While much of the nation argues about healthcare, the UTC School of Nursing (UTC SON) is making positive efforts to improve it with a collaborative, interprofessional environment, particularly in the delivery of care to older patients.
“The limited number of gerontology nurses nationwide means that it is important for all nurses to be well-prepared to work in collaborative, interprofessional teams to provide patient-centered, safe, and effective care,” says Dr. Carolyn Schreeder, Project Director for the UTC SON Nurse Education Practice Quality and Retention (NEPQR) award from the Health Resources and Services Administration (HRSA).
The aging of the U.S. population poses one of the greatest challenges for health care. On average, older adults visit physicians’ offices twice as often and have a higher use of all health services compared to those under age 65. The elderly represent only 12% of the U.S. population, yet account for approximately 26% of physician/clinic visits, 35% of hospital stays, 34% of medical prescriptions, 80% of home care visits, and 90% of nursing home use.
As students in the UTC School of Nursing learn to work in this interprofessional environment to care for elderly patients, they gain best practice skills that will allow them to be more marketable.
Nurse Education Practice Quality and Retention award
UTC SON was one of 24 universities and/or medical clinics selected for a competitive NEPQR award from HRSA, part of an initiative to increase quality of healthcare, increase access to services, and decrease costs.
Valued at more than $1.4 million, the three year award led to the design of InterProfessional Collaborative Practice Approach for Geriatric Education Strategies (IPCP-AGES), which targets older adults with heart failure. Based on faculty and student assessments held at Erlanger Health System and Memorial Health Care System—UTC’s collaborative partners, patients are enrolled in the House Calls program. Then, according to the patient’s needs, a team is formed which could include faculty and students from nursing, social work, physical therapy, and nutrition. It is the patient’s choice to be seen by a team in the home or at a hospital site.
“Physical Therapy may assess for mobility and exercise capabilities, nutrition assesses food and educational needs, social services assesses mental status, transportation, financial needs, and nurses assess medication reconciliation,” explains Schreeder.
Schreeder said the teams cannot treat the patients, but they can assess, refer to a physician, and provide education. Schreeder works closely with Dr. Joanie Jackson, who received a three year grant at the same time Schreeder’s award was made, in September 2012.
HRSA grant engages Family Nurse Practitioner students
Family Nurse Practitioner students experienced cadaver learning under the HRSA grant together with their student colleagues from Physical Therapy. While PT students have learned with cadavers for many years at UTC, it was something new for FNP students.
“During cadaver learning opportunities it was hard to tell who was who—everyone was meshing and mingling so well, bouncing ideas from discipline to discipline,” said Dr. Joanie Jackson, Project Director for the HRSA grant “Providing Advanced, Culturally Competent Care through Clinical Training for Interprofessional Geriatric Care” also known as PACT 4. “For instance, when they looked at the cadaver, the physical therapy students could explain deformities caused by muscle weakening. The nursing students recognized where a port had delivered chemo or a nutrition infusion.”
Cultural competence is a requirement of both the grant and the NEPQR award directed by Schreeder. Dr. Zibin Guo, UTC medical anthropologist, serves as a consultant for both. Along with both groups, he attends health fairs and seminars to demonstrate Tai Chi for everyone, including an adaptive form for people who use wheelchairs so that they can develop their upper body with this practice.
This collaborative environment encourages students to work together, a significant change in the health care disciplines which historically worked with minimal interaction.
“Shrinking health care dollars have led to a team approach which affords better outcomes for patients. There is no disconnect, no one gets lost in the system, and there is no shuffling of patients. All health care providers are at the table and operating at the highest level. This is outstanding for the patient as well as the health care provider, who assumes a more global understanding of their own role as they learn about everyone else’s role,” explains Jackson.
Analysis and evaluation, very important aspects of this grant, have been very positive.
“PACT 4 is hardwiring our students to have an interprofessional approach to health care—we want them to have this mindset for collaboration, so that they will have a global view of health care,” said Jackson.
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