Identifying Fall Prevention Content in Graduate Healthcare Curricula.

ISSUE: An interprofessional team-based approach to fall prevention is advocated to address the public health issue of fall-related injuries. The purpose of this study was to analyze fall-related curricular content across graduate physician assistant, nursing, occupational therapy, and physical therapy healthcare programs. METHODS: The research team conducted a qualitative thematic analysis of fall risk, assessment, and intervention content in graduate program textbooks, curricular narrative, and course objectives. OUTCOME: The four curricular themes identified were universal fall risks, varied assessments, discipline-based interventions, and minimal interprofessional approaches. All curricula universally covered fall risks. Curricular coverage of fall assessment varied by discipline. The physician assistant and nursing curricula focused on assessing fall risk and safety, while the occupational and physical therapy covered standardized functional assessments. The disciplines of physical and occupational therapy provided curricular instruction in restorative or compensatory interventions. All curricula included the interventions of patient and caregiver education and environmental modifications. Curricular coverage of an interprofessional approach to fall prevention was minimal. CONCLUSION: This study identified universal fall risks, varied fall assessments, and discipline-based fall interventions across four graduate healthcare curricula. There was minimal evidence of education in an interprofessional approach to fall prevention.

Improving Resident Oral Health and Adherence to a Ventilator-Associated Pneumonia Bundle in a Skilled Nursing Facility.

Ventilator-associated pneumonia (VAP) is common with mechanical ventilation. VAP bundles have improved outcomes in acute care and long-term acute care hospitals. This article reports on an implementation of a VAP bundle designed for a skilled nursing facility (SNF). The primary goal was to improve oral health, a significant factor for VAP, and improve SNF nurse adherence to the bundle. Improvements in oral health and adherence were demonstrated. Nurses had difficulty with adhering to maintaining the tracheostomy cuff seal.

Improving resident outcomes with GAPN organization level interventions.

This research tested the effectiveness of the second tier of interventions in a two-tiered nursing intervention model designed to improve quality of care for residents in long-term care facilities (LTCFs). The first tier of the model called for gerontological advanced practice nurses (GAPNs) to provide direct care and to teach staff to implement care protocols for residents with incontinence, pressure ulcers, depression, and aggression. Results of the first-tier study indicated significant improvement in resident outcomes in incontinence, pressure ulcers, and aggression. In the second tier, GAPNs added a set of organization-level (OL) interventions including membership on the LTCF quality assurance committee and collaborating with staff on problem-solving teams. Analysis following the addition of OL interventions revealed significant improvement in both depression scores and in the trajectory of depression in residents of the LTCF where OL interventions were used.