Integration of Geriatric Curriculum
Content into a Synergy Model Driven
Acute Care NP Program
BM CL EA R , DN P, F N P - C, ACN P - BC
G EORGIA R EG ENTS UN I V ERSITY
COL L EG E OF N URSING
GRU Acute Care Nurse Practitioner Program
History
2010-HRSA grant awarded
First DNP ACNP program in the Southeast
2011 Program for Accelerated Certification Education (PACE-ACNP)
Mastering Essentials by Gaining Awareness during immersion days
(MEGA i days)
The APRN Consensus Model
•Licensure -granting of authority to practice.
•Accreditation -formal review and approval by a recognized agency of
educational degree or certification programs in nursing or nursingrelated programs.
•Certification - formal recognition of the knowledge, skills, and
experience demonstrated by the achievement of standards identified
by the profession.
•Education -formal preparation of APRNs in graduate degree-granting
or post-graduate certificate programs
NCSBN, 2008
Primary Care NP roles
Primary Care Education:
Focus on comprehensive chronic, continuous care characterized by a
long term relationship between the patient and NP.
Cares for patients with a focus on disease prevention, assessment
and management of common acute and chronic illnesses.
Populations:
Pediatric
Adult Gerontological
Family
NONPF, 2011
Acute Care NP roles
Acute Care Education:
Focus on restorative care that is characterized by rapidly changing
clinical conditions.
Care for patients with unstable chronic conditions, complex acute
illnesses, and critical illnesses
Populations:
Pediatric
Adult Gerontological
NONPF, 2011
AACN Synergy Model
AACN,2015
Patient
Characteristics
Outcomes
Nurse
Competencies
Patient Characteristic
Stability
Level 5 Highly stable
Nurse Competency
Course
Clinical
Judgement
Constant
Responsive to
therapies
Low risk of death
Level 1
Collects basic-level data
Follows protocols
Questions the limits of one's ability
Delegates the decision-making
AGACNP I
AGACNP II
Level 3 Moderately
stable
Maintains steady
state for limited time
Some responsiveness
to therapies
Level 1 Minimally
stable
Labile
Unstable
Unresponsive to
therapies
High risk of death
Level 3
Collects and interprets complex patient data
Makes clinical judgments based on an immediate
grasp of the whole picture
Recognizes patterns and trends
Recognizes limits and seeks appropriate help
Level 5
Synthesizes and interprets multiple sources of data
Uses past experiences to anticipate problems
Helps patient and family see the "big picture“
Recognizes the limits of clinical judgement
Seeks multidisciplinary collaboration
AGACNP III
&
AGACNP
practicum
Why a geriatric focus?
Inpatients over the age of 65 years of age 38.7%(2010)
Average length of stay 5.5-5.7 days
Percent of adult day services center participants: 63.5% (2012)
Percent of home health agency patients: 82.4% (2011)
Percent of hospice patients: 94.5% (2011)
Percent of nursing home residents : 85.1% (2012)
Percent of residential care community residents: 93.3% (2012)
CDC, 2010
CDC, 2013
UAB Faculty Scholars Program
Offered by UAB Geriatric Education Center
1) advanced illness and palliative care
2) transitions in care
3) family systems and self/caregiver management
4) communication skills addressing the cultural aspects of aging and
health literacy
UAB Faculty Scholars Program
160 hours of training
5 in person sessions
2 day Interdisciplinary geriatric education conference
12 Continuing education modules
1 Scholarly activity-publishable article or grant
1 Curriculum enhancement activity
Vulnerability
• Overview of
Aging
• Low vision and
aging: an
interdisciplinary
approach
• Incontinence
Resource Availability
• SNF, ALF, SCALF, IL,
LTC – What Does It
All Mean
• Preventing Elder
Investment Fraud
• Medicare Overview
Complexity
• Complex Decision
Making
• Advanced Care
Planning
• Family systems
• Medication
Management
• Health Disparities and Aging
• Ethics and Aging
Advocacy
Moral agency
• Developing Empathy
• Geriatrics for Hospice and Palliative Care Workers
Caring Practices
• Geriatric Interdisciplinary Team Training
• Inter-professional Competencies
Collaboration
Gerontology Day
“Unless someone like you cares a whole awful lot,
Nothing is going to get better. It's not.”
An Aging Society
For the first time in history, people aged 65 and over will soon outnumber
children under the age of 5.
Throughout the world today, there are more people aged 65 and older than
the entire populations of Russia, Japan, France, Germany and Australia—
combined.
By 2050, the U.N. estimates that the proportion of the world's population
age 65 and over will more than double, from 7.6% today to 16.2%.
The United States contains more people age 65 and older than the total
population of Canada.
Americans aged 65 and older outnumber the combined populations of New
York, London, and Moscow.
http://transgenerational.org/aging/demographics.htm#ixzz2YBlYejb0
Objective Structured Clinical Exam (OSCE)
Focus on:
Uncommon presentations of common illness
Polypharmacy
Mobility
Geriatric Immersion Experience
References
Center for Disease Control(CDC),2010. Older Adult Health,National Hospital Discharge Survey. Accessed
http://www.cdc.gov/nchs/fastats/older-american-health.htm
Center for Disease Control(CDC),2013. Older Adult Health,Long term health services overview. Accessed
http://www.cdc.gov/nchs/fastats/older-american-health.htm
National Council for State Boards of Nursing(NCSBN),2008.Consensus Model for APRN Regulation: Licensure,
Accreditation, Certification and Education. Accessed http://www.aacn.nche.edu/educationresources/APRNReport.pdf
National Organization of Nurse Practitioner Faculties(NONPF), 2011. Statement on Acute Care and Primary Care
Nurse Practitioner Practice. Accessed
http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/imported/NPPrimaryCareAcuteCarePracticeFINAL.pdf