Nursing on ACE
Thinking about Geriatric Nursing? Consider ACE.
Nursing on ACE offers a unique opportunity to help the older adult population. We are a bed nursing unit devoted to care of the age 65 and over medical and surgical acute inpatient population. The ACE concept includes a specialized physical environment, a strong interdisciplinary team and a focus on preventing iatrogenic complications, maintaining physical function, and ensuring a safe discharge for our patients.
Our managers try to maintain a 4-1 ratio of patient to RNs.
Our RNs are major players in our interdisciplinary team. They are responsible for the day to day and minute to minute nursing care of our patients, as on the usual hospital unit. They are also, however, active in our daily interdisciplinary team rounds, and play a large role in discharge planning for our patients.
The RNs are supported by Patient Care Technicians. PCTs usually have a 10 - 1 ratio of PCT to patients. PCTs perform tasks such as vital signs, FSBGs, and personal care for our patients.
Many of our ACE RNs are ANCC certified in gerontological nursing. Several nurses have a 2nd certification in a related area such as medical surgical nursing, Hospice or Palliative care.
The Interdisciplinary Team
The core team on ACE consists of nursing, physical therapists, occupational therapists, a dietitation, and care managers. Speech and language pathologists, respiratory therapists, and others are available as consultants.
Deven Cockrell-Barriault, BSN,RN,CMSN
Feel free to contact Deven for information about ACE employee opportunities.
Nursing Support Staff
ACE also has a Geriatric Nurse Practitioner on the unit. The NP is a nursing resource who assists staff with geriatric concepts, and geriatric education. The NP also assists with Core measures and monitoring of quality indicators. The GNP is responsible for helping the Interdisciplinary team communicate with one another.
Bronia Michejenko, MSN,GNPBC
ACE accepts patients 65 years of age and older. We have medical as well as surgical patients. Common diagnoses include pulmonary (COPD, pneumonia, asthma), cardiac (arrhythmia monitoring/telemenry, chest pain, heart failure), cognitive impairment (dementia, delirium), infection (urinary tract, line infections, sepsis), renal (ESRD, pre-renal), as well as orthopedic surgery (hip fracture, post operative hip fracture, total hip replacement, total knee replacement, amputation), vascular surgery (femoral popliteal bypass, amputation), and general surgery (pancreatic cysts, colectomy). Common procedures include those found on any medical surgical unit, such as IVs, central lines, wound care, suctioning and tube feeding.
The ACE unit stresses the provision of expert, geriatric-specific care. Our nurses can learn how to deliver this care in a number of ways. This section contains educational resources, references, and self study modules for your education.
Acute Care of Elders: Important Nursing Knowledge ACE INK is a self study newsletter for ACE staff.
See below for current topics.
1. Bladder Assessment
2. Bladder: Emptying Dysfunction
3. Confusion Assessment Method
5. Geriatric Depression Scale
6. Mini Mental Status Exam
7. Oral Care
9. Wound Assessment and Documentation
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.