Title : Improving healthcare workers perspectives of older adults using geriatric education
Abstract:
Over the last several years geriatric patient admissions to acute care settings have increased due to the complex needs of this population. To prevent ageist perspectives from impeding care of these vulnerable populations, healthcare workers must recognize and understand any unconscious or conscious biases. On a medical observation unit in an acute care academic medical center, we identified an increase in the number of Code Manpower (M) events totally over 150 events. This is an emergency response code for aggressive or violent patient behavior. These codes were frequently and sometimes inappropriately called, particularly with older adult patients. Nursing leaders were concerned that staff were using Code M to mitigate complex patient behavioral expressions instead of implementing appropriate age-friendly de-escalation techniques. A windshield survey demonstrated that only 24% of the 79 healthcare workers surveyed completed any prior formal geriatric education. The purpose of the project was to develop, implement, and evaluate an educational program aimed at improving staff understanding and base knowledge of ageism and its impact on older adult population. Additionally, the staff were equipped with the tools to identify their own potential bias and ageism. An anonymous pre-survey using modified questions from the Facts on Aging Quiz was conducted. Education was simplified from our Nurses Improving Care for Healthsystem Elders (NICHE)-inspired class and presented as team and individual 15-minute huddles presented to a mix of healthcare worker roles such as nursing assistants, nurses, and other ancillary staff. Key terms for bias, ageism, stereotypes, and discrimination were presented. Each participant also watched a World Health Organization presentation of the impact of ageism in the perspective of older adults. Staff completed a post-survey to measure the impact of the program on staff's knowledge of ageism. Total surveys completed included 51 participants for pre-survey and 15 participants for post-survey. Staff surveyed were from diverse ethnic backgrounds and varying levels of education from high school to collegiate. Several participants had prior knowledge of geriatric care with 47% responding yes and 53% responding with no prior knowledge. Only 29% had lived exposure to older adults, while 71% had none. Using the Likert scale, we identified the average agreement with each Facts on Aging Quiz statement. The Facts on Aging instrument contains a mix of frequent misconceptions about aging. Each answer allows for us to determine if participants “totally disagree” with these misconceptions indicating knowledge about the subject. On the pre- survey 24.9% of participants selected “totally disagree” and 18.2% selected “somewhat disagree” for all questions. On the post-survey, 28.2% of participants selected “totally disagree” and 12.4% selected “somewhat disagree” indicating an approximate 13% improvement in knowledge shift to total disagreement with ageist misconceptions. This demonstrated a shift in overall geriatric knowledge as true and an improvement in identifying potential ageist statements.
