Geriatric Education Group Visit: Understanding the Healthcare Proxy (HCP) Among Spanish-Speaking Elders

Sunday, 28 July 2019

Marcia M. Duclos, BSN
Baystate Medical Center, Springfield, MA, USA

Purpose: This Quality Improvement (QI) project is focused on the implementation and improvement of the process of HCP by educational sessions offered in a community health center. This Doctor of Nursing Practice (DNP) capstone project was led by the DNP student and supervised by a Geriatrician Medical Doctor, its purpose was to increase health literacy and compliance about the meaning, purpose and importance of the Health Care Proxy (HCP) through educational group medical visits (GMV) to Spanish-speaking patients 65 years and older.

Methods: A pre-knowledge assessment survey was distributed to a convenience sample of patients who met criteria for inclusion at the beginning of each session. A post-knowledge assessment surveys were distributed at the end each session to measure the knowledge and comprehension of the HCP form after the educational session.

Results: Over a period of one month (November 17, 2017 to December 11, 2017), twenty patients completed the pre-knowledge assessment and post-knowledge assessment. Two patients did not complete the pre-knowledge assessment and post-knowledge assessment due to visual impairment, or unavailable relative they trusted to help them out. An increase in comprehension and understanding of the HCP was demonstrated by the comparison of the results of the surveys.

Conclusion: Inadequate health literacy disproportionately affects older adults in the United States. The complexities associated with managing chronic disease, language barriers, cultural differences, cognitive and sensory changes associated with the aging, increase challenges in educating this highly vulnerable group. The role of a DNP-NP as provider is to be able to recognize the importance of measuring patient literacy skills and be able to use proper educational tools. Clinicians have the responsibility to provide appropriate HCP education to improve best practice and communication between patients, caregivers, and healthcare providers. The culmination of this DNP project and sustainment in practice provided the groundwork for future scholarship and gives a meaningful contribution to improving advanced nursing practices and patient outcomes.