help project planning tool in this section think about…. will you be able to do all of the help...
TRANSCRIPT
HELP Project Planning Tool
In this section think about…. Will you be able to do all of the HELP
interventions? Will you have to modify any of the original HELP
interventions?How will you go about recruiting, training and
retaining volunteers?What type of attributes will you look for in
volunteers?
Categories of HELP Interventions
Elder Life Specialist Protocols/Volunteer Interventions
Comprehensive Gerontological Assessment, Interventions and Protocols
Interdisciplinary Interventions
Elder Life Specialist Protocols Risk factor ELS Protocol
Cognitive Impairment Daily Visitor /Orientation/
Therapeutic
Activities
Sleep Deprivation Sleep Enhancement
Immobility Early Mobilization
Vision Impairment Vision
Hearing Impairment Hearing
Dehydration Meal Assistance/ Fluid Repletion
Sleep Enhancement Criteria- difficulty falling asleep or sleeps poorly at home or in
hospital Intervention
Avoid sleeping pills Instead:
Back rub (if not contraindicated) Warm blanket Warm drink such as herbal tea or warm milk Soft music
Early MobilizationCriteria- all patients assessed for
early mobilization
Intervention- ELS/CNS consults with
Physiotherapist to determine appropriate mobilization protocol:
Active range of motion exercises 3 times per day
Supervised walking 3 times per day according to PT guidelines
Healthy Eating/Fluid Repletion Criteria-appetite rated as poor Criteria-clinical evidence of Intervention- dehydration and
Assist with set-up of meals Urea X10/Creatinine> 0.7 Encourage food intake Intervention- Encourage fluids Ensure regular mouth care if not
contraindicated Assist with menu completion
Healthy Vision/Healthy Hearing Vision Criteria- if near vision in both eyes
<20/70 Intervention - Eyeglasses clean and on - Magnifying glass
Hearing Criteria-<3 whispers from each ear
on whisper testIntervention
-Hearing aids in and turned on-Consider use of hearing amplifier
Orientation/Daily Visitor/Therapeutic Activities Criteria- all patients are enrolled Intervention-Orient 1 time per day if MMSE >20, orient 3 times per day if MMSE <20 -Explore patient’s interests and possible therapeutic activities -Discuss current events, structured reminiscence, word games
(Inouye et al. N. Engl. J. Med. 1999, March 4 340 (9): 669-676)
In this section you will learn about…Elder Life Clinical Nurse Specialist’s (CNS)
practice roles in HELP
Nursing specific HELP protocols
HELP education strategies
Program operations
CNS’ Role in HELP Clinician; CNS as an expert clinician of older adults
population conducts focused assessments and interventions based risk factors and “geriatric vital signs”; emphasis is on prevention of delirium and functional decline; post-discharge follow up
Consultant; CNS as a consultant shares her knowledge with patients, families , nurses , unit manager, allied health and physicians
Educator ; CNS as a staff coach; a mentor; a resource for staff, patient and families
Leader; CNS as a change agent, role model, patient advocate, resource for staff, coordinator of provider education program and gerontological nursing in-services.
Researcher ; CNS participates in transfer of knowledge
HELP Nursing Protocols Targeted Risk Factor Approach using
protocols
Evaluation of Cognitive Status• Delirium Protocol • Dementia Protocol • Psychoactive Medications Protocol
Sleep Enhancement ProtocolEarly Mobilization Protocol
More Nursing Protocols… Hearing Protocol
Fluid Repletion Protocol
Discharge Planning Protocol
Optimizing Length of Stay Protocol
Additional Areas –
Education strategies employed at HHS…• On demand• Scheduled education sessions for staff and
students• Annual Seniors month education• HHS new staff orientation; yearly staff review
sessions• Orthopedic staff orientation• Seniors HHS Corporate initiative – environment,
culture and clinical processes• Gentle Persuasive Approaches , e-learning • RNAO fellowships (many!)
PROGRAM OPERATIONSRecord and maintain ELNS interventions
progress reports
Serve as a liaison between the program and nursing administration
Track and address quality assurance
Provide clinical and administrative support for ELS and volunteers
Recruitment Training and Retention
HELP Project Planning ToolIn this section think about….How will you go about recruiting volunteers What qualifications will you set for the
volunteer role?(age, personal attributes, previous experience, time commitment, police check, health clearance)
How will you go about training the volunteers?
What strategies will you use to help retain volunteers?
Recruitment Work closely with Volunteer Resources -provides volunteer recruitment, screening and
general training. They also identify hospital volunteers who seem suited to undertake the additional training to become a HELP volunteer.
While the program seeks volunteers of all backgrounds, it has become a sought-after experience for many college/ university students, especially those interested in the health care field.
Look for a mixture of different types of volunteers. If you only draw from the student population you will struggle with covering shift during student downtimes like exams
Volunteer Qualifications Reliable and caring; enjoy working with older people Mature in judgment Discreet, empathetic behavior and ability to exercise
diplomacy intalking to patients, patient’s family and staff. Ability to relate with sensitivity to all patients Ability to work independently and assume
responsibility Ability to refer questions to others as neededMinimum time commitment of 1 shift per week for 6
months
Training Training should be done a minimum of three times a year Volunteers attend 12 hours of classroom training which
includes An overview of the Volunteer Manual and HELP videosGuest speakers which include Physiotherapist to
demonstrate safe mobility with patients , Speech Language Pathologist to help instruct on meal assistance, a Recreation Therapist to provide training in Montessori based activities, and a member of the Alzheimer Society to provide an overview of dementia
12 hours of ward training which includes Includes a detailed tour of the environment-where to find
supplies and how to get informationShadowing a several different experienced volunteers
during their shifts
Retention Consistent and ongoing support
and mentorship from HELP staff Volunteer Recognition