New grant funds innovative program to improve care of state’s elderly population

CHAPEL HILL -- Researchers at the University of North Carolina at Chapel Hill’s School of Nursing have received a three-year grant totaling nearly $650,000 to increase geriatric nursing skills of the state’s nurses and improve the quality of nursing care provided to acutely ill older adults.

The grant, funded by the U.S. Department of Health and Human Services Health Resources and Services Administration, will support the creation, implementation and study of educationally innovative geriatric clinical simulations and an online library of these simulations to teach nurses how to better care for older patients in acute and long-term care settings.

Dr. Mary H. Palmer, the Umphlet distinguished professor in aging, and Julianne B. Page, a clinical instructor, are project directors.

"This project is especially significant in light of the fact that more than one-third of hospital patients in the United States are over the age of 65, yet less than 1 percent of the nation’s nurses are certified in geriatrics," said Palmer. "North Carolina mirrors the national experience of facing a nursing shortage and having a rapidly growing aging population with few nurses formally prepared in geriatric nursing."

The geriatric clinical simulations will be offered through the UNC School of Nursing Department of Continuing Education as one- and three-day workshops for the state’s nurse educators, registered nurses and licensed practical nurses. Workshop leaders certified in geriatrics will use case studies and a human patient simulator to address common acute problems experienced by the elderly.

A human patient simulator is a computerized mannequin that can be programmed to imitate the health conditions of either a man or woman. It can mimic the human cardiac, neurological and respiratory systems and can imitate more than 60 different health scenarios, including heart attack, septic shock and collapsed lung. Realistic features include eyes that blink and a chest that produces heart sounds and takes in oxygen.

To reach nurses who are unable to attend the workshops, the geriatric clinical simulations will be made available through a Web-based electronic library. Nurses who participate in the clinical simulation workshops will be encouraged to use the library to teach their colleagues, particularly nursing assistants who often provide the majority of direct care in long-term care settings.

Palmer and Page said they anticipate creating 90 clinical simulations divided into different learning levels by 2006, with one-third of the simulations addressing cultural diversity issues. More than 400 nurses are expected to participate in the clinical simulation workshops, and 1,000 nurses are expected to use the electronic library and attend training sessions within their home agencies.

Program effectiveness will be based on evaluations of participants’ competencies, their satisfaction with the learning experience and the successful transfer of what they’ve learned to their home agency colleagues.

"We believe this program has the potential to expand nationwide," said Palmer. "The use of geriatric clinical simulations involving acutely ill older adults as part of continuing education offerings will help to increase the number of nurses competent in geriatric nursing and the quality of their responses to changes in acutely ill older adults’ clinical status. Decreased negative patient outcomes should occur as a result."

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Note: Palmer can be reached at (919) 966-7204 or mhpalmer@email.unc.edu.

School of Nursing contact: Sunny Smith Nelson, (919) 966-1412 or sunny_nelson@unc.edu