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Celebrating Ten Years of Improving Health Care for Older Adults
Making Best Geriatric Practice
Standard Practice

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Strategy No. 2: Promoting Work Environment Changes

Use of Geriatric Resource Nurses

The Hartford Institute has found that hospitals—NICHE sites as well as other institutions—are enthusiastic about the geriatric resource nurse model, which at its core is based on the observation that of all the health team members, nurses know the most about the older patients on their units. Under the program, nurses interested in geriatric health issues are recruited and given specialized education and training in the care of older adults. After training, the nurse serves as a resource for geriatric best practices to other nurses. Using this model, many of the problems encountered in care of geriatric patients can be handled on the unit by staff nurses.

The number of resource nurses in a participating hospital can range from 2 to 100. They are educated about the range of geriatric syndromes and issues, including fall prevention, reduction of restraint use, pain management, appropriate use of medication, wound care, dementia care, and addressing patient and family concerns such as advance directives. Initial trainings are augmented with ongoing education to deepen their knowledge, empowering them to become role models for their colleagues. In some hospitals, the responsibility of the resource nurse is informal—colleagues know which of their peers they can approach for an opinion on care for an older patient. In other hospitals, the resource nurses play a more formal role, providing educational programs and conducting quality improvement activities.

"In hospitals that use the Geriatric Resource Nurse model, the geriatrician knows that a nurse with competence in geriatric issues has addressed the problem," says Dr. Mezey. "As a result, it allows the interdisciplinary team to focus on the most complex patients and it is empowering for nurses." Visit the Hartford Institute for Geriatric Nursing Web site: www.hartfordign.org