Training Tools for Older Adult Healthcare Learners

A shift to electronic recording from the familiar paper-based format can be challenging for employees. Practice shows that older adult healthcare learners are particularly exposed to emotional discomfort associated with the implementation of digital systems (Furlong, 2015). As such, the paper at hand aims to describe two tools that can help this group of learners to feel more comfortable while adapting to the EHR system. Training Tools for Older Adult Healthcare Learners.

Proposed Tools

Simulated EHR

Description

Simulated EHR curriculum is a convenient tool that allows learning to operate the EHR system through a virtual platform. As such, learners can create curriculums and use other EHR options in this simulated system. The system allows working with virtual patients in a real-life pace. The main benefit of this tool resides in the fact that trainers can track all the learners’ errors and perform a detailed revision of the mistakes.

As such, learners receive a chance to perform one and the same task several times until they finally learn to complete it flawlessly (Milano, Hardman, Plesiu, Rdesinski, & Biagioli, 2014). The use of this tool will require expert involvement so that they help to update input on which learners can train. Simulated EHR can ensure a smooth shift from virtual to real electronic recording.

The rationale for Using This Tool

It is assumed that the use of simulated EHR will help older adult healthcare learners to adapt to the shift to a new recording system. As such, older employees might experience concerns about failing to keep up with the learning pace of younger colleagues. From this perspective, the use of simulated EHR will enable them to choose a comfortable learning pace and repeat certain procedures as many times as necessary. Training Tools for Older Adult Healthcare Learners. Additionally, older employees tend to be afraid of making mistakes while working with electronic systems. Thus, it is believed that such a tool as a simulated EHR will eliminate this fear thanks to its virtual format. As such, employees will feel free to explore the options of the EHR without experiencing tension or anxiety (Milano et al., 2014).

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Hands-On Exercises

Description

Hands-on exercises are a convenient tool that allows for an application of the acquired knowledge to practice. Thus, learners are welcomed to test their skills in the frame of a real-life environment. This tool is highly valuable from a psychological perspective. On the one hand, learners get emotionally prepared to make a shift from virtual to real programs. On the other hand, they still realize that they will receive essential support in case some challenges arise. As such, these exercises are a transition stage between education and practice. This tool can be used both at the training stage and as a part of the testing procedure (Bredfeldt, Awad, Joseph, & Snyder, 2013).  Training Tools for Older Adult Healthcare Learners.

The rationale for Using This Tool

Research reveals that a hands-on training tool is the most valuable in terms of developing the skills essential for working with the EHR system. As such, Bredfeldt et al. (2013) note that, in the frame of their recent study, the major part of participants evaluated this learning tool as the most useful from a practical perspective.Training Tools for Older Adult Healthcare Learners.  It is, therefore, assumed that the tool will be particularly useful for older adult learners to ensure a comfortable shift from using virtual simulated EHR to working with real electronic recording systems. The transition stage will help them to test their abilities in a relaxed, yet close to a real-life environment.

Reference List

Bredfeldt, C. E., Awad, E. B., Joseph, K., & Snyder, M. H. (2013). Training providers: beyond the basics of electronic health records. BMC Health Services Research, 13(1), 503-513.

Furlong, K. E. (2015). Learning to use an EHR: Nurses’ stories. Canadian Nurse. Web.

Milano, D. C. S., Hardman, D. J., Plesiu, A., Rdesinski, R. E., & Biagioli, F. E. (2014). Simulated Electronic Health Record (Sim-EHR) Curriculum: Teaching EHR skills and use of the EHR for disease management and prevention. Academic Medicine, 89(3), 399-403.

Geriatrics is the branch of medicine that focuses on health care of the elderly. This is the study of the aging process itself. The term comes from the Greek geron meaning “old man” and iatros meaning “healer”.

Geriatrics is the branch of medicine dealing with the aged and the problems of the aging.The field of gerontology includes illness prevention and management, health maintenance,and promotion of the quality of life for the aged.Training Tools for Older Adult Healthcare Learners.  The ongoing increase in the number of elder person.The experiences of aging result from interaction of physical,mental,social and cultural factors. Aging as well as the treatment of the elderly, is often determined the way elder person views the process of aging, as well as the manner in which he or she adapts to growing older. A more heterogeneous elderly population than any generation that preceded it can be expected.

The majority of elderly seen in the health care setting have been diagnosed with at least 1 chronic condition. Individuals who in the 1970s would not have survived a debelitating illness, such as cancer or a castastrophic health event leki hearth attack, can now life more period of sometimes with a variety of concurrent debilitating conditions. Although age is most consistent and strongest predictor of risk for cancer and for the death from cancer, a mangement of elder cancer patient becomes complex because the choronic conditions, such as osteoarthritis, diabetes,

Aging is a broad concept that includes physical changes in people’s bodies over adult life, psychologic changes in their mind and mental capacities, social pyschologic changes in they think and believe, and social changes in how they are viewed, what they expect, and what is expected of them. Aging is constantly evolving concept. Notions that biologic age is more critical than chronologic age when determing health status of the alderly are valid

Aging is an individual and extremely variable process. The functional capacity of major body organs varies with advancing age. As one grows older, environmental and lifestyle factors affet the age-related functional changes in body organs

GERIATRICS ASSESSMENT & CARE MANAGERS

A Care Plan is an outcome of a geriatric assessment, and is essentially an action plan for future care. Training Tools for Older Adult Healthcare Learners.A Care Plan lists all identified problems, suggests specific interventions or actions required and makes specific recommendations regarding resources needed to provide the necessary support services.

What is geriatric assessment?

A geriatric assessment is a comprehensive evaluation designed to optimize an older person’s ability to enjoy good health, improve their overall quality of life, reduce the need for hospitalization and/or institutionalization, and enable them to live independently for as l ong as possible.

An assessment consists of the following steps:

An examination of the older person’s current status in terms of:

Their physical, mental, and psycho-social health

Their ability to function well and to independently perform the basic activities of daily living such as dressing, bathing meal preparation, medication management, etc.

Their living arrangements, their social network, and their access to support services.

An identification of current problems or anticipated future problems in any of these areas.

The development of a comprehensive “Care Plan” which addresses all problems identified, suggests specific interventions or actions required, and makes specific recommendations regarding resources needed to provide the necessary support services.

The management of a successful linkage between these resources and the older person and that person’s family so that provision of the necessary services is assured. Training Tools for Older Adult Healthcare Learners.

An ongoing monitoring of the extent to which this linkage has, or has not, addressed the problems identified, and the modification of the Care Plan as needed.

When is a geriatric assessment needed?

A request for a geriatric assessment would be appropriate when there are persistent or intermittent symptoms such as:

memory loss,

confusion,

or other signs of possible dementia.

DEMENTIA :

Global impairment of intellectual function (cognition) interfering with social and occupational activities.

Often, what looks like Alzheimer’s or dementia can be the result of medication interactions or other medical or psychiatric problems. Because of the thoroughness of the geriatric assessment, it is one of the best ways to determine what the actual problem and cause is or is not. Training Tools for Older Adult Healthcare Learners.

Who performs a geriatric assessment?

A geriatric assessment can be done in many different settings such as:

a hospital,

a nursing home,

an outpatient clinic,

a physician’s office or

the patient’s home.

It is an assessment that is comprehensive in scope, involving a complete review of the current status of the older person in all of its complex dimensions, and because it is so comprehensive, it can only be successfully conducted by a multi-disciplinary team of experts. This team might include:

physicians,

ancillary personnel,

social workers,

physical and/or occupational therapists,

dieticians, psychologists,

pharmacists, and

geriatric nurse practitioners.

You can request a referral for a geriatric assessment from a primary care physician. Also, check with any large hospital or university to see whether they have a geriatric assessment unit.

Geriatric care managers

A geriatric care manager (GCM) is a professional with specialized knowledge and expertise in senior care issues. Ideally, a GCM holds an advanced degree in gerontology, social work, psychology, nursing, or a related health and human services field.  Training Tools for Older Adult Healthcare Learners.Sometimes called case managers, elder care managers, service coordinators or care coordinators, GCMs are individuals who evaluate your situation, identify solutions, and work with you to design a plan for maximizing your elder’s independence and well being.

Geriatric care management usually involves an in-depth assessment, developing a care plan, arranging for services, and following up or monitoring care. While you aren’t obligated to implement any part of the suggested care plan, geriatric care managers often suggest potential alternatives you might not have considered, due to their experience and familiarity with community resources. They can also make sure your loved one receives the best possible care and any benefits to which they are entitled.

Help provided by geriatric care managers

Geriatric care managers facilitate the care selection process for family members who live at a distance from their elderly relatives, as well as for those who live nearby but do not know how to tap into the appropriate local services.

You can hire a care manager for a single, specific task, such as helping you find a daily caregiver, or to oversee the entire caregiving process. Geriatric care managers can help families or seniors who are:

new to elder care or uncomfortable with elder care decision-making;

having difficulty with any aspect of elder care;

faced with a sudden decision or major change, such as a health crisis or a change of residence;

dealing with a complex situation such as a psychiatric, cognitive, health, legal, or social issue.

In addition to helping seniors and their families directly, geriatric care managers can act as your informed connection with a range of other professionals who are part of your elder care network, including any of the following service providers:

Attorneys or trust officers. A care manager can serve as both elder advocate and intermediary with financial and legal advisors. The GCM is often a good source of referrals if a family needs services from these professionals. Training Tools for Older Adult Healthcare Learners.

Physicians. The GCM is an ideal liaison between doctors and other health professionals, and the elder patient and family members.

Social workers. It is useful for hospital and nursing home social workers and discharge planners to know that their senior patient will have someone to coordinate their care and assist them on a long-term basis.

Home care companies. The GCM will know local agencies and be able to explain options, costs, and oversight of home care workers. The care manager can also assist in dealing with patients’ social issues, help link to other community resources, and suggest possible placement options.

Residential facilities. The GCM can help identify types of care facilities and assist you in selecting an appropriate one for your situation. The GCM may also be able to streamline the transition into or out of a senior community, for both the elderly resident, family members and staff.

Finding a geriatric care manager

In addition to the many References and resources available, a good place to start your search for a geriatric care manager is with your family physician. Other sources for referrals include:

local hospitals and health maintenance organizations

senior or family service organizations

senior centers

religious affiliations

Medicaid offices

private care management companies

While geriatric care managers are frequently licensed by the state within their respective fields of expertise, there are no state or national regulations for professional care managers per se. For this reason, anyone can use the title case or care manager. Membership in a professional organization and/or certification in care management are good indicators of appropriate background. The National Association of Professional Geriatric Care Managers recognizes the following designations for a “Certified Care Manager”: CMC, CCM, C-ASWCM and C-SWCM. Each of these requires testing and continuing education.Training Tools for Older Adult Healthcare Learners.

Geriatrics syndroms

Dementia, Delirium, Urinary Incontinence, Osteoporosis, Falls/ Gait Disorders, Decubitus Ulcers, Sleep Disorders, Failure to Thrive

Organ specific disease/syndrome

Ear, Eye, Cardiovascular, Musculoskeletal, Neurological, Communicable Diseases, Respiratory, Oral, Gastrointestinal, Endocrinological, Sexual Dysfunction and Gynecology, Hematology and Oncology, Kidney/Prostate, Skin Diseases

Geriatric psychiatry

Mood Disorders, Anxiety Disorders, Personality Disorders, Substance Related Disorders, Memory Disorders (non-dementia)

Patient care

Geriatric Assessment, Hospitalization, Emergency Medical Services, Surgical Procedures, Long-Term Care, Preventive Health Services, Rehabilitation, Pain Management/ Palliative Care

Aging

Age Distribution/Demography, Basic Sciences, Pharmacology/ Polypharmacy

Patient care of the elderly

Tips for working with the eldery patient

Take time to edudcate the patient and his or her family. Speak lower and closer treat the patient with dignity and respect.Give the patient time to rest between projections and procedures. Avoid adhesive tape: elderly skin thin and fragile. Provide arm blankets in cold examination rooms. Training Tools for Older Adult Healthcare Learners. Use table pads and hand nails. Always access the patient’s medical history before contrast media is administered.

Patient and family education

Educating all patient, especially the elderly ones, about imaging procedures is crucial to obtain their confindence abd compliance. More time with elderly patient may be necessary to accommodate their decreased ability is rapidly process information. The majority of elderly have been diagnosed with at least one chronic illness.They typically arrive at the clinical imaging environment with the natural anxiety because they are like to have lilttle knowledge of the procedure or highly technical modalities employed for their procedure. Moreover, a fear concerning consequences resulting from the examination exacerbates their increased level of anxiety. Taking time to educate patient and their family or signification caregivers in their support system about the procedures makes of a less stressfull experiences and improved patient compliances and satisfaction.

Communication

Good communication and listening skills create a connection between the radiographer and his or her patient. Older people are unique and should be treated with dignity and respects. Each elderly person is a wealth of cultural and historical knowledge that is turn becomes a learning experiences for the radiographer. If it is a evident that the patient cannot hear or understand the verbal directions. Training Tools for Older Adult Healthcare Learners. It is appropriate to speak lower and closer. Background noise can be disrupting to an older person and should be eliminated of possible when giving precise instructions. Giving instruction individual gives the elder person time to process a request. An empathetic, warm attitude and approach to the geriatric patient will result in a trusting and compliant patient.

Transportation and lifting

Balance and coordination of the elderly patient can be affected by normal aging changes. Their anxiety about falling can be diminished by assistance in out of a wheelchair and to and from the examination table. Many elderly patient have decreased height perception resulting from some degree of vision impairment. Hesitition of the elderly person may be due to previous falls. Assiting an older patient when there is need to step up or down throughout the procedure is more than a reassuring gesture. Preventing opportunities for falls is a necessity for the radiographer. The elderly patient will often experiences vertigo and dizziness when going from a recumbent postion to a sitting position. Giving the patient time to test between position will mitigate these disturbing, frightening, and uncomfortable sensations. The use of table handgrips and proper assistance from the radiographer creates a sense of security for the elderly patient. A sense of security will result in a compliant and trusting patient throughtout the imaging procedure. Training Tools for Older Adult Healthcare Learners.

Skin care

Acute age-related changes in the skin will cause it to become thin and fragile.The skin becomes more susceptible to bruising, tears, abrasion, and blisters. All health care professional should use caution in turning and holding the elderly patient.Excessive pressure on the skin will cause it to break and tear .Adhesive tape should be avoided because it can be irritating and can easily tear the skin of an older person. The loss of fat and makes it painfull for the elder patient to lie in a hard surface and can increase the possibility developing ulceration. Decubitus ulcers, or pressure sores, are commonly seen in bedridden people or those will decreased mobality.Bony areas such as the heels, angkle, elbow and the lateral hips are frequent side for pressure sores. A decubitus ulcer can develop in 1 to 2 hours. Almost with out exception, table use for imaging procedures are hard surface and cannot be avoided.However the use of table pad can reduce the friction between the hard surface of the table and the patient fragile skin.Training Tools for Older Adult Healthcare Learners. Sponges,Blankets and the positioning aids will make the procedures much more bearable and comfortable for the elderly patient.Because skin plays a critiscal role in maintaining body temperature, the increasingly thinning process associated with aging skin renders the patient less able to retain normal body heat. Thus the regulation of body temperature of the elderly person varies from that to a younger person. To prevent hypotamia in room where the ambient ier temperature is comfortable for the radiographer, it may be essential to provide blankets for the elderly patient.

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Contrast administration

Because of age related changes in kidney and liver function, only the amount, the type of contrast media is varied when performing radiographic procedures on the elderly patient. The number of functioning nephrons in the kidneys steadily decreases from middle the throughout the life span. Compromised kidney function contributes to the elderly patient being more prone to electrolcyte and fluid imbalance. This can create life-threatening consequences. They are also more suspectible to the effect of dehydration because of diabetes and decreased renal or adrenal function. The decision if type and amount of contrat media used for the geriatric patient usually follow some sprt of routine protocol. Assessment for contrast agent administration accomplished by the imaging technologist must include

age and history of liver, kidney or thyroid disease;

history of hypersensitivity reactions and previous reaction to medications or contrast agent ;

sensitivity to asprin;

over the-counter and prescription drug history including acetotaminophen (Tylenol);

and history of hypertension.

The imaging technologist must be selective in locating an appropriate vein for contrast administration on the elderly patient. They should consider the location and condition of the vein, decrease intergrity of the skin, and the duration of the theraphy.Thin superficial veins, repeatedly used veins,and veins located area where the skin is bruised or scarred should be avoided. Assess the patient for any swallowing impairments, which could lead to difficulties with drinking liquid contrast agents. The patient should be instructed to drink slowly to avoid choking, and an upright position will help prevent aspiration. Training Tools for Older Adult Healthcare Learners.