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V O L U M E2 ,I S S U E1F E B R U A R Y1 0 ,2 0 1 2AgeWISEPilot SitesAgeWISE Encourages Reflec ve Prac ce2010‐2012Nebraska MethodistHospital, Omaha, NENYU Langone MedicalCenter, New York, NYSt. Joseph’s RegionalMedical Center,Paterson, NJSanford USD MedicalCenter, Sioux Falls, SDUH Case Medical Center,Cleveland, OHURMC Strong MemorialHospital, Rochester, NY2011—2013Abington MemorialHospital, Abington, PAPassengers embarking a flight at Joe Foss Field Airport, Sioux Falls, SD. Photo by Susan Lee.Beaumont Hospital ‐Royal Oak, Royal Oak, MIDear Colleagues:Dartmouth‐HitchcockMedical Center,Lebanon, NHNurses everywhere are busy,constantly adjus ng to new rulesand regula ons, new knowledgefor prac ce, and changing policiesand procedures. It would seemthat nurses have li le me forreflec on and apprecia veinquiry that bring personal andprofessional fulfillment but that isjust what AgeWISE is helping toaccomplish in Sioux Falls, SouthDakota.Northwest CommunityHospital,Arlington Heights, ILOSF Saint Francis MedicalCenter, Peoria, ILRoswell Park CancerIns tute, Buffalo, NYMy recent trip to Sanford MedicalCenter was a reunion withtreasured AgeWISE colleagueswho are making me toimplement their AgeWISElearning into prac ce. I spent aday with the AgeWISE residentswhose personal and clinicalstories affirmed that AgeWISEis providing an important“ me out” to reflect on themeaning of their work and todeepen their commitment tohumankind. Nurses who arecaring for their own aging lovedones are also learning to bespecial advocates for them withtheir new knowledge from beingAgeWISE.Page 1Thanks to the Sanford AgeWISETeam and all of the residentsfor sharing their stories withme. Reflec ve prac ce is whatwill protect us all from “theelements” that we all face.These nurses taught me aboutthe joy they have found in ourgreat profession. Look inside toread about their amazingaccomplishments.Susan Lee, PhD, RNAgeWISE Program Director

AgeWISE AdvisorsIra Byock, MD, Director, Pallia veMedicine, Dartmouth HitchcockMedical Center, Lebanon, NHBrenda Cleary, PhD, RN, FAAN,Ageing Ini a ves Administrator,Sigma Theta Tau Interna onal,Indianapolis, INConstance Dahlin, MSN, ANP‐BC,FAAN, MGH Cancer Center,Boston, MAKaren Drenkard, PhD, RN, NEA‐BC,FAAN, Execu ve Director, AmericanNurses Creden aling Center,Silver Spring, MDTerry Fulmer, PhD, RN, FAAN,Dean, Bouve College of HealthSciences, Northeastern University,Boston, MAJennie Chin Hansen, MS, RN, FAAN,CEO, The American GeriatricSociety, New York, NYKaren Hill, DNP, FACHE, Editor ofJournal of Nursing Administra onand VP, Central Bap st Hospital,Lexington, KYDorothy A. Jones, EdD, RNC, FAAN,Professor, Boston College ConnellSchool of Nursing; Director, TheYvonne L. Munn Center for NursingResearch, MGH, Boston, MAClareen Wiencek, PhD, RN, NP,Nurse Director, VirginiaCommonwealth University,Richmond, VA“You’re Looking at Me Like I Live Hereand I Don’t”An AgeWISE Must See!March 29, 2012 ‐ Check Your Local Lis ngsNa onal Broadcast Premiere!You're Looking At Me Like I Live Here And I Don't is theinvigora ng first‐person documentary account of Lee Gorewitz's lifeinside the Tradi ons Alzheimer's & Other Demen a Care Unit at theReutlinger Community for Jewish Living in Danville, California.A total immersion into the fragmented day‐to‐day experience of thedisease, the film reveals Lee's penetra ng rumina ons and charisma cvitality, challenging our preconcep ons of illness and aging."You're Looking At Me Like I Live Here And I Don't is the firstdocumentary to truly present the perspec ve of a person withdemen a. It is a great contribu on to the understanding ofAlzheimer’s disease and a respec ul portrait of those who areafflicted."Addi onal informa on regarding the movie, including video trailers,can be found at the show’s website:h at‐me/Angelo Volandes, MD, AssistantProfessor, HMS, and A ending,Massachuse s General Hospital,Boston, MAPage 2

AgeWISE NewsAs men oned in the February 9th telecon‐ference, Sigma Theta Tau Nursing HonorSociety has excellent, some free, con nuingeduca on and resources available.Please refer to their website for direct links,addi onal informa on and other resources:h d 92&channelid 4&ContentID 94843FREE! Providing ExcellentPallia ve CareThe purpose of this course is todemonstrate how effec ve communica onwith a health care team provides desiredquality of life and allows one to prepare fora peaceful death.Dr. Marilyn Valerio, Dean of the School of Nursing, Nebraska Methodist College; Terri Tipton,MS, RN, CNO and Senior Vice President, Nebraska Methodist Hospital; Dr. Fran Henton,Professor, Nebraska Methodist College preside at AgeWISE Gradua on on Feb 3, 2012,which happened to coincide with “Wear Red Day” for Women’s Heart Health Month.Nebraska MethodistHospital graduates itssecond group of AgeWISEnurse residents onFebruary 3rd, 2012:FREE! Role Strain and Ease inDecision‐Making to Withdrawor Withhold Life Support forElderly Rela vesThe goal of this module is to provide nurseswith informa on about how to reduce rolestrain and facilitate decision‐making towithdraw or withhold life support forelderly rela ves.FREE! Clinical Prac ce Guidelines for theAssessment and Preven on ofFalls in Older PeopleThe goal of this module is to ensureconsistency of care through the implemen‐ta on of evidence‐based guidelines for theassessment and preven on of falls inolder people.Alicia Abboud, RNRobyn Michal, RNBecky Bischof, RNKari Perry, RNAmy Brasel, RNKari Roehr, RNHolly Christensen,RNHeather Rolling,RNBud Erickson, RNMaria Sadoval, RNDianne Fuhs, RNLinda Sedlacek, RNRose Gilsdorf, RNJamie Veneil, RNTerry Meidlinger,RNAshleyWrobleswski, RNRecent Cer fica onsDonna Boyd, CHPNNorthwwest Community HospitalPeggy Dyer, RN‐BCNebraska Methodist HospitalCatherine White‐Barber, RN‐BCURMC Strong Memorial HospitalPlease submit the names of AgeWISE par cipants who haveachieved cer fica on.Page 3

AgeWISE Innova on: “Just Move”Sanford Medical Center AgeWISE residents on 3000, acardiology unit at Sanford MedicalCenter, have found a way topromote early mobiliza on throughthe “Just Move” program. They set a goal that every pa entwho was able would ambulate in thehalls three to four mes a day. They marked the distance betweenphotographs located on the walls of the hallway to set goals and measurepa ents’ progress.Nurses might say, “Let’s walk to theFalls this me.” They chart the mesand distances in the electronicmedical record.Jana Niles, RN made the poster,“Why Walk,” to remind colleaguesabout the hazards of immobility andthe benefits of early mobiliza on.She and other AgeWISE residents arethe champions behind this program.They have about 50% adherence tothis new program, slowly increasingall the me.Page 4 As with any innova on, it takes me ‐but they are persistent in theirmessage. Early mobiliza on is one AgeWISEinnova on that is sure to impactlength of stay and 30‐dayreadmission rate. Congratula onsto Jana and all of the nurses on 3000.We are so proud of you!

AgeWISE Innova on: AgeWISE Care RoundsSanford Medical Center AgeWISE residents on 6000, anoncology/medical unit at SanfordMedical Center, have iden fiedAgeWISE Care Rounds as theirprocess improvement project. Cyne e Wipf, RN, Senior AgeWISE Nurse and her colleagues have donean outstanding job of leading thisproject, which can be seen as difficultto implement. The oncology pa ent popula on is achallenging group when it comes tofalls preven on— people o en donot see themselves at high risk forfalls and do overes mate theirphysical abili es and stamina.rounding. They have essen allystopped all falls caused whenpa ents try to get out of bedunassisted and they have an easy fixfor those falls that did occur. The group has tracked thepercentage of adherence to thisinterven on; it is currently over 85%!What is really amazing is what nurses have learned about falls andThis is wonderful new evidence aboutrounds. They do work. They do helppa ents. Congratula ons to Cyne eand all the nurses on 6000.Keep up the wonderful work!Sanford Medical Center AgeWISE Site Team (L to R): Fran Henton, PhD, RN, Site Researcher, Augustana College;Robin Randall, RN, Nurse Manager; Jana Niles, RN, Senior AgeWISE Nurse; Cyne e Wipf, RN, Senior AgeWISE Nurse;Gwen Jensen, PhD, RN, Site Director, and Arlene Horner, RN, GCNS‐BC, Site Coordinator.Page 5

AgeWISE Innova on: Falls Tracking PosterNebraska Methodist Hospital Unit‐based Staff Educator, AmyBrasel, BSN, RN of NebraskaMethodist Hospital has imagina ve ways of keeping nursing staff abreastof pa ent falls.As pictured below, Amy begins withthe NDNQI benchmark and then setsa goal to beat that number (in thiscase 31). She then posted31 monkeys in the tree.Every me a pa ent falls, Amy movesthe monkey under the tree andbriefly describes the situa on of each fall, what was done well, and whatcan be improved. These cute li lemonkeys are ashappy as can be,At any given me, nurses can seewhere the unit stands in falls andwhy each fall occurred. when they stay on thebranches up high in this tree.Nebraska Methodist Hospital has avery successful falls preven onprogram using LEAF: Let’s End AllFalls. a fallen li le monkey, too, will befound.This visual is a novel reminder aswell as a learning opportunity foreveryone on the unit. But if one of our pa ents falls to theground, If at least one monkey remains by theme the year ends, a party is due for my Progressive Carefriends!Please assure you are doing all that youcan, to keep our pa ents, and monkeys,safe to the end!Amy Brasel, BSN, RN and her imagina ve way of keeping everyone informed of their units’ falls. Bravo!Page 6

AgeWISE Innova on: Personalized Care ToolNebraska Methodist Hospital Nurses in AgeWISE cohorts one andtwo, created and piloted the“Personalized Care Tool,” as part of their performance improvement ini ‐a ve.This is a two‐sided, single page formthat families complete to assist nurs‐ing staff in be er knowing pa entswith confusion caused be demen aor delirium.The Personalized Care Tool is affixedto the white board but is not part ofthe pa ent’s record. Pa ent drinks these liquids best Tips for taking pills Pa ent eats these foods best Pa ent is able to say what he/sheneeds or wants (pain, thirst, bath‐room)Pa ent eats best when: Helped with tray Shown how to use spoon/fork Reminded to chew/swallow Given small por onsSusan adds: The tool is an expansion ofinforma on commonly presented on“Get to Know Me Posters”, askingspecific ques ons about the olderperson’s habits and preferences prior to the current illness.Examples include:What gives comfort when person isupset Two AgeWISE competencies are alsodirected related: The AgeWISE nurse assesses caringneeds; The AgeWISE nurse co‐createswith the pa ent/family a plan forcomprehensive caring and healingthat intersects with and iscoordinated with the medicalplan of care.This “Personalized Care Tool” isaligned with Watson’sCaritas Process 8: Crea ng a healingenvironment at all levels wherebywholeness, beauty, comfort, dignity,and peace are poten ated.The tool is also aligned with CaritasProcess 6: Crea ve use of self and allways of knowing/being/doing as partof the caring process (engaging inar stry of caring‐healing prac ces)because nurses then use thispersonal knowledge of the pa ent tomeet the pa ent’s unique needs andpreferences.Nebraska MethodistHospital AgeWISE Nursesand Faculty from Cohort 2.Names listed on page 3.Page 7Did you know that a singing bowl precedesa centering exercise that occurs before everymee ng at Sanford Medical Center?Very zen in Sioux Falls.

AgeWISE Innova on: Spiritual CareRev. Dan Johnston, Nebraska Methodist Hospital, wrote the prayer (below) which can be found on the reverse side oftheir FICA Spiritual Assessment cards. AgeWISE nurses in Nebraska and other sites are paying more a en on to thespiritual needs of pa ents and families.Page 8