Nurses from hundreds of U.S. and Canadian hospitals will be among the healthcare providers attending the annual NICHE conference April 6-8 in San Diego.
The aim of the conference is to explore innovative solutions and approaches for improving the care of older adults.
Eileen Sullivan-Marx, RN, PhD, FAAN, dean of the NYU College of Nursing in New York City, is among three keynote speakers addressing this years theme: Care. Collaborate. Change. Conference highlights include panel presentations during which clinicians, administrators and researchers will present evidence-based approaches to promote positive outcomes and experiences for hospitalized older adults. There will be more than 100 poster presentations on topics such as palliative and end-of-life care, pain and pain management, care transitions and chronic and acute illness.
Filling key care gaps
NICHE keynote speaker Diane E. Meier, MD, FACP, director, Center to Advance Palliative Care, Icahn School of Medicine at Mount Sinai, New York City, said geriatric care in the U.S. health system is in disarray, with insurance not covering many of the services adults need most. Nurses and other healthcare professionals cant help older hospitalized adults achieve health goals that matter most to these patients without services such as family support, practical and social support, spiritual and emotional support and time for communication about patients concerns and goals.
Nurses probably experience the greatest amount of moral distress by being forced to deliver care to vulnerable older adults in a system that is not designed to attend to their needs, Meier said.
This is why the NICHE program is so important, she said. It actually says to frontline nurses trying to care for very vulnerable, fragile older adult populations in hospitals: There are skills that you can acquire that on an evidence-based level will make a difference in how your patients get through hospitalizations.
The NICHE program is an empowerment program for nurses who are the frontline deliverers of critical care to older adults in hospitals, Meier added.
In her keynote address, Meier will deliver the message that palliative care principles and practices are a crucial component of geriatric nursing and geriatric medicine. Palliative care focuses on what matters most to older patients and their families, she said.
What palliative care brings to nurses, doctors and others is training in communication skills and training in the identification and safe management of distressing symptoms, like pain, shortness of breath, agitation, fatigue or constipation, Meier said. These symptoms are virtually universal in some combination or another in older adults and are a major driver of emergency department visits and hospital admissions.
Just as there is no training for nurses and doctors in geriatrics in school, there is no training in the principles and practices of palliative care for nurses and doctors, she added. We have a lot of mid-career training and improvement to do in the connected fields of geriatrics and palliative care.
Beyond the bedside
Sullivan-Marx sees an expanding role for nurses in their care of older adults.
Now is the time for us to look at care of the elders from both an individualized, or patient-centered, approach and a population approach, she said. There are now challenges ahead for us with the growing aging population and the sheer numbers of people who will need care for chronic illness and functional impairment. In order to address those needs, we need to apply principles of population health.
Areas to address include prevention, improvement of priority outcomes for older adults and ways in which nurses can inform policymakers about how to fund or better meet the needs of the elderly population.
Nurses need to embrace working as a team with direct-care workers such as nurses aides, nursing assistants and personal care assistants, Sullivan-Marx said, especially because direct-care workers are becoming more integral in the care of older adults who want to age at home.
We havent found a way in our professional world to completely, seamlessly include the people who are doing direct-care work, she said. I think we can do a lot more as nurses to make sure that there is a well-developed seamless way of working together.
For nurses, caring for older adults is a professional and personal issue, Sullivan-Marx said. I cant go anywhere where someones not saying, What are we going to do when were 90?
Along with Meier and Sullivan-Marx, Sister Carol Keehan, DC, president and CEO of the Catholic Health Association of the United States, will be a keynote speaker at the conference. She is responsible for all association operations and leads CHA’s staff. She has worked in administrative and governance positions at hospitals sponsored by the Daughters of Charity for more than 35 years
For more about the NICHE conference or to register: http://conference2014.nicheprogram.org