Sample Implementation Goals
You can develop and implement 3 goals for your organization. Review sample goals listed below for initiatives to implement.
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- Add geriatric assessment tools to admission assessment, such as measures of function, nutrition, cognition, social support, comorbidity, and psychological state.
- Utilize a chemotherapy toxicity predictive model in 20 new patients 65 years of age and older who are anticipated to start a new treatment regimen.
- Develop an interdisciplinary team to review cases of oncology patients 75 years of age and older to determine geriatric needs or resources which could be offered (Ex: rehab, nutrition, pharmacy, supportive care, etc.).
- Pilot the use of a short geriatric assessment tool (Ex: VES-13 or Geriatric 8) for patients 70 years of age and older in the outpatient and/or inpatient care setting and determine further referrals that might be needed.
- Perform a Timed-Up-and-Go (TUG) as baseline for new patients starting treatment (chemotherapy/ immunotherapy) to assess functional status and fall risk.
- Implement the use of a pain assessment scale (Ex: PAINAID) for patients with dementia at our institution.
- Develop a polypharmacy review program in which inpatients over 70 years of age with more than 5 medications receives a pharmacist review of medications for interactions, duplication, and appropriateness for use in older adults (using the Beers Criteria).
- Perform a preoperative geriatric assessment in patients 70 years of age and older to evaluate physical function and cognition prior to surgery to predict the risk for postoperative delirium, morbidity, and mortality by using the Mini-COG© and TUG screening tools.
- For hospitalized patients age 65 and older with a Body Mass Index (BMI) of 20 or below will have a Mini-Nutritional Assessment (MNA) performed and nutrition consult prior to discharge.
- Track National Database of Nursing Quality Indicators data in patients age 65 and over to monitor rates of catheter-associated urinary tract infections (CAUTI) and falls in the older population. Develop plans for impacting rates through education of staff and monitor rates pre- and post-education.
- Perform a needs assessment of your nursing staff to determine gaps in knowledge in the care of geriatric oncology patients. Provide education on the top 3 topics from your needs assessment.
- Develop or incorporate a Geriatric Oncology Nursing Grand Rounds program and present quarterly to nursing staff.
- Develop nursing staff education (RNs, APPs, NAs, MAs) to increase knowledge and assessment skills to help identify issues unique to geriatric population. Incorporate CE’s where applicable.
- Develop or update the educational materials handed out to patients/families to be Gero-Friendly using enlarged fonts, low glare, appropriate reading level, color pictures, and bolded titles.
- Disseminate gerontology education (Ex: geriatric assessment, geriatric tools and interventions) to nursing and ancillary staff for inpatient and/or outpatient care setting.
- Implementing screening process for cognitive impairment with BMT patients 65 and older prior to transplant admission and with each milestone office visit post-transplant in order to identify cognitive decline.
- Create a list of community resources for geriatric patients with local resources already in place and disperse information on paper as well as post on hospital/clinic website.
- Perform the Katz Activities of Daily Living Scale on Day 1 of each treatment cycle for patients 65 years of age or greater to screen for functional issues and refer or educate as needed.
- Create or evaluate nutritional tools and provide age appropriate nutrition tips for adults greater than 75 years.
- Disseminate gerontology educational monthly or quarterly via a newsletter to post and educate nursing staff.