Online Training to Become Board Certified!

Gero Nurse Prep is an online training course designed to prepare RNs who care for elders to attain board certification in Gerontological Nursing by the American Nurses Credentialing Center (ANCC). This course equips RNs with a broad array of clinical knowledge, skills and competencies that are tested on the ANCC certification exam and essential for quality gerontological nursing practice and leadership of elder care teams.

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New Pressure Injury Presentation Added to Gero Nurse Prep

Gero Nurse Prep is pleased to announce that we have added material to our Module 7 section on Integument. Gero Nurse Prep faculty and internationally recognized wound specialist and researcher Dr. Joyce Black, was a key author of the updated 2016 National Pressure Ulcer Advisory Council Pressure Injury Guidelines. Dr. Black has put together a presentation for you based on the official NPUAC resources that provides an overview of these new guidelines, to include definitions, staging, and documentation of pressure injury. Check it out today in Module 7!

#pressureulcers  #pressureinjuries #NPUAP

National Recognition to GeroNursePrep Contributing Faculty

Dr. Joyce Black, Associate Professor at the UNMC College of Nursing, and faculty contributor to Gero Nurse Prep, was recently recognized for both clinical and advocacy expertise.

Joyce Black, Ph.D - GeroNursePrep faculty

Dr. Black was awarded the Thomas Stewart Founder’s Award at the National Pressure Ulcer Advisory Panel Biennial Conference in recognition of her significant contributions in furthering pressure ulcer public policy. Dr. Black can be heard in the Module 7 presentation on Integument. Way to go, Dr. Black!

The issue of sexual orientation is of growing concern

Care practices will have to be reevaluated based on the increasing number of openly homosexual adults, particularly as they age.


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Gay marriage has been legalized by thirty two states and District of Columbia. President Obama, once a adversary of same-sex marriage now believe that “The Constitution’s equal protection clause should protect all marriages, gay or straight”.

DuVall says “He is glad to see so many advocates take on the problem of anti-gay discrimination head on”.

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Rating the Ratings


 Medicare has revised the 5 start rating system which is used to evaluate nursing home performance. The reason for revising rating system is that the system does not do anything fruitful. An Investigation piece in the New York Times shed some light on the difference between reality and rating. Ratings were positioned on the basis of annual health inspections and on 2 measures reported by the nursing home itself. The revised rating system will introduce external audits of nursing home quality and electronically submitted staffing data, as well as by incorporating some new measures such as the proportion of residents taking antipsychotic medications, hopes to overcome the shortcomings of the existing rating approach.

There are now so many rating agencies, using very different rating scales. The key point is that single grade cannot grasp all features of medical facility’s performance that are suitable to all the group, individual and organization whom the ratings are designed.

So will the revised ratings of nursing homes (coming in January, 2015) make grades meaningful?

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Modernizing Medicare

The Medicare Modernization Act of 2004 didn’t really modernize Medicare.It is really important to have coverage for prescribed drugs, which is a huge support for older individuals. Medicare was pretty much complete apart from this one change, albeit most important one.The problem with the approach which turns 40 this year is that most of the illness are critical requires hospitalization.
Today, most illness is long-lasting illness costliest patients typically have multiple chronic conditions.The good news is that JAMA this week entitled “Optimizing health for persons with multiple chronic conditions,” is that Medicare has made a number of changes that move the program into the modern world.
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Penny Wise, Pound Foolish

Problem about practicing medicine in nursing home is many medical problems which includes cognitive impairment.
The major challenge about nursing home is Medicare billing. The problematic was that in the nursing home environment, many of patients were demented and couldn’t possibly give a coherent history.

No wonder physicians often respond to a call from the nursing home about a sick patient with an order to send the patient to the hospital for assessment. Send a weak nursing home patient to the emergency room and he has so about a 90% chance of being admitted. So instead of paying a physician an appropriate amount for making a visit to the nursing home.

Image source: Nurse Practitioner | Family Practice | Gallup, NM

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Must have a Plan

Planning Ahead

A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD 



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April 16 – It was officially the day Americans were made-up to remember to complete an advance directive.

Nobody put much consideration to National Healthcare Decision Day since it came just after the anniversary of Boston Marathon bombing or possibly Americans were overburdened by holiday work.

A new study published this month in the journal of the American Geriatrics Society the main focus was – how many people have an advance directive and how has this changed over the past 10 years? But this study has some major limitations-

  • Only includes people who died and relies on the testimony of relative or friend.
  • It was restricted to people over age 60.

Author of current study conclude that having an advance directive is correlated to one’s wishes for end-of-life care are followed. It was based on the report which states that the person who died had actually wanted. Also National Healthcare Decisions Day was ignored by media because it was surpassed by the other more exciting events or  because it continues to pay attention on a form, on finalizing a legal document, rather than on addressing head on what is most important to us in the last year or two or five of life, on the decisions that will matter most in life’s last stage, however long that lasts.

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Sedentary Lifestyle Increases Risk for Heart Failure

We are all aware of the risks of heart disease: diet, exercise, smoking, lipid levels, stress, genetics, etc. Now, research is showing us more specifically to what these lifestyle risks relate. A recent study published in the Journal Circulation: Heart Failure, found that a high sedentary lifestyle increased the chance of having heart failure, as much as 1.34 times that of a low sedentary lifestyle.

Heart Failure

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Similarly, the study found that lower levels of physical activity were also related to heart failure, as much as 1.52 times as likely to get heart failure that those with high levels of physical activity. It is crucial to stress the importance of healthy, active lifestyle for all, to the individual’s highest ability, to protect the heart from disease. This evidence can be used as a motivator to discourage sedentary behaviors.

Young DR, Reynolds K, Sidell M, Brar S, Ghai NR, Sternfeld B, et al. Effects of physical activity and sedentary time on the risk of heart failure. Circ Heart Fail. 2014 Jan 1;7(1):21-7.

For more on this study, see: