Our patients are acutely ill, yet we promote maintenance of function, self care activities and social interaction. All patients who can are assisted to be out of bed. We like patients to spend time in our living room, interacting with each other and with our therapists. We have a fish tank and a dog on the unit. We try to get tubes out or off as soon as possible...including oxygen, IVs, foley catheters, and telemetry... to assist with promoting out of bed activity. Nutrition is important, as is prevention of constipation and early intervention with acute onset of confusion.
ACE is a NICHE site. NICHE stands for Nurses Improving Care for Healthsystem Elders, a program that promotes evidence based nursing care of the older adult. Thus, we use NICHE based protocols to ensure that our patients receive an acceptable level of care. We try to send staff to the annual NICHE conference in New York. We share information with other NICHE sites, so that we can problem solve with other nurses around the country. And we keep up to date on the NICHE listserve.
ACE Involvement at UTMB
ACE nurses are involved in may ways at UTMB. At the unit level, we actively participate in both the ACE nursing shared governance as well as the interdisciplinary share governance groups. We also participate in unit based, interdisciplinary continuous process improvement. ACE Nurses have representatives at the Medical-Surgical Department Sharee Governance meeting. ACE is also represented on the Nursing Quality Council, the Practice Council and the Workplace Council. ACE nurses have represented us on the acuity task force, the skin care Resource tem, and the pain team.
There are many opportunities for updating your education at UTMB. Specifically, on ACE, we offer ongoing nursing inservices and self study guides. Nurses are welcome to attend the Geriatric Physician Grand Rounds, the Fellows Grand Rounds, and other medical inservices. UTMB also offers periodic nursing continuing education activities, such as the Bridging the Gap between Research and Bedside series. We try to support nurses in attending geriatric-specific conferences, such as the National Gerontological Nurses Association annual conference. UTMB also offers a work-school program, assisting nurses to advance to BSN, MSN and PhD degrees.
Membership in a geriatric-specific professional organization is highly encouraged for ACE nurses. Options include the National Gerontological Nurses Association, the American Geriatric Society, and the Gerontological Society of America. More information about these organizations is available on their websites.
The department of internal medicine is developing evidence based clinical protocols which will be available in EPIC (as order sets) for use when admitting patients with these diagnoses. Their AIM is to standardize care and decrease length of stay and readmission rates.Currently available protocols are:
- CAP - Community Acquired Pneumonia Orderset
- Congestive Heart Failure (CHF)
- Chronic Obstructive Pulmonary Disease (COPD)
- Diabetic Ketoacidosis Adult, ICU
- General Medicine Admission
- Immunodeficiency Flow Panel
- MICU/CCU Admission Order Set
- Oral Analgesic Medicaitons
- Parenteral Opioids
- Sepsis, Adult ICU
- 111 - Stroke Alert
- 112 - Stroke Activation
- 300086 - Stroke Floor Admission
- 3000000001 - Stroke Critical care without tPA
- 300088 Stroke - Transfer from Critical care to floor
- 3004002 - Stroke Discharge
All protocols can be found in the EPIC order set section.
The department of Internal Medicine has a large role in the Meaningful Use Initiative. Our participation is key for the success of the initiative. Please visit the meaningful use website for important communication and updates from the Meaningful Use Initiative.