Mary Elaine Koren

Management of Relocation in Cognitively Intact Older Adults.

Relocation, a major life transition that can affect health positively and negatively, is moving from one permanent home to another. Many older adults will relocate at some time during their life. Relocation is also a complex process that requires careful consideration and planning before the move (i.e., pre-location) and adjustment to the new home after the move (i.e., post-relocation). The current article is a summary of content based on a comprehensive evidence-based practice guideline focused on management of relocation in cognitively intact older adults. The guideline was designed to be used across diverse settings by nurses and other providers. Pre-relocation guidelines include assessment for the need for relocation, interventions prior to moving, and outcomes for evaluation of the pre-relocation process. For post-relocation, content focuses on assessment of risks for not adjusting after the move as well as intervention guidelines to promote adjustment and outcomes for evaluation. Implications include advocacy for older adults by using the guideline, disseminating it, and conducting future research. [Journal of Gerontological Nursing, 42(11), 14-23.].

Interventions to improve patient appointments in an ambulatory care facility.

Failed patient appointments in ambulatory care may result in decreased revenues. The purpose of this study was to determine if patient reminders would affect the “no-show” rate of a medical ambulatory care setting. Patients of 10 physicians participated in a 6-week study. Patients were randomly assigned to one of three groups: 2 weeks of appointment reminder postcards, 2 weeks of appointment reminder phone calls, and 2 weeks of no intervention. Chi-square analysis revealed significant differences between the control group and the two groups receiving interventions. Patient reminders may be a mechanism to decrease the no-show rate in ambulatory care.

Is the Hospitalʼs Magnet Status Linked to HCAHPS Scores

This study identified a significant link between Magnet hospitals and higher HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores across 110 Illinois hospitals. Compared with registered nurse nursing hours per patient-day and registered nurse turnover rate, Magnet status was a stronger contributor to the HCAHPS scores. A moderate to strong, reverse relationship between hospitals percentage of African American patients and HCAHPS scores suggests a need for strengthening culturally sensitive nurse-patient communications.

Early identification of relocation risk in older adults with critical illness.

One aspect of an evidence-based practice (EBP) guideline on managing relocation in cognitively intact older adults is elaborated upon in this article. The older population is at particular risk for needing to relocate to a new permanent home following hospitalization for a critical illness, but planning for these moves is often done in crisis mode. The purpose of this article is to sensitize nurses to risks for relocation in critically ill older persons and to encourage application of the EBP guideline in practice. Recommendations for risk assessment are made including using existing and supplementary assessment methods and data. Implementing EBP guidelines such as this is one key element in providing quality care to critically ill older adults.

Creating a Culture of Evidence in Nursing Education Using Student Portfolios

There has been a growing interest in the use of portfolios to assess nursing student progress in areas such as critical thinking, problem solving, and communication. The data obtained from student portfolios can be used to improve undergraduate nursing curricula; however in order for change to occur, closing the assessment feedback loop is essential. The portfolio program of one Midwestern school of nursing has successfully used portfolio evidence to effect undergraduate curricular change. This portfolio program, under the direction of the school’s Portfolio Subcommittee, involves active participation by students, faculty and administration. Examples of curricular improvements based on portfolio findings included increasing rigor in course assignments, improving student self reflection, promoting students’ ability to write in the discipline, and maintaining writing assignments in larger classes.