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Older American Month: Blazing the Trail through Partnership

Tuesday, May 17, 2016

The month of May isn’t just about recognizing mothers and nurses. It is also designated as Older Americans Month. This is a time to acknowledge the perennial contributions of older adults to our nation. This year’s theme is “Blaze a Trail,” which hopes to raise awareness on important issues facing older adults such as civic engagement, finances and wellness. For more than 50 years, Duke University School of Nursing (DUSON) has been committed to advancing health and wellness for older adults.

 “DUSON started the first-ever graduate program in gerontological nursing in 1965 under the leadership of Dr. Virginia Stone, and it has been an area of strength within the School ever since,” said Eleanor McConnell, PhD, MSN, RN, GCNS, BC, associate professor and director of the Center of Geriatric Nursing Excellence (CGNE), a member of the Hartford CGNE Network. “In the late eighties and early nineties, the growing elderly population, with long-term, chronic and acute health care needs, had been one of the most critical issues facing nursing professionals. Therefore, in 1996 and in collaboration with Dr. Harvey Cohen and the Duke Center for the Study of Aging and Human Development, DUSON launched the first graduate gerontology nurse practitioner program in North Carolina.”

DUSON’s collaboration in the care of older adults continues today. Duke NICHE: Nurses Improving Care of Health System Elders, a collaborative effort of DUSON and Duke University Health System (DUHS) Nursing, launched in 2008 and continues to grow and evolve.

“Evidence suggests that outcomes may improve when elders are cared for by nurses with expanded competence in geriatric care,” said Loretta Matters, MSN, RN, associate director for the Center of Geriatric Nursing Excellence and director of Duke NICHE. “Since establishing this partnership, more than 140 registered nurses across DUHS have acquired advanced competencies in geriatrics.”

The academic-practice partnership hasn’t just increased the number of nurses with specialty expertise; it has also supported and enhanced interprofessional collaborations to improve the quality of care the older population receives.

Some of these collaborations were recently recognized at the annual national NICHE Conference in Chicago last month.

  • Matters, DUHS Palliative Care Service Nurse Practitioner Jennifer Gentry, RN, ANP-BC, ACHPN, FPCN, and CEO of the Hospice and Palliative Nurses Association Sally Welsh, MSN, RN, were invited to speak about their collaborative effort to develop a “Facilitating Difficult Conversations” program. The program aims to assist staff in engaging in difficult conversations by better understanding their patients’ needs and responses using an adaptive leadership framework. Other DUSON and DUHS collaborators included Chip Bailey, PhD, RN, FAAN, co-director of the ADAPT Center for Cognitive/Affective Symptom Science at DUSON, and Rebecca Porter, MSN, A/GNP-BC, Bone Marrow Transplant Service for DUHS.
  • Another program entitled “Health Optimization Program for Elders (HOPE): Enhancing Care Transitions between Acute Care and Skilled Nursing Facilities” is an interprofessional-interagency collaboration that identifies process improvement opportunities in elder care such as medication reconciliation, provider-to-provider communication and patient-family engagement. This program included collaboration with Corinne Machado, BSN, RN, director of Nursing for Peak Resources and Treyburn, Matters, McConnell and Shari Rushton, MSN, MS, RN, CCM, assistant professor for DUSON, as well as numerous others from across the health system, the medical center, Duke NICHE and the community.

“All of the work that is being done through Duke NICHE is very person-centered,” Matters said. “However, I always think the best way to showcase this is in a personal story, such as the one that shows the impact of dementia on the patient and their family like Duke Regional Hospital NICHE Coordinator Denise Guerrier and her sister so beautifully brought to life.”

Guerrier, MSN, RN-BC, and her sister Jean Simons, PhD, who lives with early onset dementia, presented “Living with Dementia: Patient and Family Narratives to Building Understanding Among Health Care Professionals.” Their presentation, originally developed for a Geriatric Grand Challenge Institute in Dementia Care by McConnell, provided conference attendees with a personal perspective of what it is truly like living with dementia as well as to encourage dialogue regarding dementia in the African-American community.

Matters and McConnell both agree that continuing to blaze a trail that will make a difference for older Americans will depend on more interprofessional collaborations. Matters said, “While Duke NICHE is a nurse-led initiative, improving care of older adults is a team effort. We’re a team of diverse health care professionals and community leaders who are committed to enhancing care for all older adults.”