Evidence-Based Geriatric Nursing Protocols for Best Practice, Sixth Edition

Marie Boltz, PhD, RN, GNP-BC, FGSA, FAAN, is the Elouise Ross Eberly and Robert Eberly Endowed Professor, Penn State College of Nursing, where she teaches both gerontological nursing and PhD research courses. In addition to teaching students, she has had a significant influence on the education of nurses, physicians, and clinicians in other disciplines through the generation, synthesis, and dissemination of gerontological knowledge. She has provided leadership training and ongoing consultation to hundreds of nurse clinicians and administrators who are leading systemwide geriatric programs. Dr. Boltz has developed more than 40 evidence-based, field-tested teaching tools and resources for clinicians, administrators, patients, and families. She has authored and coauthored more than 200 journal publications and 40 book chapters and has co-edited six books. Dr. Boltz's areas of research are geriatric models of care, including dementia-capable and family-centered interventions that support function, and nonpharmacological approaches to support well-being of older adults with dementia. Her multiple research studies have been funded by the National Institute on Aging, the National Institute on Nursing Research, and multiple foundations. Her scholarship has been recognized with writing, teaching, and research awards, including the ENRS Geriatric Practice Research Award and the Gerontological Society of America Doris Schwartz Gerontological Nursing Research Award. She is a fellow in the American Academy of Nursing and the Gerontological Society of America. Dr. Boltz received her bachelor's degree in nursing from LaSalle University, her master's degree as a geriatric advanced practice nurse from the University of Pennsylvania, and her doctoral degree from New York University. She participated in postdoctoral study at the University of Maryland. Elizabeth A. Capezuti, PhD, RN, FAAN, is the William Randolph Hearst Foundation Chair in Gerontology at the Hunter-Bellevue School of Nursing of the City University of New York (CUNY), where she directs the PhD in Nursing program. She is known for her work in improving the care of older adults by interventions and models that positively influence healthcare providers' knowledge and work environment. Dr. Capezuti's research interests include fall prevention, nonpharmacological approaches to improve sleep, palliative care, the geriatric nursing work environment, and the design of the "built environment" to facilitate older persons' health outcomes. Dr. Capezuti has disseminated the findings of 40 funded projects in five co-edited books and more than 150 peer-reviewed articles and book chapters. She is the recipient of the Otsuka/American Geriatrics Society Outstanding Scientific Achievement for Clinical Investigation Award and the American Academy of Nursing Nurse Leader in Aging Award. She is an international speaker and consultant, including a Fulbright Specialist to Lithuanian University of Health Sciences. Dr. Capezuti received her bachelor's degree in nursing from Lehman College (CUNY), her master's degree as a geriatric advanced practice nurse from Hunter College, and her doctoral degree in nursing from the University of Pennsylvania. DeAnne Zwicker, DrNP, AGNP-BC, is a certified adult nurse practitioner and geriatric nurse practitioner. She is currently working as an independent geriatric consultant. Terry Fulmer, PhD, RN, FAAN, is the President of the John A. Hartford Foundation in New York City, a foundation dedicated to improving the care of older adults. Established in 1929, the Foundation has a current endowment of more than half a billion dollars. She serves as the chief strategist for the Foundation, and her vision for better care of older adults is catalyzing the Age-Friendly Health Systems social movement. She is an elected member of the National Academy of Medicine and served on the independent Coronavirus Commission for Safety and Quality in Nursing Homes established to advise the Centers for Medicare and Medicaid Services. She previously served as Distinguished Professor and Dean of Health Sciences at Northeastern University. Prior, she served as the Erline Perkins McGriff Professor and Founding Dean of the New York University College of Nursing. She received her bachelor's degree from Skidmore College, her master's and doctoral degrees from Boston College, and her Geriatric Nurse Practitioner Post-Master's Certificate from New York University. She completed a Brookdale National Fellowship and is the first nurse to have served on the board of the American Geriatrics Society. She is also the first nurse to have served as President of the Gerontological Society of America, which awarded her the 2019 Donald P. Kent Award for exemplifying the highest standards for professional leadership in the field of aging. Dr. Fulmer is nationally and internationally recognized as a leading expert in geriatrics. She is known for conceptualization and development of the Age-Friendly Health Systems movement and the national Nurses Improving Care for Healthsystem Elders (NICHE) program, as well as for her research on the topic of elder abuse and neglect, which has been funded by the National Institute on Aging and the National Institute of Nursing Research. She is a Trustee for the Josiah Macy Jr. Foundation, Springer Publishing Company, and the Bassett Healthcare System and is a Member of the Reimagining Long-Term Care Task Force in New York State and a member of the National Academy of Medicine's Forum on Aging, Disability, and Independence. Dr. Fulmer also serves as Vice Chair of the Department of Veterans Affairs Special Medical Advisory Group. She was the Chair of the National Advisory Committee for the Robert Wood Johnson Foundation Executive Nurse Fellows Program and held board positions at Skidmore College, the Institute for Healthcare Improvement, the Geriatrics and Gerontology Advisory Committee for the U.S. Department of Veterans Affairs, and the Advisory Board for Hong Kong Polytechnic University School of Nursing. She is one of the top 50 Influencers in Aging by PBS's Next Avenue, the premier digital publication dedicated to covering issues for older Americans. Dr. Fulmer is the recipient of prestigious awards, including the American Society on Aging's 2017 Rosalie S. Wolf Award for her body of work on elder abuse. In 2016, she received the 2016 Award for Exceptional Service to The New York Academy of Medicine for her distinguished service on the Academy's Board of Trustees, including as vice-chair, and for her active engagement in the policy work of the Academy, especially its Age-Friendly NYC initiative. She has been honored with invitations for named lectureships from noted universities. She has held faculty appointments at Columbia University, where she was the Anna C. Maxwell Chair in Nursing, and she has also held appointments at Boston College, Yale University, and the Harvard Division on Aging at Harvard Medical School. She has served as a visiting professor of nursing at the University of Pennsylvania and Case Western Reserve University. She is a Distinguished Practitioner of the National Academies of Practice and is currently an attending nurse at Mount Sinai Medical Center in New York City. Her clinical appointments have included the Beth Israel Hospital in Boston, the Massachusetts General Hospital, and the NYU Langone Medical Center. She is a Fellow of the American Academy of Nursing, the Gerontological Society of America, and the New York Academy of Medicine, where she served as vice-chair. She has authored more than 150 peer-reviewed papers and edited 23 books.

Contributors

Foreword

Preface

Acknowledgments

I. INCORPORATING EVIDENCE INTO PRACTICE

1. Developing and Evaluating Clinical Practice Guidelines: A Systematic Approach

2. Measuring Performance and Improving Quality

3. Informational Technology: Embedding Geriatric Clinical Practice Guidelines

4. Organizational Approaches to Promote Person-Centered Care

5. Environmental Approaches to Support Aging-Friendly Care

II. ASSESSMENT AND MANAGEMENT PRINCIPLES

6. Age-Related Changes in Health

7. Healthcare Decision-Making

8. Sensory Changes in the Older Adult

9. Assessing Cognitive Function in the Older Adult

10. Assessment of Physical Function in the Older Adult

11. Oral Healthcare in the Older Adult

12. Managing Oral Hydration in the Older Adult

13. Nutrition in the Older Adult

14. Family Caregiving

15. Issues Regarding Sexuality in Older Adults

16. Elder Mistreatment Detection

17. Advance Care Planning

III. CLINICAL INTERVENTIONS

18. Preventing Functional Decline in the Acute Care Setting

19. Late-Life Depression

20. Delirium: Prevention, Early Recognition, and Treatment

21. Dementia: Assessment and Care Strategies

22. Pain Management in the Older Adult

23. Assessing, Managing, and Preventing Falls in Acute Care

24. Reducing Adverse Drug Events in the Older Adult

25. Urinary Incontinence in the Older Adult

26. Prevention of Catheter-Associated Urinary Tract Infection

27. Physical Restraints and Side Rails in Acute and Critical Care Settings

28. Preventing Pressure Injuries and Skin Tears

29. Optimizing Mealtimes for Persons Living With Dementia

30. Disorders of Sleep in the Older Adult

31. The Frail Hospitalized Older Adult

32. HIV Prevention and Care for the Older Adult

33. LGBTQ Perspectives for Older Adult Care

IV. INTERVENTIONS IN SPECIALTY PRACTICE

34. Substance Misuse and Alcohol Use Disorder in the Older Adult

35. Comprehensive Assessment and Management of the Critically Ill Older Adult

36. Fluid Overload: Identifying and Managing Heart Failure Patients at Risk for Hospital Readmission

37. Cancer Assessment and Intervention Strategies in the Older Adult

38. Perioperative Care of the Older Adult

39. General Surgical Care of the Older Adult

40. Care of the Older Adult With Fragility Hip Fracture

V. MODELS OF CARE

41. Acute Care Models

42. Transitional Care

43. Palliative Care Models

44. Care of the Older Adult in the Emergency Department

Index