Geriatrics and the Advanced Practice Curriculum

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Geriatrics and the Advanced Practice Curriculum

• Mathy Mezey, EdD, RN, FAAN, Director
• The John A. Hartford Foundation Institute for
  Geriatric Nursing
• The Independence Foundation Professor of Nursing
  Education New York University
  
  Division of Nursing

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Older Patients are a hospitals Core Business

• As the number of elderly Americans rises in the
  years ahead, hospitals will be taking care of a
  larger proportion of older, sicker patients ...
  treating more older patients, using more
  technology, and being held accountable for higher
  levels of quality will present formidable
  challenges for the future hospital workforce
• (Beurhaus et al, Health Affairs, 2002, 21(5) pg.
  127)

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Older Patients are 48 of hospital admissions

• 60 of adult primary visits
• 80 of home care visits
• 63 of patients with cancer
• 60 of visits to cardiologists
• 53 of visits to urologists
• 52 of visits to ophthalmologists
• 46 of patients in critical care

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As compared to other adults, Older Patients have

• Longer lengths of stay (7.8 days vs. 5.4 days)
• Stable discharge rates
• Higher rates of re-admission within 30 days
• Documented functional declines and iatrogenesis

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Advanced Practice Nurses NP
Berlin LE, Stennett J, Bednash, GD. (2003)
2002-2003 Enrollment and Graduations in
Baccalaureate and Graduate Programs in Nursing.
Washington, DC American Association of Colleges
of Nursing.
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Advanced Practice Nurses CNS
Berlin LE, Stennett J, Bednash, GD. (2003)
2002-2003 Enrollment and Graduations in
Baccalaureate and Graduate Programs in Nursing.
Washington, DC American Association of Colleges
of Nursing.
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Advanced Practice Nurses continued

• Fewer than 4,200 GNPs/ GCNSs nationally
• Less than 300 GNP graduates (2002)

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Advanced Practice Nurses continued

• 1999 - 2000
• 63 GNP programs 200 graduates

• 1999 - 2000
• 245 FNP programs 3,440 graduates
• 115 ANP programs 988 graduates

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Meeting healthcare demands Need for geriatrics
content in all Advanced Practice nursing programs

• How does one choose what geriatric content to
  include in the advanced practice nursing program?

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Development of Recommended Baccalaureate
Competencies and Curricular Guidelines in
Geriatric Nursing Care

• In 2000, AACN and the Hartford Institute
  developed baccalaureate core competencies, Older
  Adults Recommended Baccalaureate Competencies
  and Curricular Guidelines for Geriatric Nursing
  Care
• AACN/Hartford Institute for Geriatric Nursing
  joint publication as companion piece to the
  Essentials document
• Available on AACN website http//www.aacn.nche.ed
  u/Education/gercomp.htm

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Development of Competencies continued

• Process for developing baccalaureate
  core competencies
• How competencies drive change
• Curriculum mapping
• NCLEX
• Hospital Competencies

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Development of Competencies continued

• In 2003, AACN and the Hartford Institute are
  developing core competencies for Advanced
  Practice programs of nursing
• Today is your opportunity to participate and
  offer feedback

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Gerontological Certification

• Geriatric content will be essential because it
  will be on certification exam
• Healthcare demands for certification
  (i.e. Magnet Status)

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Gerontological Certification continued

• 400,000 nurses who are members of specialty
  nursing associations that work primarily with
  older adults
• Grant with ANA/ANF to impart geriatric content to
  these nurses
• special interest groups
• technical assistance materials, speakers
• certification

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Prepare nursing students to meet the changing
tides

• 13 of Americans (35 million) are gt65
• By 2050, 20 of Americans (78 million) will be
  gt65

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