White Paper: Building a Continuum of End of Life Care in Whatcom County: Train All Clinicians in Palliative Care

Despite the increase in focus and attention on palliative care services in Whatcom County, significant gaps in palliative care knowledge and skills exist among clinicians throughout the care continuum in Whatcom County. It is widely recognized that palliative care improves quality of life for patients with advanced illness and their families, reduces costs, and advances the Triple Aim. The recommendations provided in this report support the collective recognition that all clinicians caring for patients with serious illness, irrespective of practice discipline, background, or setting, require competency and skill in palliative care. All clinicians (including but not limited to doctors, nurses, social workers, chaplains, complementary care providers, and CNAs) in our region must have core knowledge, skills, and attitudes to provide palliative care in our community, including advance care planning conversation training, pain and symptom management, and strategies to participate in multi-disciplinary palliative care processes

Controlled Postpartum-Newborn Simulation With Objective Evaluation Exchanged for Clinical Learning

Background: Simulation is a widely used teaching strategy. A paucity of evidence exist about evaluating acquisition of formal knowledge gained from simulation participation. This study compared practicing simulated assessments in the CSLC to practice in the clinical setting plus simulation, high/low level of student performance, and evaluated performance. Study variables were assessment, intervention, and critical thinking. Methods: Non-equivalent comparison group, post-test only quasi-experimental. 80 undergraduate nursing students individually demonstrated assessments while trained observer scored performance. Students provided written response to 7 questions before debriefing. T-tests, ANOVA, and MANOVA compared scores between the two groups. An outlier analysis operationalized high /low student performance. 92 points on both simulations equated to competent performance; lower scores required remediation. Results: No significant differences between the two groups on three study variables. A significant correlation found between postpartum and newborn psychomotor skills in high and low performing students. Average simulation performance score was 83 points. Conclusion: Well-designed simulation can be exchanged for learning in clinical, identify underperforming students, and evaluate performance qualit

Advancing the Future of Nursing: A Report by the Building Academic Geriatric Nursing

In the United States, the number of older adults will double during the next 25 years (United States Census Bureau, 2008). This dramatic demographic shift is changing the landscape of health care practice as more people live longer with multiple chronic conditions. To better prepare nurses to care for this future population, the John A. Hartford Foundation partnered with the American Academy of Nursing in 2000 to launch the Building Academic Geriatric Nursing Capacity (BAGNC) program. Since that time, 251 scholarships and fellowships have been awarded to nurses to advance geriatric nursing education, research, and practice. In 2009, the BAGNC nurse scholars and fellows formed an alumni organization to expand and continue their leadership development through peer networking and mentored policy initiatives. The BAGNC Alumni organization represents an elite set of new leaders in gerontological nursing to advance geriatric nursing education, research, and practice (Fagin, 2012). To this end, at the 2011 Council for Advancement of Nursing Science\u27s Special Topics Meeting, the BAGNC Alumni presented their ongoing and completed projects that relate to the Institute of Medicine (2011) (IOM) report The Future of Nursing: Leading Change, Advancing Health. Summaries of the individual presentations from this panel addressed the four key IOM messages and are presented in this article to highlight the action of these scholars and fellows

Development and Implementation of a Peer Mentoring Program for Early Career Gerontological Faculty: Mentoring Early Career Gerontological Faculty

In conjunction with the National Hartford Centers of Gerontological Nursing Excellence (NHCGNE), formerly known as the Building Academic Geriatric Nursing Capacity Initiative (BAGNC), the Hartford Gerontological Nursing Leaders (HGNL) developed and executed a program beginning in 2011 to enhance both (a) the experience of newly selected scholars and fellows to the NHCGNE and (b) the ongoing professional development of the HGNL. The purpose of this article is to describe key strategies used to develop and execute the mentoring program and to present the formative and summative program evaluation

Keynote: Care for the Whole Person: Improving Quality of Life Beyond Biopsychosocial Approaches to Palliative Care

Casey Shillam, PhD, MSN, RN, is the Dean of the School of Nursing at the University of Portland. She was the founding Director of Western Washington University’s RN-BSN Nursing Program. Casey serves on the Health Policy Advisory Council for the American Association of Colleges of Nursing Washington, DC, and was selected for the American Association of Colleges of Nursing Leadership for Academic Nursing Program (LANP) and Robert Wood Johnson Foundation Executive Nurse Fellow program. This opening session will set the stage for the conference by providing an overview of important aspects of palliative care outside of traditional medical approaches to care. Particular focus is placed on differentiating between religiosity and spirituality and the importance of supporting spiritual and cultural preferences in palliative care. On completion of this session, participants should be able to: 1. Describe the impact of providing spiritual care on the biopsychosocial model of palliative care; 2. Distinguish between religiosity and spirituality; 3. Explore different dimensions of spiritual care in palliative care; 4. Develop a strategy for incorporating spiritual care into current practices

An Ecological Understanding of Caregiver Experiences in Palliative Care

Palliative care is specialized health care to improve quality of life for patients with serious illness and their families through prevention and relief of suffering. A Palliative Care Institute was held in western Washington to capture community voices about diverse needs, strengths, and opportunities for improvement of palliative care. Researchers employed qualitative methods to obtain thematic data, provide real-time analysis, and engage in a multivoting technique to reflect stakeholder interest in individual themes and prioritize larger group interests. Bronfenbrenner’s ecological systems framework was used to explore caregiver experiences. Within the microsystem, caregivers reported difficulties in interactions with medical providers as a key challenge. Within the mesosysytem, interactions between patients and medical providers and the impact on caregivers were explored. Within the exosystem, caregivers reported lack of control over the schedules of personal care staff. Macrosystem influences included impact of local culture on the development of palliative care services. Chronosystem influences include de-medicalization of childbirth and its impact on perceptions of palliative care. Implications include the need for social workers to be proactive in fostering trust and effective communication between care providers and caregivers, and the demand for health care provider training in communication with patients and families

Beyond Resilience: Building an Anti-Fragile Approach to Compassion Fatigue

Casey Shillam presented evidence on factors contributing to health providers\u27 compassion fatigue. She also described emerging trends in developing resilience for both professional and family caregivers

Development and Implementation of a Peer Mentoring Program for Early Career Gerontological Faculty

PurposeThe Hartford Gerontological Nursing Leaders (HGNL) formerly known as the Building Academic Geriatric Nursing Capacity Initiative (BAGNC), in conjunction with the National Hartford Centers of Gerontological Nursing Excellence (NHCGNE), developed and executed a peer mentoring program beginning in 2011 to enhance both (a) the experience of newly selected scholars and fellows to the NHCGNE and (b) the ongoing professional development of HGNL members. The purpose of this article is to describe key strategies used to develop and execute the peer mentoring program and to present formative program evaluation.DesignThe program was launched in January 2011 with seven peer mentor and mentee matches. In June 2012, the peer mentoring committee solicited feedback on the development of the peer mentoring program and changes were made for the subsequent cohorts.FindingsAn additional 12 matches were made in the following 2 years (2012 and 2013), for a total of 31 matches to date. We have learned several key lessons from our three cohorts regarding how to structure, implement, and carefully evaluate a peer mentoring program.ConclusionsInformal evaluation of our peer mentoring program noted several challenges for both peer mentors and mentees. Having knowledge of and addressing those challenges may increase the overall quality and effectiveness of peer mentoring programs and, in turn, benefit academic nursing by strengthening the faculty workforce.Clinical relevanceFindings from development and implementation of a peer mentoring program for gerontological faculty could lead to new and adaptable programs in a variety of clinical and education settings