HGNI New Directions

Welcome to New Directions, a publication of the Hartford Geriatric Nursing Initiative (HGNI). This e-newsletter is designed to inform interested academic and practice leaders, faculty members, students, practitioners and others about the work of the HGNI and provide the latest news and information relevant to geriatric nursing.

As many of you know, the HGNI is preparing professional nurses to play leadership roles in improving the health of older adults. In partnership with the nation's nursing schools and a variety of health care organizations and systems, this dynamic, national initiative, supported through a $38 million investment from the John A. Hartford Foundation, works in five areas, including:

Shaping nursing practice to best meet the health care needs of older adults;

Enhancing professional education to ensure all nurses are prepared to treat older patients;

Promoting research needed to guide the care and promote the health of older people;

Developing leadership in academic and professional settings; and

Demonstrating nursing's commitment to enacting public policy that improves older Americans' health care.

We are proud to represent this critically needed effort, which is involving the nation's top nurses—including you—in making a difference in the health care of our nation's older adults. If you would like more contact information about, and links to all of the programs of the HGNI, please see the HGNI's Evaluation Web site at www.geriatricnursing.info.

In this Issue

1. Specialized Nursing Care Improves Heart Failure Outcomes, Cuts Costs to the Health Care System
2. Announcements
3. Tools, Resources and Opportunities
4. HGNI People
5. HGNI Link of the Month-Health Services Technology Assessment Texts

Please note: New Directions will take a summer hiatus and will return in September.

1. Specialized Hospital to Home Care Improves the Health of Older Adults with Heart Failure, Cuts Costs to the Health Care System

A new study shows that when elderly heart-failure patients receive specialized nursing care throughout their hospital stay and at home following hospital discharge, the patients have a better quality of life and have fewer hospital readmissions. Instead of costing more money for this specialized care, the study showed that the care resulted in a nearly 38% savings in Medicare costs. The study, funded by the National Institute of Nursing Research (NINR), one of the National Institutes of Health (NIH), appears in the May 2004 issue of the Journal of American Geriatrics Society.

The study, which involved six academic and community hospitals in Philadelphia, was conducted by researchers at the University of Pennsylvania and led by Professor of Nursing Mary Naylor, PhD, RN.

The study found that while the total costs of providing this level of care for patients in the APN group was nearly double that provided to patients receiving routine care, this increase was more than offset by cost savings from fewer hospital readmissions. The higher level of care actually saves taxpayers an average of $4,845 per patient, the researchers found a 37.6 percent savings over 12 months. As a result of these findings, a major health insurer has launched a $1 million pilot program to test Dr. Naylor's research in practice.

"With Americans living longer, chronic health issues affecting the elderly are overtaking acute illnesses as a major concern. It is becoming increasingly important to develop and test strategies that will help these vulnerable, at-risk populations live healthier, more independent lives," said NINR Director Dr. Patricia A. Grady, PhD, RN, FAAN. It is heartening to see a public-private partnership that facilitates translating research results to practice. The success of the insurance company's pilot program will mean better quality of care and improved health for many, with the added benefit of reducing costs," noted Dr. Grady. For a full report on the study go to: www.nih.gov/news/pr/may2004/ninr-12.htm.

2. Announcements

Geriatric Activities Highlighted at 2004 American Nurses Association Convention
Please visit the Hartford Geriatric Nursing Initiative (HGNI) at Booth #535.

Plenary Session
Tuesday, June 29, 2004
8:00 AM - 9:00 AM
Facing the Future and Embracing Nurse Competence in Aging
Speaker: Mathy Mezey, EdD, RN, FAAN, Director, The John A. Hartford Foundation Institute for Geriatric Nursing

Continuing Education sessions with geriatric content:
Sunday, June 27, 2004
SC012 Environmental Risks & Nursing Care
SC015 Nursing Management & Administration in LTC
SC019 Are You Prepared for End-of-Life Nutrition & Hydration
SC033 Assessing & Managing Delirium in Older Patients Across Care Continuum
SC036 Nurse Led Interdisciplinary Clinical Improvement Project for Frail Adults

Monday, June 28, 2004
SC039 Old Age in New Age: Comprehensive Geriatric Nursing Education
SC063 Palliative Care
SC069 Oncology Trends I
SC070 Oncology Trends II
SC074 Using Evidence to Reduce Falls and Injuries

Tuesday, June 29, 2004
SC088 Plenary II: Facing the Future and Embracing Nurse Competence in Aging
SC094 Psychiatric Nursing for Non-Psychiatric Nurses
SC101 Advanced Practice Nurse/Faculty Partnerships in Geriatric Nursing

Measures of Family Assessment of Nursing Home Care Due July 6
The Agency for Healthcare Research and Quality (AHRQ) is currently soliciting a voluntary submission by researchers, survey firms, stakeholders, and other interested parties of survey instruments or items from survey instruments measuring family assessments of nursing home care. The Centers for Medicare and Medicaid Services (CMS) established as a priority support for the development of a standardized survey for measuring and publicly reporting family and residents' assessments of nursing home care that could be used nationwide.

CMS asked AHRQ for assistance in the development and testing of the survey instruments. A resident survey has been developed and is in the process of being field tested. The next step is the development of a standardized instrument for investigation of family perspectives on residents' nursing home care. If selected for incorporation into a standardized CAHPS (formerly the Consumer Assessment of Health Plans) instrument for comparing family assessments of nursing home care, measures will be made freely available to encourage widespread use. Submissions are due July 6, and should be mailed to Judith A. Sangl, AHRQ, 540 Gaither Road, Rockville, MD, 20850, or preferably e-mailed to her at jsangl@ahrq.gov.

Call for Nominations: Springer Award in Geriatric/Gerontologic Nursing
Co-sponsored by the John A. Hartford Foundation Institute for Geriatric Nursing at NYU, the annual Springer Award recognizes a distinguished single work of research in applied geriatric nursing. The award, which will be presented in November at the Geriatric Nursing Interest Group meeting of the Gerontological Society of America, includes $500 and consideration for publication by Springer Publishing Co. in either book format or journal article. Eligible candidates for the award are nurses whose work applies to improving the nursing care of older adults. Submission requirements for the award are: three copies of double-spaced typescript; five-page maximum description of research and its significance for practice; two-page curriculum vitae; and letter of endorsement from dean or supervisor. Submissions must be received by September 30, 2004. Facsimiles are not accepted. Mail to:

Springer Publishing Co.
536 Broadway
New York, NY 10012
Attn: Sheri Sussman

Coming Soon!
The 2004 Leadership Conference Program Agenda will be available at www.geriatricnursing.org at the end of June. The Conference is scheduled to open November 17th in Washington, D.C., once again leading into the annual GSA meeting. Check back for more information!

Also, there will be a new face to the Building Academic Geriatric Nursing Capacity (BAGNC) Web site this month! Mark your calendar and visit www.geriatricnursing.org at the end of June.

Reminder: Building Academic Geriatric Nursing Capacity (BAGNC) Predoctoral and Postdoctoral Scholarship Applications Now Available On-Line
The American Academy of Nursing, with support from the John A. Hartford Foundation, is seeking applicants for Predoctoral and Postdoctoral Scholarships in gerontological nursing. The Scholars Program offers grant support up to $50,000 per year for two years to successful candidates who will commence or continue education or research training no later than September 2004. For eligibility requirements and applications, visit www.geriatricnursing.org or contact Patricia Franklin at pfrankli@ana.org.

3. Tools, Resources and Opportunities

NEW Geriatric Resources for Staff Development
The John A. Hartford Foundation Institute for Geriatric Nursing will introduce new materials for Staff Development Education at the National Nurse Staff Development Organization (NNSDO) Convention July 29 - August 1, 2004 in San Diego, CA. Each participant will receive a complimentary set of materials.

Enhancing Nurse Competence in Aging
Sunday, August 1, 2004
8:00 - 9:00 AM
Sponsored by Nurse Competence in Aging Initiative and The John A. Hartford Foundation Institute for Geriatric Nursing.

The Pocket Guide to Staying Healthy at 50+
AHRQ has released a booklet for older adults, "The Pocket Guide to Staying Healthy at 50+" which incorporates new research-based recommendations from the U.S. Preventive Services Task Force. The guide was developed in partnership with AARP and updates the original "Staying Healthy at 50+" published in 2000.

The Pocket Guide, available in English and Spanish, includes tips and recommendations on good health habits, screening tests, and immunizations. It provides easy-to-use charts to help track personal health information and includes questions to ask health care providers, as well as resources to contact for additional information. This publication is part of the Put Prevention Into Practice program, which is designed to increase the appropriate use of clinical preventive services. PPIP tools such as this booklet enable health care providers to determine which services their patients should receive and how best to deliver them.

A complete listing of Task Force recommendations and PPIP resources can be found at www.ahrq.gov/clinic/prevenix.htm. The new Pocket Guide to Staying Healthy at 50+ is available on the AHRQ Web site in English at www.ahrq.gov/ppip/50plus/, and in Spanish at www.ahrq.gov/ppip/50plussp/. Copies of this publication and related materials are available from the AHRQ Publications Clearinghouse by calling (800) 358-9295 or sending an e-mail to ahrqpubs@ahrq.gov. Clinical information also is available from the National Guideline Clearinghouse at www.guideline.gov.

"Try This" Series
Beers' Criteria for Potentially Inappropriate Medication Use in the Elderly

"Try This," a publication of the John A. Hartford Foundation Institute for Geriatric Nursing at NYU, is a series of assessment tools where each issue focuses on a topic specific to the older adult population. "Beers' Criteria for Potentially Inappropriate Medication Use in the Elderly" explains the HCFA Guidelines for potentially inappropriate medication in the elderly. To download this or other Try This issues, go to: http://www.hartfordign.org/resources/education/tryThis.html.

Older Americans 2000: Key Indicators of Well-Being
Older Americans 2000: Key Indicators of Well-Being covers 31 key indicators selected by the Federal Interagency Forum on Aging-Related Statistics to portray aspects of the lives of older Americans and their families. The report is divided into five subject areas: population, economics, health status, health risks and behaviors, and health care. The 2004 edition will be released in November 2004. For more information or to order visit: www.agingstats.gov.

Publications of Interest

A recent article published in the British Medical Journal USA (Vol 328, No 7449, May 15, 2004) shows striking variations in the utilization of end-of-life care among U.S. medical centers with strong national reputations for clinical care. "Use of hospitals, physician visits, and hospice care during last six months of life among cohorts loyal to highly respected hospitals in the United States," by John E. Wennberg, Elliott S. Fisher, Therese A. Stukel, Jonathan S. Skinner, Sandra M. Sharp, and Kristen K. Bronner, looks at the use of health care resources during the last six months of life among patients of U.S. hospitals. Hospitals included in the study were selected from the 2001 US News and World Report "best hospitals" list for heart and pulmonary disease, cancer, and geriatric services. For more information about the study go to: http://bmj.bmjjournals.com/cgi/content/full/328/7440/607.

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"New Frontiers in Geriatrics Research: An Agenda for Surgical and Related Medical Specialties"
This first-ever research agenda aimed at enhancing outcomes in elderly patients who receive surgical treatment or other specialized care, was released by the American Geriatrics Society in conjunction with its Annual Scientific Meeting. The book puts forth ten distinct research agendas that encompass the full course of care that most surgical patients receive.

The development of New Frontiers was supported by the AGS/John A. Hartford Foundation project, Increasing Geriatrics Expertise in Surgical and Related Medical Specialties (Geriatrics-for-Specialists) and may be downloaded from the AGS Web site at www.americangeriatrics.org.

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The Merck Manual of Health and Aging (2004)
The Merck Manual of Health and Aging, edited by Mark H. Beers and Thomas V. Jones, is a comprehensive manual written to help individuals navigate the health care system and find useful information on health and disease. For excerpts from the book and ordering information go to: http://www.merck.com/pubs/mmanual_ha/sec2/ch04/ch04a.html.

4. HGNI People

Congratulations to the first-ever BAGNC Scholars, who completed their two-year award program during the last six months of 2003.They set a standard of excellence and have now joined the growing cadre of leaders in the field of geriatric nursing. In this and subsequent issues, we highlight these graduates, where they are and what they're doing post-award. To view the call for BAGNC Scholar Award Applications issued in March 2004, visit the program's Web site. Here, we feature another in this inspiring class of Scholars.

Following the completion of her JAHF postdoctoral award, which was a collaborative effort between University of Pennsylvania and Brown University, Meg Bourbonniere, PhD, RN, ONC, was appointed an Assistant Professor of Community Health (Research) at Brown. Her work with an interdisciplinary team of health services researchers in the Center for Gerontology and Health Care Research focuses on the interface of nursing homes and hospitals in an effort to improve the quality of care in nursing homes.

Dr. Bourbonniere is conducting a study funded by the Oncology Nursing Society/Genentech, Inc. that examines the discharge process from the perspective of hospital discharge planners for older cancer patients who enter skilled nursing facilities following surgery. Her area of expertise is outcomes for frail older adults and elders with cancer following the transfer of care.

Recently, Dr. Bourbonniere accepted a position as Assistant Professor at Yale School of Nursing, where she can further bolster the HGNI's efforts to increase academic geriatric nursing capacity, exert a wider influence on career choices of nursing students, and mentor innovative aging research.

Meet the HGNI Communications Team

Each issue of New Directions highlights a member of the HGNI Communications Working Group. This month we feature Patricia Franklin, MSN, RN, CPNP, Project Manager for the John A. Hartford Foundation's (JAHF) Building Academic Geriatric Nursing Capacity Scholars Program & the Nursing School Geriatric Investment Project.

Ms. Franklin's 28-year nursing career includes clinical practice at Georgetown University Hospital and 19 years in primary care as a Pediatric Nurse Practitioner. In addition, she brings almost 20 years of association experience to her role as project manager.

After completing her graduate program at the Catholic University of America in 1980, she joined a newly formed state chapter of the National Association of Pediatric Nurse Associates and Practitioners (NAPNAP). Over the next 19 years while working in a private, primary care setting, Ms. Franklin also served in a number of state and national nursing and health care leadership positions, including President of NAPNAP in 1997. Ms. Franklin formally shifted her career focus from clinical practice to program development in 1999 and accepted a Senior Staff position at the American Nurses Association in their Constituent Affairs department.

In May 2001, Ms. Franklin joined the staff of the American Academy of Nursing, serving as Program Manager of the Scholars Program. Within five months the Academy was awarded a second JAHF grant, and in March 2002 the Academy was listed in the American Society of Association Executives 2002 Honor Roll in recognition of the Building Academic Geriatric Nursing Capacity Scholars Program.

5. HGNI Link of the Month — Health Services Technology Assessment Texts

The Bookshelf at the National Center for Biotechnology Information is the new home of HSTAT (Health Services Technology Assessment Texts). HSTAT contains full text documents that provide health information and support health care decision making. To view HSTAT texts, go to:
http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat.

Write to Us

We are committed to creating a monthly publication that serves your needs and interests. New Directions, therefore, welcomes your feedback and encourages you to supply ideas, stories, resources, news and other content for subsequent issues. To make a contribution, please contact Patty Franklin at pfrankli@ana.org, Deirdre Thornlow at dthornlo@aacn.nche.edu or Elaine Gould at elaine.gould@nyu.edu.

Please Note

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