Saturday, July 24, 2004: 8:30 AM-10:00 AM

Transforming Nursing Care Delivery in Long-Term Care (LTC): Integrating Evidence With Experience

Learning Objective #1: Describe opportunities and challenges of implementing evidence-based nursing in a long-term care (LTC) setting
Learning Objective #2: Articulate the relationship of expertise (art of nursing) and evidence (science of nursing) in a LTC setting
In many industrialized societies, an aging population, increases in the prevalence of chronic disabling diseases, changes in social migration patterns and economic realities result in the need for more long term care settings, such as nursing homes. In 1997, 1.6 million Americans lived in nursing homes (Gabriel, 2000). In California, the current nursing home population of 100,000 is expected to double by 2030 (Centers for Medicare and Medical services, 2003). Traditionally, nursing homes have not been innovative practice settings. Some argue that innovation is in fact discouraged in the highly regulated nursing home environment. Poor public image, limited funding, quality of care issues and compliance-based care are sources of concern for consumers and professionals alike. Laguna Honda Hospital and Rehabilitation Center (LHH), is an 1100-bed publicly owned and operated long term care facility that serves ethnically diverse and economically disadvantaged San Franciscians. Unlike many nursing homes whose typical resident is white, female and over the age of 80 (Gabriel, 2000), half of LHH residents are male and 30% are under the age of 60. LHH is committed to leading the nursing home industry in developing standards and serves as a research site to identify practice innovations. This symposium describes one institution’s efforts to integrate evidence based nursing while honoring skills that do not lend themselves to empirical testing. The process has required scrutiny of the evidence base used in time-honored care practices while at the same time, recognizing the clinical experience and the value of knowledge derived from the nurse-patient relationships. Leadership, academic partnerships and the use of industry standards to benchmark care outcomes (e.g. satisfaction, resource utilization, quality indicators) are key components in creating a climate to promote, examine and evaluate nursing practice.
Organizer:Mary Louise Fleming, RN, MSN
 Changing a Nursing Home Culture Through Narrative: Articulating Experience and Clinical Wisdom in EBN
Mary Louise Fleming, RN, MSN, Mozettia Henley, RN, DNS, Anne M. Hughes, RN, MN, FAAN
 Implementing EBN, It’s Not as Straightforward as It Seems: Chronic enteral nutrition for persons with severe cognitive impairments
Anne M. Hughes, RN, MN, FAAN, Bronwyn Gundogdu, RN, Mary McCutcheon, RN, MS
 Putting Humpty Dumpty together again: integrating mind, body, spirit and family in the long term care setting
Mozettia Henley, RN, DNS, Lucy Fisher, RN, MS, Mary Louise Fleming, RN, MSN
 The Other Side of the Coin: Using “Practice-Based-Evidence” to Drive Improvements in Pressure Ulcer Risk Assessment and Care Planning
Ron Walent, RN, MS
 Using Existing Data as an Evidence Source for Practice: Possibilities and Problems
Gail Cobe, RN, MSN, Carol Maher, RN, RAC-C, Anne M. Hughes, RN, MN, FAAN

15th International Nursing Research Congress
Sigma Theta Tau International
July 22-24, 2004