J Gerontol Nurs
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Becoming part of the plan to help conquer Alzheimer's disease: the national Alzheimer's project act.
Alzheimer's disease presents one of the largest challenges facing the aging population. The National Alzheimer's Project Act (NAPA) led to a national plan to engage health care team members in addressing this challenge. As nurse clinicians, educators, and researchers review the NAPA and resultant national plan, they can gain further direction in enhancing or expanding their roles to help stem the devastation of Alzheimer's disease.
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Inadequate pain medication management is pervasive in nursing homes (NHs). Licensed practical nurses (LPNs) deliver the majority of licensed nursing care, but LPNs are neither trained nor licensed to provide comprehensive pain assessment and medication management. ⋯ Differences clustered in three areas: (a) the extent to which RNs and LPNs connected formally and informally to provide pain care, (b) the degree to which RNs and LPNs were considered interchangeable with one another, and (c) the RN-to-LPN ratio. Results highlight quality issues and suggest ways to improve pain medication management in NHs.
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The medical records of 273 patients 75 years and older were reviewed to evaluate quality of emergency department (ED) care through the use of quality indicators. One hundred fifty records contained evidence of an attempt to carry out a cognitive assessment. ⋯ These findings suggest that the majority of older adults in the ED are not receiving a formal cognitive assessment, and more than half with CI do not receive quality of care according to the quality indicators for geriatric emergency care. Recommendations for improvement are discussed.
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The purpose of this narrative literature review was to describe the state of the science on the effectiveness of opioid medications to palliate dyspnea in older adults with advanced disease. A three-stage critical appraisal process was used to evaluate articles published between 2000-2011 that were retrieved from the CINAHL, Ovid MEDLINE, and PsycINFO databases. ⋯ Many recent articles on this topic shed light on the importance but underuse of opioid agents to palliate dyspnea, particularly in older adults with advanced chronic illnesses, such as heart failure and chronic obstructive pulmonary disease. ADRA (Assess, Document, Re-assess, Advocate) is a proposed framework that gerontological nurses can use to ensure patients receive adequate symptom management for refractory dyspnea.