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NGR 6255, Section 7717 COURSE SYLLABUS PAGE 1 UNIVERSITY OF FLORIDA COLLEGE OF NURSING COURSE SYLLABUS SUMMER 2014

COURSE NUMBER NGR 6255 - Section 7717

COURSE TITLE Advanced Nursing Care of the Older Adult

CREDITS 2

PLACEMENT Required Course in Adult-Gerontology Primary Care Nurse Practitioner Elective Course for all other Tracks

PREREQUISITES NGR 6241 Common Adult Health Problems NGR 6241L Common Adult Health Problems: Clinical NGR 6172 Pharmacotherapeutics for Advanced Practice Nursing or Permission of the Instructor

CO-REQUISITES NGR 6244 Complex Adult-Gerontology Health Problems NGR 6244L Adult-Gerontology Primary Care Nurse Practitioner Clinical 2

FACULTY Toni L. Glover, PhD, GNP-BC, FNP-BC, CPE [email protected] HPNP 3229, (352) 273-6334 office, (352) 494-7215 cell Office hours: by appointment

DEPARTMENT CHAIR Joyce K. Stechmiller, PhD, ACNP-BC, FAAN [email protected] HPNP 3230, (352) 273-6370 office Office hours: by appointment

JACKSONVILLE CAMPUS DIRECTOR

Andrea Gregg, DSN, RN [email protected] (904) 244-5172 Office hours: by appointment

NGR 6255, Section 7717 – Summer 2014 – Course Website COURSE DESCRIPTION This course provides the student with knowledge to care for the health care problems that result from normal and pathologic aging. The emphasis will be on gaining the knowledge necessary to prevent, diagnose and manage both acute and chronic age-related health problems. The focus is on management of older adults from diverse backgrounds with health problems that are caused or exacerbated by the processes of normal and pathologic aging in the primary care setting.

COURSE OBJECTIVES Upon completion of this course, the student will be able to:

1. Integrate knowledge from health, psychological, and social sciences in the clinical reasoning process and advanced nursing management of older adults with health problems related to normal or pathologic aging.

2. Develop diagnostic plans based on holistic health assessment data for older adults with health problems related to normal or pathologic aging.

3. Utilize critical thinking and current research to develop management plans for disease prevention and treatment of older adults with health problems related to normal or pathologic aging.

4. Formulate strategies to evaluate the effectiveness of health promotion, disease prevention, and management plans in older adults with health problems related to normal or pathologic aging.

COURSE SCHEDULE E-Learning in Sakai is the course management system that you will use for this course. E-Learning in Sakai is accessed by using your Gatorlink account name and password at http://lss.at.ufl.edu. There are several tutorials and student help links on the E-Learning login site. If you have technical questions call the UF Computer Help Desk at 352-392-HELP or send email to [email protected].

It is important that you regularly check your Gatorlink account email for College and University wide information and the course E-Learning site for announcements and notifications.

ATTENDANCE Students are expected to be present for all classes, other learning experiences and examinations. Students who have extraordinary circumstances preventing attendance should explain these circumstances to the course instructor prior to the scheduled class as soon as possible. Instructors will make an effort to accommodate reasonable requests. A grade penalty may be assigned for late assignments or make-up exams.

ACCOMMODATIONS DUE TO DISABILITY Each semester, students are responsible for requesting a memorandum from the Disability Resource Center (http://www.dso.ufl.edu/index.php/drc/) to notify faculty of their requested individual accommodations. This should be done at the start of the semester.

COUNSELING AND MENTAL HEALTH SERVICES Students may occasionally have personal issues that arise on the course of pursuing higher education or that may interfere with their academic performance. If you find yourself facing NGR 6255, Section 7717 – Summer 2014 – Course Website problems affecting your coursework, you are encouraged to talk with an instructor and to seek confidential assistance at the University of Florida Counseling and Wellness Center, 352-392-1575, visit their web site for more information: http://www.counseling.ufl.edu/cwc/.

STUDENT HANDBOOK Students are to refer to the College of Nursing Student Handbook for information about College of Nursing policies, honor code, and professional behavior. http://nursing.ufl.edu/students/student- policies-and-handbooks

ACADEMIC HONESTY The University of Florida Student Conduct and Honor Code may be found at http://www.dso.ufl.edu/index.php/sccr/process/student-conduct-honor-code/

TOPICAL OUTLINE 1. Theories of aging (physiologic, psychological, social)

2. Aspects of assessment, diagnostic testing, and pharmacology unique to the older adult.

3. Prevention, diagnosis, and management of common health problems of normal and pathologic aging. A. Cognitive impairment B. Genito-urinary alterations C. Musculoskeletal problems D. Mental health alterations E. Symptom management i. Pain ii. Fatigue iii. Altered sleep iv. Inadequate nutrition F. Sensori-neuro problems G. End-of-life issues

TEACHING METHODS Lecture, collaborative discussion, case studies, quizzes, and audiovisuals.

LEARNING ACTIVITIES Reading, online discussions, article reviews, reflection paper, and quizzes.

EVALUATION METHODS/COURSE GRADE CALCULATION Each student is expected to (1) comprehensively read and critically analyze materials assigned for each class topic, (2) actively participate in weekly discussions of class topics, and (3) successfully complete all assignments. Evaluation will be based on the achievement of these criteria. The elements that contribute to the final course grade and their relative weights are as follows:

NGR 6255, Section 7717 – Summer 2014 – Course Website Assignment % of Final Grade Pain Knowledge Test (pre-test) 5% Quiz, Weeks 1-4 15% Article Review 15% Quiz, Weeks 5-8 15% Reflection Paper 15% Pain Knowledge Test (post-test) 5% Discussion Board Participation 30% 100%

GRADING SCALE/QUALITY POINTS A 95-100 (4.0) C 74-79* (2.0) A- 93-94 (3.67) C- 72-73 (1.67) B+ 91-92 (3.33) D+ 70-71 (1.33) B 84-90 (3.0) D 64-69 (1.0) B- 82-83 (2.67) D- 62-63 (0.67) C+ 80-81 (2.33) E 61 or below (0.0) * 74 is the minimal passing grade

For more information on grades and grading policies, please refer to University’s grading policies: http://gradcatalog.ufl.edu/content.php?catoid=4&navoid=907#grades

MAKE UP POLICY Instructors will make an effort to accommodate reasonable requests regarding due dates of assignments.

FACULTY EVALUATION Students are expected to provide feedback on the quality of instruction in this course based on ten criteria. These evaluations are conducted online at https://evaluations.ufl.edu. Evaluations are typically open during the last two or three weeks of the semester, but students will be given specific times when they are open. Summary results of these assessments are available to students at https://evaluations.ufl.edu.

REQUIRED TEXTBOOKS Ham, R.J., Sloane, P.D., Warshaw, G.A., Potter, J.F., and Flaherty, E. (2014) Ham’s Primary care geriatrics: A case-based approach (6th ed). Philadelphia, PA: Elsevier Saunders.

RECOMMENDED TEXTBOOKS Boltz, M., Capezuti, E., Fulmer, T., Zwicker, D. (2012). Evidence-based geriatric nursing protocols for best practice. New York, NY: Springer Publishing Company.

And All texts required for: . NGR 6002C Advanced Health Assessment and Diagnostic Reasoning . NGR 6636 Health Promotion and Role Development in Advanced Practice Nursing . NGR 6140 Physiology and Pathophysiology for Advanced Nursing Practice . NGR 6101 Theory and Research for Nursing . NGR 6172 Pharmacotherapeutics for Advanced Practice Nursing . NGR 6052C Adult Nursing: Diagnostics & Procedures NGR 6255, Section 7717 – Summer 2014 – Course Website NGR 6255, Section 7717 – Summer 2014 – Course Website NGR 6255, Section 7717 COURSE SYLLABUS PAGE 6

WEEKLY CLASS SCHEDULE

DATE TOPICS READINGS LECTURES/VIDEOS ASSIGNMENTS Ham’s Primary Care Geriatrics Chapter 1 Familiarize yourself with resources on the course website. Read the following sections of the Post on the Discussion Board Course Overview Week 1 Older Americans 2012: Key Review the AGS-GRS Demography A brief description of yourself: nursing Aging Demographics Indicators of Well-Being Report, and Biology slides interests/track, your ideal job when you May 12 Theories of Aging Population, pages 2-10 graduate. Add your photo to your Health Status, pages 24-32 profile.

Post by Thursday, 11:59 pm. Read NGR 6255 Frequently Asked Questions document Post on the Discussion Board The population is aging. Florida has the highest percentage of elderly residents. Ham’s Primary Care Geriatrics Review the AGS-GRS Assessment slides Gerontological nursing includes Chapter 2-3 comprehensive assessment and care. Watch the YouTube video, Physical Discuss one of your strengths in the Week 2 Physiological Changes of Aging Exam on the Older Adult, with Dr. holistic assessment of older adults? Are Geriatric Assessment Depending on your track, read the Douglas Drummond at: there any physical exam pearls specific AACN, Adult-Gerontology Acute- to older adults you would recommend to May 19 Role of the ARNP https://www.youtube.com/watch? Care or Primary Care Nurse v=OeXVV3elJx8 your colleagues (include references or Practitioner Competencies resources)? Watch the YouTube video, What is a Nurse Practitioner? at: Post by Thursday, 11:59 pm. Respond to http://youtu.be/F91gqaQs7Lc two of your colleagues’ comments by Sunday at 11:59 pm.

NGR 6255, Section 7717 – Summer 2014 – Course Website DATE TOPICS READINGS LECTURES/VIDEOS ASSIGNMENTS Take the Pain Knowledge Test Review the AGS-GRS Please do not use any learning Pharmacotherapy slides materials (books, websites, etc. during the test) – this is a pre-knowledge Ham’s Primary Care Geriatrics Watch the YouTube video, assessment. In other words, you will receive a score of 100 (5% of your Chapter 6 Deprescribing 101 with Dr. Douglas Drummond at: grade) for completing the test, Week 3 Appropriate Prescribing http://youtu.be/ubum-IJMxAE regardless of your score. May 26 Medication Management Read the AGS-GEM on Appropriate Prescribing Quiz is located in Sakai (under Tests & Print the AGS Beers Criteria of Quizzes). Please be ready to take the Potentially Inappropriate exam when you open it – you may only Medications. Keep this as a open it once. reference for your clinical practice.

Due: June 1st, 11:59 pm. Ham’s Primary Care Geriatrics Post on the Discussion Board Chapter 19-20, 54 Review the AGS-GRS Falls, Gait Impairment, and Dermatology slides Which of the Choosing Wisely recommendations is relevant to your Read the Health Affairs Blog on clinical practice? Provide a rationale for Measuring Quality Care for Older Review the Choosing Wisely your answer. Discuss how you might Adults with Serious Illness at: website at: apply the concept of slow medicine to Week 4 Falls and Frailty http://healthaffairs.org/blog/2014/01 http://www.choosingwisely.org/ the care of older adults. You may /22/measuring-quality-of-care-for- choose any of the Choosing Wisely Dermatology Click on Lists to find AGS June 2 older-adults-with-serious-illness/ recommendations from the specialty societies or select one from the American Geriatrics Society (AGS) list. You may wish to sign up for Derm Read the NY Times article, For the Dx, a free monthly dermatology Very Old, a Dose of ‘Slow photo quiz at: Post by Thursday, 11:59 pm. Respond to Medicine’ http://www.clinicaladvisor.com/ two of your colleagues’ comments by http://www.nytimes.com/2008/02/26 Sunday at 11:59 pm. /health/views/26books.html

NGR 6255, Section 7717 – Summer 2014 – Course Website DATE TOPICS READINGS LECTURES/VIDEOS ASSIGNMENTS Review the AGS-GRS Hearing Quiz on Weeks 1-4 Impairment and Vision Impairment Quiz opens in Sakai (under Tests & slides Quizzes) June 13th at 5pm until June 15th Ham’s Primary Care Geriatrics Week 5 Sensory Changes at 5 pm. You may use your books for Chapter 25-26, 35 Review the Fitness-to-Drive website the quiz. Please note there is a 1-hour June 9 Assessing Driving Ability at: http://ftds.phhp.ufl.edu/ time limit. Watch the YouTube news story by Please be ready to take the exam when clicking on the tab on the upper right you open it – you may only open it side of the screen. once. Ham’s Primary Care Geriatrics Review the AGS-GRS Delirium and Chapter 16-17 Dementia slides Week 6 Watch the YouTube video, The Delirium and Dementia Aging Brain: Dementia, Delirium, See assignment under week 7. June 16 Read the AGS-GEM on Delirium and Depression with Dr. Douglas and Dementia Drummond at: http://youtu.be/AjQQkx-zw4A June 23 Summer Break (June 23-27)

Article Review Choose one of the three peer-reviewed research articles on depression in older adults posted under weekly resources. Ham’s Primary Care Geriatrics These studies utilized the one of the Chapter 18, 33 Review the AGS-GRS Depression assessment tools listed in the GEMs for and Other Mood Disorders and Delirium, Dementia, or Depression. Week 7 Depression Elder Mistreatment slides Write a one-page description of the June 30 Elder Abuse Read the AGS-GEM on Depression study, what was the research question, which tool was used and why, comment on the stated validity/reliability, and discuss the findings pertaining to the utilized assessment tool.

Due: July 6th, 11:59. July 4 Holiday

NGR 6255, Section 7717 – Summer 2014 – Course Website DATE TOPICS READINGS LECTURES/VIDEOS ASSIGNMENTS Post on the Discussion Board Discuss the difference between normal sleep changes associated with aging and sleep disorders. Investigate a clinical Week 8 Ham’s Primary Care Geriatrics measure of sleep and discuss how you Review the AGS-GRS Sleep Sleep and Fatigue Chapter 31 could implement this measure in clinical July 7 Problems slides practice.

Post by Thursday, 11:59 pm. Respond to two of your colleagues’ comments by Sunday at 11:59 pm.

Quiz on Weeks 5-8 Quiz opens in Sakai (under Tests & Quizzes) July 18th at 5pm until July 20th at 5 pm. You may use your books for Week 9 Ham’s Primary Care Geriatrics Review the AGS-GRS Malnutrition the quiz. Please note there is a 1-hour Nutrition Chapter 28 time limit. July 14 slides

Please be ready to take the exam when you open it – you may only open it once. Review the AGS-GRS Persistent Reflection Paper Pain slides Write a 3-page reflection paper on the Watch the movie Wit, available on movie Wit. Reflections are subjective – I Ham’s Primary Care Geriatrics YouTube at -- am looking for a thoughtful commentary Week 10 http://www.youtube.com/watch? Pain Chapter 27 on the issues presented in the movie. July 21 v=8IyEsnzH1uE Discussion Questions and grading rubric The movie is available to purchase in Week 10. on Amazon.com ($5.11). It is also available on Netflix and may be Due: August 3rd, 11:59 pm available at your local library.

NGR 6255, Section 7717 – Summer 2014 – Course Website DATE TOPICS READINGS LECTURES/VIDEOS ASSIGNMENTS Post on the Discussion Board Discuss your reaction to the Ten Steps Review the AGS-GRS Palliative video. Have you ever had to share bad Care slides news with a patient, or witnessed it? If Ham’s Primary Care Geriatrics not, perform a search for additional Week 11 Pain resources on delivering bad news and Chapter 14 Watch the video, Ten Steps for What Palliative Care to Say and Do, featuring palliative share a resource or recommendation on July 28 the discussion board. care expert, Dr. Diane Meier, at http://www.capc.org/capc- resources/capc-videos/ Post by Thursday, 11:59 pm. Respond to two of your colleagues’ comments by Sunday at 11:59 pm. Take the Pain Knowledge Test Please do not use any learning materials (books, websites, etc. during the test) – this is a post-knowledge assessment. In other words, you will receive a score of 100 (5% of your Week 12 grade) for completing the test, Palliative and End-of-Life Care regardless of your score. August Last class 4 Quiz is located in Sakai (under Tests & Quizzes). Please be ready to take the exam when you open it – you may only open it once.

Due: August 10th, 11:59 pm

Approved: Academic Affairs Committee: 04/02 Faculty: 09/02 UF Curriculum: 01/03

NGR 6255, Section 7717 – Summer 2014 – Course Website