Chapter6PPT

Chapter 6

The Specialty of Gerontological Nursing

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Development of Gerontological Nursing • 1904: First article on care of the aged published in the American Journal of Nursing • 1935: Federal Old Age Insurance Law, or Social Security • 1962: First meeting of the ANA’s Conference Group on Geriatric Nursing Practice • 1966: Division of Geriatric Nursing— gerontological nursing as a nursing specialty Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Development of Gerontological Nursing • 1970: published first Standards for Geriatric Nursing Practice • 1975: first certification of nurses for excellence in geriatric nursing • 1975: Journal of Gerontological Nursing first published • 1976: Geriatric Nursing Division became the Gerontological Nursing Division Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Development of Gerontological Nursing • Growth in the last few decades – Increase in gerontological nursing texts – Increase in journal articles – Gerontological nursing education

– Certification in gerontological nursing – Subspecialization – Hartford Institute for Geriatric Nursing Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Core Elements of Gerontological Nursing Practice • Evidence-based practice: – Systematic

– Based on research • Standards for Nursing Practice:

– Used to guide and evaluate nursing practice – ANA Standards Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Core Elements of Gerontological Nursing Practice • Principles: – Scientific data regarding theories – Biological and social sciences – Nursing principles – Guides care for gerontological nursing Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Aging: A Natural Process • Process of maturing or aging • Comments associated with aging • Aging is not a disease • Aging brings the opportunity for usefulness, fulfillment, and joy • Need for a realistic understanding of the aging process Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Factors Influencing the Aging Process • Heredity, nutrition, health status, life experiences, environment, activity, and stress • Aging is individualized • General characteristics evident among most people in a given age category

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The Nursing Process Framework • Scientific data and knowledge of nursing • Systematic approach to nursing care • Holistic approach to individuals

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Common Needs to Promote Health and Quality of Life • Core needs: – Physiologic balance – Connection – Gratification • Self-care practices Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Optimal Health and Wholeness • Aging as the process of realizing one’s humanness, wholeness, and unique identity • Self-actualization • Harmony with internal and external environment • Sense of purpose

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Nursing Actions to Promote Self-Care • Strengthening self-care capacity • Eliminating or minimizing self-care limitations • Providing direct services

• Promotion of maximum independence

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Nursing Roles

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Gerontological Nursing Roles: Healer • Recognizing the interdependency of body, mind, and spirit in health and aging

– Staying well – Overcoming or coping with disease – Restoring function – Finding meaning and purpose in life – Mobilizing internal and external resources Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Gerontological Nursing Roles: Caregiver • Utilization of gerontological theory in the application of the nursing process • Promotion of active participation of older adults and their significant others • Ensures care of the older adult is based on sound knowledge

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Gerontological Nursing Roles: Educator • Takes advantage of formal and informal opportunities to share knowledge and skills related to care • Education extends to the general public • Requires effective communication techniques

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Gerontological Nursing Roles: Advocate • Aids older adults in asserting rights and obtaining required services • Facilitation of a community’s efforts to effect change for the benefit of older adults • Promotes gerontological nursing

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Gerontological Nursing Roles: Innovator • Inquisitive style • Efforts to experiment to improve gerontological practice – Thinks “out of the box” – Takes risks – Transforms visions into reality Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Advanced Practice Nursing Roles • Preparation in unique principles and best practices for the older adult – Broad knowledge base – Capacity for independent practice – Leadership – Complex clinical problem-solving abilities Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Advanced Practice Nursing Roles • Advanced practice nurses make a significant difference in the care of the older adult: – Improvement in quality of care – Reduction in cost of care – Acute care: reduction in complications, length of stay, and need for readmission Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Future of Gerontological Nursing • Lessons from the past • Challenges for the future

– Gerontological nursing as a dynamic specialty – Multitude of opportunities – Development of new practice models

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Nursing Research • Need for a strong knowledge base • Support of research: – Network with nurse researchers – Support research efforts in practice – Support and testimony to funding agencies – Keeping abreast of new findings Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Promote Integrative Care • Nurses must ensure that gerontological care is holistic • Alternative and complementary therapies

• Inclusion of caregivers in the plan of care

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Education of Caregivers • Caregivers at every level require competency in providing services to older adults • Nurses have the ability to influence the education of caregivers • Include family caregivers in educational efforts

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Development of New Roles • Opportunities for nurses to develop new roles within the field of gerontological nursing • Need for creativity and leadership

• Examples of new roles

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Balance Quality of Care and Health Care Costs • Increasing number of older adults necessitates diversity of health care services for the older adult • Effects of third-party insurers and changes in reimbursement policies • Nurses need to be involved in cost-containment efforts to promote quality services Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Nurses’ Involvement in Cost-Containment Efforts • Test creative staffing patterns • Use lay caregivers

• Abolish unnecessary practices • Ensure safe care • Advocate for older adults Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins