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