Building a Culture of Geriatric Excellence: One Hospital's Experience

Building a culture of geriatric excellence:  Educational Innovations

It is well known that an acute care hospitalization can be a pivotal event in the life of an older person.  Within our hospital, the average daily inpatient census is seventy (70%) over the age of 65.  As the American population ages, so does the need to care for acute and chronic conditions effecting the geriatric population.

Through the leadership of the hospital’s nursing vice president, it was determined that there was a need to have nurses with expertise in gerontological nursing practice. 

Key stakeholders were chosen to focus on geriatric education, certification, and evidence based practices to provide superior geriatric care.  These individuals formed geriatric work groups. 

At the forefront was gerontological registered nurse certification.  With in a three year period of time, the hospital was successfully able to have 63 registered nurses certified in gerontology.  These nurses have been instrumental in leading geriatric work groups that are tackling challenges in providing excellence in geriatric care. These workgroups are focused on:  dermal defense and wound care, early mobility and early ambulation practices, medication management, reduction in falls and aging sensitive care initiatives.  They provide continuing education opportunities through lunch and learn events, community program offerings, Pit Stop education, computer based learning and innovations in content presentation and testing using technology.

The collaboration of these certified gerontology nurses has taken another step as they meet monthly with a physician Geriatrician champion and RN Geriatric Service Line Manager co-leading them.  This inter-professional group has led to sharing of best practices within all of the nursing units, continuous learning utilizing the Nurses Improving Care for Healthsystem Elders Geriatric Resource Model of nursing practice, and the encouragement of more eligible registered nurses to become certified with hospital based gerontology certification review courses available to them.

Through continuing education, nurses working primarily with geriatric adults and their families, have been able to incorporate gerontological competencies to assess, implement, maintain and evaluate care to meet their specialized needs.     

The hospital has also had two mentor/mentee dyads successfully complete the Sigma Theta Tau International (STTI) Geriatric Nurse Leadership Academy (GNLA).  Each dyad piloted a geriatric initiative on their nursing unit that was later implemented throughout the acute inpatient care areas of the hospital where geriatric patients are treated.  Through education innovations the gerontological nurses have transformed the delivery of care to patients over 65 years of age in manner that is geriatrically sensitive, knowledge driven and underscored by quality.