Promoting Evidence-Based Geriatric Care on Microsystems Utilizing a Non-traditional CNL Role

Monday, 18 November 2013: 10:40 AM

Emily Simmons, MSN, RN-BC, CNL
The Center for Nursing Excellence, The University of Alabama at Birmingham Hospital, Birmingham, AL

Our hospital launched the innovative geriatric nursing education program entitled the UAB Geriatric Scholar Program (GSP).  The GSP is led by a CNL at the macrosystem level and is modeled after successful NICHE programs implemented in over 200 hospitals nationwide. The CNL utilizes her core competencies and training to assist the scholars in the development and implementation of their evidence-based projects.  Using a “train-the-trainer” model, the benefits of this new program are exponential.   The aims are to discuss 1) the implementation of Geriatric Scholar Projects on microsystems and 2) to discuss how CNL competencies can be utilized in non-traditional CNL roles to improve patient care outcomes.

The GSP’s CNL mentored 14 geriatric scholars in the completion of 5 evidence-based projects on 10 microsystems.  The following is a summary of the outcomes: 1) Promoting mobility in the hospitalized patient-  the number of patients without an activity order decreased from 21% to 6%, the number of patients that ambulated increased from 52% to 81%, the percentage of patients/families educated about importance of mobility improved from 45% to 75%, and the unit fall rate declined from 3.43 to 0.54. 2) Assessing for delirium - Confusion Assessment Method completed daily on 52- 61% of patients. 3) Pressure ulcer prevention using turning clocks - 70% of patients ≥ 65 with a braden score ≤ 17 had a turning schedule posted and 66% of those patients were turned correctly. 4) Assessing for functional status using Katz Index - the percentage of patients aged ≥ 65 years with a documented Katz Index ranged from 73-81% and the data showed significant differences in mean baseline and current Katz scores.