The University of Chicago Division of the Biological Sciences and the Pritzker School of Medicine

CHAMP: Curriculum for the Hospitalized Aging Medical Patient

Welcome to your first survey! Your participation in the evaluation component of CHAMP is invaluable to the on-going success of our educational program.

We appreciate your cooperation.

To begin with, we want you to focus on your clinical practice in the hospital. We are interested in how confident you feel performing a range of clinical skills, how important they are to your hospital practice, and how often you perform them.

The Importance of the Practice of Clinical Skills in the Hospital Care of Older Adult Patients

Degree of Importance How important is it for you to: Somewhat Moderately Very Extremely Unimportant Important Important Important Important Conduct functional status assessments in hospitalized older adult patients? Conduct cognitive assessments in hospitalized older adult patients? Assess risk and prevent delirium in hospitalized older adult patients? Reduce polypharmacy and use of high risk/low benefit drugs in hospitalized older adult patients? Screen for depression in hospitalized older adult patients? Determine appropriateness for urinary (Foley) catheter use, discontinuing when inappropriate in hospitalized older adult patients? Mobilize hospitalized older adult patients early to prevent deconditioning? Routinely perform a complete Degree of Importance How important is it for you to: Somewhat Moderately Very Extremely Unimportant Important Important Important Important skin exam in hospitalized older adult patients? Document advance directives and DNR orders with hospitalized older adult patients?

Give bad news?

Discuss hospice care with hospitalized older adult patients? Routinely assess pain at bedside in persons with DEMENTIA? Manage pain using the WHO 3- step ladder and opiate conversion table, and manage side effects of opiates? Identify risk factors of hospital falls, including conventional and unconventional types of restraints? Develop safe and appropriate discharge plans for older adult patients, beginning shortly after admission and involving communication with other members of the multidisciplinary team (e.g. SW and case manager), family members, and primary care physicians? Confidence in Performing Geriatric Clinical Skills in the Hospital

Your Level of Confidence How confident do you feel in your ability to: Very Very Low Moderate High Low High Conduct functional status assessments in hospitalized older adult patients? Conduct cognitive assessments in hospitalized older adult patients? Assess risk and prevent delirium in hospitalized older adult patients? Reduce polypharmacy and use of high risk/low benefit drugs in hospitalized older adult patients? Screen for depression in hospitalized older adult patients? Determine appropriateness for urinary (Foley) catheter use, discontinuing when inappropriate in hospitalized older adult patients? Mobilize hospitalized older adult patients early to prevent deconditioning? Routinely perform a complete skin exam in hospitalized older adult patients? Document advance directives and DNR orders with hospitalized older adult patients?

Give bad news?

Discuss hospice care with hospitalized older adult patients? Routinely assess pain at bedside in persons with DEMENTIA? Manage pain using the WHO 3-step ladder and opiate conversion table, and manage side effects of opiates? Identify risk factors of hospital falls, including conventional and unconventional types of restraints? Develop safe and appropriate discharge plans for older adult patients, beginning shortly after admission and involving communication with other Your Level of Confidence How confident do you feel in your ability to: Very Very Low Moderate High Low High members of the multidisciplinary team (e.g. SW and case manager), family members, and primary care physicians?

The Frequency of your Practice of Geriatric Clinical Skills in the Hospital

Frequency How often do you: Some- Very Never Often Always times Often Conduct functional status assessments in hospitalized older adult patients? Conduct cognitive assessments in hospitalized older adult patients? Assess risk and prevent delirium in hospitalized older adult patients? Reduce polypharmacy and use of high risk/low benefit drugs in hospitalized older adult patients? Screen for depression in hospitalized older adult patients? Determine appropriateness for urinary (Foley) catheter use, discontinuing when inappropriate in hospitalized older adult patients? Mobilize hospitalized older adult patients early to prevent deconditioning? Routinely perform a complete skin exam in hospitalized older adult patients? Document advance directives and DNR orders with hospitalized older adult patients?

Give bad news?

Discuss hospice care with hospitalized older adult patients? Routinely assess pain at bedside in persons with DEMENTIA? Manage pain using the WHO 3-step ladder and opiate conversion table, and manage side effects of opiates? Identify risk factors of hospital falls, including conventional and unconventional types of restraints? Frequency How often do you: Some- Very Never Often Always times Often Develop safe and appropriate discharge plans for older adult patients, beginning shortly after admission and involving communication with other members of the multidisciplinary team (e.g. SW and case manager), family members, and primary care physicians?