Nursing Research Spotlight

Geriatric Care at Penn State Hershey Medical Center

The January-March 2008 issue of Critical Care Nursing Quarterly focuses on the challenges of geriatric care in acute tertiary hospital settings. Featured are several complex issues that are being addressed at Penn State Hershey Medical Center. In their article, Mary Lou Kanaskie and Carol Tringali present the complexities of nursing care of elderly cancer patients. They describe the importance that nursing care has to quality of life for elderly patients treated at the Penn State Cancer Institute. Jennifer Humbert and her colleagues Kendra Gallagher, Dr. Robert Gabbay, and Cheryl Dellasega describe how nurses are making a difference in care outcomes for critically ill elderly diabetic patients.  Vicky Schirm and colleagues provide evidence for use of a tool to initiate conversations and discern preferences for care at end of life. A multifaceted approach to falls reduction in acute care is presented by Tammy Murphy, Paula Labonte, and Larry Houser. This article highlights the TEACH (Transitioning Elders Across the Continuum of Healthcare) program and stresses the importance of nurse involvement in the sustainability of falls prevention and reduction programs. Dr. Noel Ballentine in his article notes that active involvement by care providers at all levels is paramount to understanding appropriate medication use by elderly patients. In separate but related articles, Deb Himes and Mary Merriman show how PSHMC is dealing with the complexities associated with hospital discharge of elderly patients. They describe the components that are needed to ensure safe and cost effective care to elderly patients after acute hospital care is no longer appropriate. The article by Susan Heffner and Sally Rudy points out that knowledge and skill development in critical thinking helps nurses provide age-appropriate care to hospitalized elders and their families. Erin Sarsfield also describes the continuous improvement process as another nursing skill that is used to enhance care of older patients in critical care environments.

As these authors show, the care of increasing numbers of elders who are patients in critical care creates challenges within a complex health system. In the hospital environment the focus is on technical care and cure, and disease and symptom management in elders are often complicated by multiple comorbidities. These factors make them more vulnerable to risks, such as polypharmacy, transitional stresses, and adverse events like falls. For more information and to view the Table of Contents see: Critical Care Nursing Quarterly.