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Nursing Research: Nursing Research to Establish Best Practices in Elder Care

Posted: Oct. 17, 2016

Tracie Harrison, PhD, RN, CS, FGSA, FAAN
and associate professor

In 2003, the Texas Legislature charged the Texas Department of Aging and Disability Services (DADS), a component of the Texas Health and Human Services Commission, with assessing how satisfied people who live in Medicaid-certified nursing homes are with the quality of their care and quality of life. In 2014, DADS, after a competitive process, turned to Tracie Harrison, PhD, RN, CS, FGSA, FAAN and associate professor, to make this research one of the only high- quality, on-going studies of nursing homes in the country.

To date, the assessments are done every other year, with outcomes tracked at the facility level. The DADS has awarded $650,000 to Dr. Harrison to lead a longitudinal assessment of the facilities and report on quality outcomes in a random sample of more than 1,250 nursing facilities.

“We have trained RN-quality reviewers to work with administrators in the community to gather rigorous assessment data and perform interviews with residents of all ages using a structured survey tool to track resident and facility indicators,” Dr. Harrison said. “The information collected will help track nursing home outcomes for the purpose of creating evidence-based strategies for new initiatives to improve the quality of care and quality of life for residents of Texas nursing homes.”

To further improve care in Texas nursing homes, DADS held a competitive call for proposals to develop the Center of Excellence for Long-Term Care. The center, which launched in August 2016, was awarded to the School of Nursing and Dr. Harrison to promote positive outcomes and improve the quality of care in long-term care facilities and help residents with dementia live better lives.

Patients consulting with their physician

The new partnership spearheaded by Michelle Dionne-Vahalik at DADS includes the development of a web-based educational platform for delivering best practices to providers of long-term care, presented as a series of projects addressing a specific topic or area of care. Each project will focus on education for physicians, nurses, pharmacists, direct care staff, residents and their family members, with multiple modules addressing the project’s topic or area of care.

The first phase of the project will focus on improving dementia care with modules developed to address the use of antipsychotic medications for residents with dementia with an emphasis on alternatives to the use of these drugs.

Research has found that providers in Texas nursing homes prescribe antipsychotic medications to residents more often than most other states despite recent studies showing that these drugs may in fact limit the types of interactions people with dementia may have with their families. Providing alternative interventions that can reduce problematic behaviors while maintaining quality of life is the ultimate goal.

The second phase will focus on resources for nurses transitioning to practice in geriatric care, particularly those who will be working in long-term care settings.

“We couldn’t be more excited about this opportunity to work with DADS and the long-term care community,” said Dr. Harrison, director of the Center of Excellence. “But more importantly, we believe this partnership will bring about improved care and positive outcomes for patients in Texas nursing homes.”

Drawing from her research with people aging with disabilities she added, “The nursing home may or may not be your first choice for residency at any stage of life; however, I want to ensure that once that choice is made in the state of Texas, professional nurses are there to provide the care that promotes independence, community reintegration, and health enhancement whenever and wherever possible.”

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