispectral Index to monitor and control depth of anaesthesia reduces the incidence of postoperative delirium. The role of drugs and other anaesthetic techniques to prevent delirium remains uncertain

Forming Communities of Practice: Education of Health Professionals in Interprofessional Settings

FORMING COMMUNITIES OF PRACTICE: EDUCATION OF HEALTH PROFESSIONALS IN INTERPROFESSIONAL SETTINGSSusan Elaine Sterrett, BSN, MSN, MBAUniversity of Pittsburgh, 2008This qualitative study will describe and analyze the perspectives of health professions students, teachers and administrators involved in interprofessional learning experiences. The primary purpose of this study is to understand the phenomenon of participation in interprofessional learning experiences and the extent to which the elements of communities of practice are evident in these learning experiences. Interprofessionality indicates the development of a cohesive practice between professionals from different disciplines. The theoretical framework providing a context for this study is social learning theory, particularly Lave and Wenger's theory of communities of practice. A grounded theory study will utilize data obtained from semi-structured interviews and researcher memos to identify themes and concepts. The participants are graduate students, faculty and administrators from an interprofessional fellowship in developmental disabilities. The research will have implications for educators and administrators of educational programs who want to design, initiate, and sustain effective programs that promote interdisciplinarity. This study will contribute conceptually to the theory of effective interprofessional communities of practice, and to praxis through the development of a model of an effective, interprofessional community of practice