How evidence Informs NP practice- Regina Lutheran Home Experience.

Leah Clement BSN RN

Director of Care/Leader for Elder Services

Maureen Klenk MHs (APN) RN(NP)

Nurse Practitioner

Eden Philosophy

Mission – to improve the well-being of Elders and those who care for them by transforming the communities in which they live and work

Vision – to eliminate the 3 plagues Loneliness, helplessness, boredom – bulk of suffering for

those living in LTC

Eden Care Philosophy Guided by 10 Principles

1. Human habitat

2. Loving relationships

3. Give and receive care

4. Loving companionship

5. Spontaneity

6. Meaningful activity

7. Medicine the servant not the master

8. Elder centered care – autonomy in decision making

9. Human growth

10.Wise leadership

How to build an Eden Care LTC facility?

Dream a Dream

Create the Vision

• A HOME in which all Elders have an opportunity to have timely access to a primary care provider

• Elders have the best possible opportunity for a healthy quality of life so they can grow and flourish

• Add an RN(NP) to the staffing complement as a ‘best fit’.

• RN(NP)s are evidenced based providers with a holistic philosophy of care.

Implementing RN NP in LTC

Steps in the Process:

• Plant the seeds with physicians, nursing team, pharmacist, others

• Advertise & Recruit

• Plant more seeds and warm the soil

• Hire

• Muddle through………..

Nurse Practitioners in Long-Term Care Facilities: Clinical and Cost-Effectiveness and Guidelines – CADTH (2012)

RESEARCH QUESTIONS

1. What is the clinical effectiveness of having nurse practitioners in long-term care facilities? .

2. What is the cost effectiveness of having nurse practitioners in long-term care facilities?

3. What are the evidence-based guidelines for having nurse practitioners in long-term care facilities?

Nurse Practitioners in Long-Term Care Facilities: Clinical and Cost-Effectiveness and Guidelines – CADTH (2012)

KEY MESSAGE

The evidence identified suggests that the implementation of nurse practitioners in long-term care facilities may result in an increase in family satisfaction and improved health services.

NP care improves Elder Care

Present –Monday to Friday

Able to observe Elders first hand.

Raises the ‘bar’ for assessment and learning for all staff.

Lowers the cost to the system, the facility and the elder.

NP utilize evidence to improve outcomes

Reduce adverse events by reducing pill burden

Reduce antibiotic resistance by decreasing the use of antibiotics – less UTI

Reduce fall rates-decrease use of antipsychotic and BEERS list medications

Reduce levels of pain- provide consistent analgesia

Still to work toward

Improve Incontinence by increasing fluid intake

Improve mental status by improving sleep- do elders need q2h turning?

“Younger’ Elders are coming under how care- how can we improve the social need for this age group.

Outcomes

Falls

Antipsychotic use

Pain control

Pressure ulcers

Elders with 8 prescriptive medications or less

Less visits to ER/Hospital admissions

Survey results-

Elder

Family

Care Team

Physicians

Implementing RN NP in LTC

Final Thoughts:

• PERSERVERE!!!! • Innovation is hard!• “How will this contribute to the quality

of life to Elders I serve?”

Thank you!

Questions?

Contact Information:

Leah Clement

Maureen Klenk