Adult-gerontology nurse practitioners (AGNPs) take a comprehensive approach to care. They examine the biological, physiological, and social aspects of aging. They have an advanced education, which means that they can diagnose and treat conditions experienced by adults. They can work in primary care, educating patients on maintaining health and preventing disease. AGNPs manage patient transitions between care settings and use skills and strategies to provide quality healthcare.
There is an increasing number of older people in the US, and health access is a growing concern, particularly in underserved rural and urban communities. Nurse practitioners (NPs) can help this situation by providing quality and comprehensive care.
A career as an AGNP
Registered nurses who wish to further their career in adult gerontology can enroll in the online Master of Nursing – Adult-Gerontology Nurse Practitioner from a reputable institution, such as Wilkes University. Wilkes University has a clinical placement team that helps students ensure a high-quality placement experience and become a skilled adult gerontology nurse practitioner.
According to the US Bureau of Labor Statistics, the employment of nurse midwives, nurse anesthetists and NPs is projected to grow 38% by 2032. This increase is much higher than the average for all occupations. There are many reasons for this growth, including meeting the healthcare needs of a growing older population, the increased requirements of underserved communities, and the recognition that NPs improve health outcomes.
APRNs
Advanced practice registered nurses (APRNs) are essential to healthcare provision. Advanced nursing practice furthers knowledge and expands the limits of nursing. These professionals have independence and versatility at work and can be healthcare leaders. Nurses with advanced practice roles have gained a master’s or doctorate in a specialty area, allowing them to have high-level positions.
APRNs provide healthcare services independently without or with minimal doctor supervision. Their work includes assessment, prescribing medication, making diagnoses, and organizing tests. They work to develop treatment plans and deliver patient care in clinical settings. Through advanced education and clinical training, APRNs can provide healthcare services to people of all ages. There are specializations within master’s programs, including nurse practitioners in adult gerontology.
Gerontological nurse practitioners
Gerontology is the study of the aging process and looks at the causes and effects of age-related illnesses. AGNPs working in primary care provide general healthcare for patients from adolescence to old age.
Nursing in primary care involves working with patients over long periods. They often work with patients over many years and build relationships with them. The older population have bodies that are not developing anymore, and they are susceptible to changes related to age, such as reduced bone density, decreased respiratory strength and a higher likelihood of infection. AGNPs deliver quality care with an emphasis on educating patients on preventing disease and maintaining health. They help patients develop and implement healthy lifestyles and disease prevention plans, often focusing on exercise, diet, and physical therapy. They communicate with patients’ families to keep them informed and make it easier for them to support the patient.
They may work in long-term care facilities, hospital-based clinics, or private practices. AGNPs examine patients, diagnose illnesses, develop treatment plans, and prescribe medicine. They also help patients navigate the healthcare system, refer patients to specialists, and collaborate with other healthcare professionals. There are many additional specialty opportunities, such as diabetes, palliative care, and HIV/AIDS.
The most common areas for adult-gerontology nursing are primary care, geriatrics, and hematology/oncology. The most frequent diagnoses made by AGNPs are hypertension, abdominal pain, and anxiety. Another common health issue is falling. As people age, they can walk more slowly and become more likely to miss a step or slip. AGNPs understand specific geriatric syndromes and the specific mental health and physical challenges related to aging and the aging process.
AGNPs obtain medical histories, perform examinations, organize screening tests, interpret diagnostic tests, and deliver pharmacological and nonpharmacological therapies. They also provide patient and caregiver education and evaluate caregiver competence. The field examines the biological aspects of aging, such as artery walls stiffening in the cardiovascular system. AGNPs consider the social, economic, occupational, and environmental backgrounds of patients. They are prepared to follow evidence-based practice guidelines and to analyze and adapt interventions after carrying out individualized assessments. They work within a community context and are aware of the needs of patients from diverse backgrounds and cultures.
Skills required
AGNPs need effective skills in analysis, critical thinking, attention to detail, communication, problem-solving, decision-making and leadership. These professionals are advocates for their patients. They must provide a good example of quality adult nursing and encourage other nurses to show commitment to and learn more about gerontology.
Older patients have more complex illnesses and conditions and AGNPs need effective analytical skills to have a full understanding of their health needs. They must consider all aspects of the patient’s health before developing a care plan. They must use critical thinking skills to think through care plans, evaluate health conditions, and put forward solutions for treatment and preventing illness. AGNPs use attention to detail to observe patients’ allergies, symptoms, and physical and emotional responses during examination. They can review symptoms and decide if they are connected or stem from complex conditions.
AGNPs use verbal, nonverbal, and written communication skills at work. They write emails to colleagues and patients and update diagnostic notes. They explain complex medical details to patients and share information with physicians and other healthcare professionals. They use nonverbal communication to interpret a patient’s health status and to present themselves as approachable and trustworthy. They adapt their communication skills to ensure that patients understand what is being said. This may involve speaking more slowly and spending extra time with patients who have hearing loss. Nurses must be patient with individuals with conditions such as dementia or memory loss. AGNPs are often responsible for delegating tasks to office staff and medical assistants. They may ask these staff to take patient vitals, update patient records, and connect with pharmacies or other clinical services.
Settings
AGNPs work in different settings where there is a requirement for primary care gerontological nursing. Long-term care facilities care for patients recovering from injury or illness who need daily support with dressing, walking, and bathing. AGNPs can supervise assisted living facilities, delivering medications and helping with patient checkups. Nursing homes care for patients with a range of mental and physical conditions who need full-time care. They provide day and night supervision and help with personal care such as eating and bathing. Patients often have degenerative or chronic conditions, including dementia or osteoporosis. AGNPs can work with patients, caregivers, and families to address care plans, prescribe and administer medication, and evaluate health conditions.
Transitional care
Transitional care refers to the services designed to ensure the timely and safe continuity of care for patients as they move between care settings. Transitional care management services are particularly important for older patients with chronic conditions and complex care plans who need fastidious continuity of care when moving between care settings. AGNPs need knowledge and skills to manage the transition of care, especially when working with older adults with complex care needs. There are risks associated with transitions between care settings, including treatment delays, unnecessary or duplicated tests, and lost test results or follow-up. They address the care needs of older adults as they transition between care settings using evidence-based interventions.
Transitional care models are used to manage moving older patients between healthcare providers and settings, such as hospitals, assisted living facilities and nursing homes. One of the main aims of transitional care models is to develop comprehensive care plans that address patients’ individualized needs while ensuring consistent care across numerous care settings. Transitions of care are actions designed to ensure continuity and coordination.
Discharge planning is essential to the process and takes place when the healthcare professional meets the patient and their family to ensure the best outcome for the patient. Pharmacists play an important role in medication safety through discharge education and medication reconciliation. Effective discharge planning can help reduce medical errors during transition. Research has shown that these transitions are a vulnerable time for patients and that well-managed transitional care makes readmission less likely.
Care transitions intervention
The care transitions intervention (CTI) is an evidence-based model that improves healthcare management and patient engagement. It is a short-term model, typically lasting for 30 days. Patients with complex care issues or chronic illnesses work with a healthcare professional to improve their self-management skills.
There are four parts of the CTI, known as the four pillars of health, and they are applied to measure a patient’s condition. The first part is patient-centered records, which the patient and their family have access to and which allow effective communication between healthcare professionals to ensure continuity of care between all providers and settings. The second part is medication self-management, which involves educating the patient and their family about the prescribed medication and how to manage the dosage correctly. The third part is encouraging patients and their families to attend follow-up sessions with primary care and specialist appointments. The final part is red flag awareness, which involves educating patients and their families about their health conditions so that they recognize symptoms of their condition deteriorating and act.
Successful transition of patients involves numerous parties sharing responsibility, including hospitals, providers, patients, and their families.
The transitional care model
The transitional care model (TCM) improves patients’ quality of life and reduces the number of hospital readmission rates. It also controls costs for primary care, emergency care, nursing homes and long-term care centers. The TCM ensures that patient care is in place when discharge planning begins and continues for at least 30 days so that patients can adapt to the new care setting and adverse effects are avoided.
Managing transitions in care, especially with older patients, can improve health outcomes, enhance the patient’s experience, and use resources effectively. Transitional care includes time-bound services that ensure healthcare continuity and prevent poor health outcomes among at-risk populations as they move between settings. AGNPs adopt a TCM that is nurse-led and follows the patient between care settings using the tools required for a fluent transition in care. They communicate with bedside nurses, physicians, and other members of the healthcare team.
BOOST
Another transition of care model is BOOST (Better Outcomes for Older Adults through Safe Transitions), which helps to reduce medication-related errors. There is a full implementation toolkit for implementing BOOST to improve discharge education. This model can reduce readmissions and medication errors and empower patients and families.
Patient risk for adverse events after discharge is assessed, and interventions are initiated to reduce risk. A checklist is completed to measure the patient’s readiness for transition. Patient-centered written discharge instructions can convey essential information about the patient’s needs. BOOST encourages the use of Teach Back, which is a patient-centered communication tool used to ensure patients’ understanding of the information they have been given.
Making a difference
AGNPs strive to provide high-quality primary care to their patients. AGNPs play a considerable role in improving health outcomes as more adults present with age-related conditions and illnesses. They advocate for older patients and provide comprehensive treatment and care. They deliver healthcare to patients over many years, building relationships and gaining an in-depth knowledge of gerontology. They emphasize disease prevention and health promotion and educate patients, families and caregivers. They have advanced nursing skills and are involved in all aspects of nursing care. They oversee transitions in care and implement evidence-based care transition models, ensuring that all aspects of the move are managed safely. They use the skills to understand the patient’s health and create the most appropriate care plan.
AGNPs strive to improve older people’s health and ensure that they have the best quality of life possible.
