CADTH 2015 Symposium

1. How evidence Informs NP practice-
Regina Lutheran Home Experience.
Leah Clement BSN RN
Director of Care/Leader for Elder Services
Maureen Klenk MHs (APN) RN(NP)
Nurse Practitioner

2. Eden Philosophy
 Mission – to improve the well-being of Elders and
those who care for them by transforming the
communities in which they live and work
 Vision – to eliminate the 3 plagues
 Loneliness, helplessness, boredom – bulk of suffering for
those living in LTC

3. Eden Care Philosophy
 Guided by 10 Principles
1. Human habitat
2. Loving relationships
3. Give and receive care
4. Loving companionship
5. Spontaneity
6. Meaningful activity
7. Medicine the servant not the master
8. Elder centered care – autonomy in decision
making
9. Human growth
10.Wise leadership

4. How to build an Eden Care LTC
facility?
 Dream a Dream
 Create the Vision
• A HOME in which all Elders have an opportunity to have timely
access to a primary care provider
• Elders have the best possible opportunity for a healthy quality of
life so they can grow and flourish
• Add an RN(NP) to the staffing complement as a ‘best fit’.
• RN(NP)s are evidenced based providers with a holistic philosophy of
care.

5. Implementing RN NP in LTC
 Steps in the Process:
• Plant the seeds with physicians, nursing team, pharmacist, others
• Advertise & Recruit
• Plant more seeds and warm the soil
• Hire
• Muddle through………..

6. Nurse Practitioners in Long-Term Care
Facilities: Clinical and Cost-Effectiveness and
Guidelines – CADTH (2012)
 RESEARCH QUESTIONS
1. What is the clinical effectiveness of having nurse
practitioners in long-term care facilities? .
2. What is the cost effectiveness of having nurse practitioners
in long-term care facilities?
3. What are the evidence-based guidelines for having nurse
practitioners in long-term care facilities?

7. Nurse Practitioners in Long-Term Care
Facilities: Clinical and Cost-Effectiveness and
Guidelines – CADTH (2012)
 KEY MESSAGE
 The evidence identified suggests that the implementation
of nurse practitioners in long-term care facilities may
result in an increase in family satisfaction and improved
health services.

8. NP care improves Elder Care
 Present –Monday to Friday
 Able to observe Elders first hand.
 Raises the ‘bar’ for assessment and learning for all staff.
 Lowers the cost to the system, the facility and the elder.

9. NP utilize evidence to
improve outcomes
 Reduce adverse events by reducing pill burden
 Reduce antibiotic resistance by decreasing the use of
antibiotics – less UTI
 Reduce fall rates-decrease use of antipsychotic and BEERS
list medications
 Reduce levels of pain- provide consistent analgesia

10. Still to work toward
 Improve Incontinence by increasing fluid intake
 Improve mental status by improving sleep- do elders need
q2h turning?
 “Younger’ Elders are coming under how care- how can we
improve the social need for this age group.

11. Outcomes
 Falls
 Antipsychotic use
 Pain control
 Pressure ulcers
 Elders with 8 prescriptive medications or less
 Less visits to ER/Hospital admissions
 Survey results-
 Elder
 Family
 Care Team
 Physicians

12. Implementing RN NP in LTC
 Final Thoughts:
• PERSERVERE!!!!
• Innovation is hard!
• “How will this contribute to the quality
of life to Elders I serve?”

13. Thank you!
Questions?
 Contact Information:
 Leah Clement
 Maureen Klenk