Description & Schedule of the Teaching Nursing Home (TNH) Program Deliverables 2005-2006
 
The Teaching Nursing Home program creates forums, initiatives, and core resources for identification and eventual resolution of complex long-term care issues. 
The program promotes research and training directed at best practices in long-term care and their adoption by communities and involved health-care providers.
 
Click on a link in the table below to download a zip of the deliverable or scroll below the table to see the files in each deliverable.

 September 1
DELIVERABLE I

November 1
DELIVERABLE II

February 1
DELIVERABLE III

March 1
DELIVERABLE IV

April 1
DELIVERABLE V

May 1
DELIVERABLE VI

June 1
DELIVERABLE VII

  Ruiz, Smith

Roos, Cheung 

1. TNH will:
a. Develop & provide a survey to the Agency, which the Agency will distribute to all facilities under cover letter from the Agency, Division of Health Quality Assurance Deputy Secretary. The results of the survey will be compiled & analyzed by TNH with the hope of determining the following:
i. What facilities are using the GeriU Web site or related distributed products?
ii. What training or best practices are being used by the staff? What other training would staff like?
iii. If the staff at the facility are not using it, why not?
iv. What will it take for facility staff to use it?
v. Is the reason it is not being used related to corporate policies, not knowing it was there, no computer access for staff, not relevant to the needs of the facility, other?
vi. Would DVDs, PDAs, computer touch screens, videos, or other electronic means be useful to provide staff with access to the training?

 b. If  survey results show that facilities cannot use computer-based training at this time, TNH will work with the facilities, associations, & AHCA to develop onsite trainings to meet requested needs & locations for trainings. Deliverable III for GeriU enhancements may be reduced, as decided by the Agency with TNH staff, to meet this training need.
c. Develop & implement ePortfolios that will allow for individual education activity & outcomes to be tracked & reported on by TNH. This effort will include evaluation of utility & usability of ePortfolios for nursing staff in nursing homes.

2. Provide a report to the Agency with the following program information:
a. Annual summary & evaluation of the TNH project for the past fiscal year ending 6/30/05, with a list of activities proposed/ planned for the upcoming fiscal year 7/1/05– 6/30/06.

    Roos, Cheung
b. A detailed report on publications & manuscripts pertaining to past & ongoing TNH–supported activities.

    Hyer, Wilkes,
Polivka-West
c. Provide agenda & summary for annual statewide quality summit addressing the priority for integrating concerns over QOL & QOC. This summit report will include how QI for both concerns is being done & can be improved through acquisition & sharing of methods & data.

 Mintzer, Roos, Ruiz
Develop & provide in DVD format, a blended-learning curriculum (preceptored with computer-based instructional aids), addressing the assessment of pain in LTC residents. In addition, complete sharing of information will be provided on efforts to improve pain assessment & management from testing at the MJHHA &/or other nursing homes & the outcomes from model testing. This information will  include training on data collection & entry into the MDS system. This effort will be shared in the statewide LTC conferences & other Agency-supported training efforts, & the DVD will be mailed out to all FL nursing homes.

Ruiz, Smith, Roos

Should survey results from Deliverable I provide information that the majority of surveyed nursing homes wish to use GeriU & to see further upgrades & training modules established, further enhancement of GeriU utility & usability will include:
1. Development & provision of a beta version of a new library & content search & retrieval capability based on emerging e-learning standards.  TNH will expand GeriU interactive multimedia e-learning to provide faster & simpler access & operation, including evaluation of the effectiveness & usability of CELGI (Consortium of E-Learning in Geriatrics Instruction) & e-learning educational tools. Also included will be the outlining of key terms, technological requirements, faculty development, the evaluation process, the potential for improving QOC & QOL, along with barriers & future outlook for e-learning in LTC settings. 

 

2. Computer-based design & implementation of improved online classes & modules including
(a) depression in dementia,
(b) falls QI outreach, &
(c) dementia care.
This process will include utility & usability evaluations from instructors & learners.
3. Computer-based design &/or implementation of online classes or modules to include
(a) workforce development,
(b) “Dining At Home,” &
(c) QI efforts with FL QIO.

 

Williams, Molinari, Brown, Ruiz, Roos
For the further development of the depression in dementia training module, TNH will provide the following:
1. A manuscript describing nurse competencies & learning objectives for improving care of nursing home residents with depression in dementia.
2. A set of 5 GeriU learning objects (LEOs) on improving recogni-tion & management of depression in dementia that will be developed & linked into an instructional module.
3. The design, development, & delivery of a module for a blended-learning curriculum in depression in dementia in LTC, including the design & develop-ment of a set of multimedia learning objects (coded according to a computer industry standard), with instructor & user guides, a curriculum outline, & evaluation Methodology.
4. Feedback from focus groups & testing of a sample of LPNs.
5. Evaluation of a beta version of individual LEOs on improving recognition & management of depression in dementia.
6. Facilitation of the mail-out of the training module DVD to all FL nursing home facilities.
 

Brown, Ruiz, Mintzer, Roos
Further development of the falls tools to provide:
1. Design & develop-ment of a touch–screen-based blended-learning outreach in QI for the prevention of falls & related injuries in nursing homes, including an initial plan & subse-quent modifications based on input from stakeholders, including NH care staff & adminis-tration & AHCA’s quality monitors. 2. Implementation of  touch-screens & expert-guided blended-learning outreach for introducing a QI process for prevention of falls & related injuries in self-selected south FL nursing homes. The project will be intro-duced at a minimum of  3 nursing homes in south FL. A complete analysis of the project will be provided along with a work plan for implemen-tation to a large number of facilities in the contract year 2006-07.
3. Development & implementation of an aggressive marketing plan of the falls tools to include mail-out & feedback from all FL nursing home facilities. The project will include the production of a printed curriculum that links to the MDS Fall RAP. The mail-out will be directed to the risk manager at each nursing home with a feedback survey of the tools.
 

A. Kelly 

Based on previous planning & coordination with 2 study sites, implement a model for residential dining called “Dining At Home” at those 2 sites. Provide training to nursing & administrative staff, along with collection & full analysis of data from the 2 facilities to include at a minimum the following:
1. Management & analysis of self-reported qualitative & quantitative data for an ongoing QI process, including baseline & 6-mo data from residents, family, & staff surveys, interviews, & focus groups. Provide an analysis of the data & summary evaluation of the “Dining At Home” project for this phase of the project, along with feasible approaches to additional program support & dissemination.
2. Work with the facilities to include students from the Dept. of Communicative Disorders & other departments at the U of Central FL & involve separately funded faith- based program participants.
3. Provide commentary on any relevance to the newly implemented rule, if available, pertaining to paid feeding assistants.
4. Establish & provide a conference/ symposium on QOL & dining in LTC that includes all AHCA programs directed at improving nursing home dining & QOL.

Sadowsky

Continue work with  the Nursing Workforce Development program to provide the following elements important to  replication of current workforce development successes:
1. A follow-up report on outcomes for graduating LPNs from Palm Beach county–based work-force development project, including their licensure & employ-ment status, role of literacy enhancement via the Literacy Coalition, & program satisfaction for CNA/ LPN participants & their employers (via questionnaire survey).
2. Development of further needs & strategies to provide support for nursing assistant trainees while they pursue LPN status in the Palm Beach project.
3. The manual written on the Palm Beach County workforce development model.
 
 

AHCA Deliverables 2005-2006
   
 

State of Florida, AHCA Standard Contract

Deliverable I - September 1, 2005

  • I.1 - TNH will:
    • I.1.a - Develop & provide a survey to the Agency, which the Agency will distribute to all facilities under cover letter from the Agency, Division of Health Quality Assurance Deputy Secretary. The results of the survey will be compiled & analyzed by TNH with the hope of determining the following:
      • i - What facilities are using the GeriU Web site or related distributed products?
      • ii - What training or best practices are being used by the staff? What other training would staff like?
      • iii - If the staff at the facility are not using it, why not?
      • iv - What will it take for facility staff to use it?
      • v - Is the reason it is not being used related to corporate policies, not knowing it was there, no computer access for staff, not relevant to the needs of the facility, other?
      • vi - Would DVDs, PDAs, computer touch screens, videos, or other electronic means be useful to provide staff with access to the training?
    • I.1.b - If  survey results show that facilities cannot use computer-based training at this time, TNH will work with the facilities, associations, & AHCA to develop onsite trainings to meet requested needs & locations for trainings. Deliverable III for GeriU enhancements may be reduced, as decided by the Agency with TNH staff, to  meet this training need.
    • I.1.c - Develop and implement ePortfolios that will allow for individual education activity and outcomes to be tracked and reported on by TNH. This effort will include the evaluation of the utility and usability of ePortfolios for nursing staff in nursing homes.
  • I.2 - Provide a report to the Agency with the following program information:
    • I.2.a - Annual summary and evaluation of the TNH project for the past fiscal year ending June 30, 2005, with a list of activities proposed/planned for the upcoming fiscal year beginning July 1, 2005 and ending June 30, 2006.
    • I.2.b - A detailed report on publications and manuscripts pertaining to past and ongoing TNH–supported activities.
      • Appendix 1 - Williams C, Hyer K, Kelly A, Leger-Krall S, Tappen R. Development of nurse competencies to improve dementia care. Geriatric Nursing 26:98-105, 2005
      • Appendix 2 - Ruiz J, Smith M, van Zuilen M, et al. The educational impact of a computer-based training tutorial on dementia in long term care for licensed practice nursing students.  Gerontology & Geriatrics Education. In press
      • Appendix 3 - Williams C, Molinari V, Bond J, et al. Development of a curriculum for long term care nurses to improve recognition of depression in dementia. In preparation
      • Appendix 4 - Milanez M, Paniagua MA, van Zuilen MH, Roos BA. Beyond disease management:  residents as reinforcers of medical student competencies for geriatric syndromes. Journal of the American Geriatrics Society. 53(4, Suppl S1-S244):S89, 2005
      • Appendix 5 - Hyer K, Polivka L. Nursing home quality and the Florida Teaching Nursing Home Program. USF Aging Research & Policy Report 10:49-56, 2004
      • Appendix 6 - Mintzer M, Hyer K, Ruiz J. Statewide process in developing geriatric training materials: a government-industry-public/private-organization-professional-citizen effort. Journal of the American Geriatrics Society 50:S76, 2002
      • Appendix 7 - Signorile J, Carmel M, Lai S. Roos B. Early plateaus of power and torque gains during high- and low-speed resistance training of older women. Journal of Applied Physiology  98:1213-1220, 2005
      • Appendix 8 - Signorile J, Roos B. Resistance training for power, strength, and functionality: a long-term prescription. The American Journal of Medicine & Sports Sept-Oct, 398-402, 2002
      • Appendix 9 - Signorile J, Carmel M, Czaja S, et al. Differential increases in average isokinetic power by specific muscle groups of older women due to variations in training and testing.  Journal of Gerontology 57A: M683-M690, 2002
      • Appendix 10 - Andersen D, Roos B, Smith W, Signorile J. Walker use, but not falls, is associated with lower perceived physical functioning and health residents in an assisted-living environment. Submitted to the Journal of the American Geriatrics Society
      • Appendix 11 - Phancao F, Katz A, Milanez M, et al. Benefits of a learning management system and the use of e-learning technology in a geriatric medicine fellowship program. Journal of the American Geriatrics Society 53:S138, 2005
      • Appendix 12 - Katz A, Smith M, Mintzer M, et al. Evaluation of a blended-learning approach to training LTC nurses in pain assessment and management in dementia. Journal of the American Geriatrics Society. 52(S1-S246):S135, 2004
      • Appendix 13 - Ruiz J, Smith M, Mintzer MJ, et al. Pilot study of a blended-learning approach for screening for dementia using the MMSE. Journal of the American Geriatrics Society 52(S1-S246):S39, 2004
      • Appendix 14 - Ruiz J, Smith M, Mintzer M, et al. The educational impact of a dementia care computer-assisted training tutorial on LPN students. Journal of the American Geriatrics Society  52(S1-S246):S39, 2004
      • Appendix 15 - Ruiz J, Granville L, Ribera V, et al. Computer-assisted training in gait and balance assessment. Journal of the American Geriatrics Society 50:S73, 2002
      • Appendix 16 - Ruiz J, Dang S, Alzugaray E, Kai T, et al. Expanding Internet access to nurses practicing in nursing homes. Journal of the American Geriatrics Society 50:S75, 2002
      • Appendix 17 - Ruiz J, Kai T, Smith M, et al. GeriU, the Online Geriatrics University (www.geriu.org): enhancing geriatrics education through Web-based learning. Journal of the American Geriatrics Society 50:S72, 2002
      • Appendix 18 - Ruiz J, Bludau J, Wiles T, et al. Physician's Electronic Pocket Guide on Geriatrics. Journal of the American Geriatrics Society 50:S76, 2002
      • Appendix 19 - Ruiz J, van Zuilen M, Kai T, Mintzer M. Blended learning and geriatrics education.  In Thirunarayanan  MO, Perez-Prado A, Eds. Integrating Technology in Higher Education.   Lanham: University Press of America, 177-195, 2005
      • Appendix 20 - Ruiz, J, Smith M, Dang S, Kai T, Mintzer M. Internet training for nursing home nurses. Long-Term Care Interface 5:44-47, 2004
      • Appendix 21 - Ruiz J, Mintzer M, Leipzig, R. E-learning in medical education: the state of the art.  Academic Medicine. In revision
    • I.2.c - Provide agenda and summary for an annual statewide quality summit addressing the priority for integrating concerns over quality of life and quality of care. This summit report should include how QI for both concerns is being done and can be improved through acquisition and sharing of methods and data.

Deliverable II - November 1, 2005

  • II - Develop & provide in DVD format, a blended-learning curriculum (preceptored with computer-based instructional aids), addressing the assessment of pain in LTC residents. In addition, complete sharing of information will be provided on  efforts to improve pain assessment & management from testing at the MJHHA &/or other nursing homes & the outcomes from model testing. This information will  include training on data collection & entry into the MDS system. This effort will be shared in the statewide LTC conferences & other Agency-supported training efforts, & the DVD will be mailed out to all FL nursing homes.

Deliverable III - February 1, 2006

  • III - Should survey results from Deliverable I provide information that the majority of surveyed nursing homes wish to use GeriU & to see further upgrades & training modules established, further enhancement of GeriU utility & usability will include:
    • III.1 - Development & provision of a beta version of a new library & content search & retrieval capability based on emerging e-learning standards.  TNH will expand GeriU interactive multimedia e-learning to provide faster & simpler access & operation, including evaluation of the effectiveness & usability of CELGI (Consortium of E-Learning in Geriatrics Instruction) & e-learning educational tools. Also included will be the outlining of key terms, technological requirements, faculty development, the evaluation process, the potential for improving QOC & QOL, along with barriers & future outlook for e-learning in LTC settings.
    • III.2 - Computer-based design & implementation of improved online classes & modules including
      (a) depression in dementia,
      (b) falls QI outreach, &
      (c) dementia care.
      This process will include utility & usability evaluations from instructors & learners.
    • III.3 - Computer-based design &/or implementation of online classes or modules to include
      (a) workforce development,
      (b) “Dining At Home,” &
      (c) QI efforts with FL QIO.

Deliverable IV - March 1, 2006

  • IV -  For the further development of the depression in dementia training module, TNH will provide the following:
    • IV.1 - A manuscript describing nurse competencies & learning objectives for improving care of nursing home residents with depression in dementia.
    • IV.2 - A set of 5 GeriU learning objects (LEOs) on improving recogni-tion & management of depression in dementia that will be developed & linked into an instructional module.
    • IV.3 - The design, development, & delivery of a module for a blended-learning curriculum in depression in dementia in LTC, including the design & develop-ment of a set of multimedia learning objects (coded according to a computer industry standard), with instructor & user guides, a curriculum outline, & evaluation Methodology.
    • IV.4 - Feedback from focus groups & testing of a sample of LPNs.
    • IV.5 - Evaluation of a beta version of individual LEOs on improving recognition & management of depression in dementia.
    • IV.6 - Facilitation of the mail-out of the training module DVD to all FL nursing home facilities.

Deliverable V - April 1, 2006

  • V - Further development of the falls tools to provide:
    • V.1 - Design & develop-ment of a touch–screen-based blended-learning outreach in QI for the prevention of falls & related injuries in nursing homes, including an initial plan & subse-quent modifications based on input from stakeholders, including NH care staff & adminis-tration & AHCA’s quality monitors.
    • V.2 - Implementation of  touch-screens & expert-guided blended-learning outreach for introducing a QI process for prevention of falls & related injuries in self-selected south FL nursing homes. The project will be intro-duced at a minimum of  3 nursing homes in south FL. A complete analysis of the project will be provided along with a work plan for implemen-tation to a large number of facilities in the contract year 2006-07.
    • V.3 - Development & implementation of an aggressive marketing plan of the falls tools to include mail-out & feedback from all FL nursing home facilities. The project will include the production of a printed curriculum that links to the MDS Fall RAP. The mail-out will be directed to the risk manager at each nursing home with a feedback survey of the tools.

Deliverable VI - May 1, 2006

Deliverable VII - June 1, 2006