Specialist Gerontology Nurse in Primary Care
Harbour Health PHO is working in collaboration with the University of Auckland, Freemasons’ Department of Geriatric Medicine and with the support of the specialist services for adults at Waitemata District Health Board to develop a specialist nurse role based around care of the older adult.
Practices to take part in the demonstration have been selected and the demonstration commenced in October 2010. Final evaluation is due July 2011.
Primary care nursing roles have developed significantly in recent years, with more nurse-led clinics, particularly focused on chronic health conditions. With the rapidly increasing older adult population, there is an increasing need for a nurse role with gerontology expertise to meet the needs of this group. The demonstration offers the first primary care-based career pathway for registered nurses in the care of the older adult.
The role in this care co-ordination demonstration focuses on improving chronic conditions management for older adults, particularly improved diabetes and cardiovascular services. Those patients with diabetes and/or CVD are being actively monitored and supported in accessing various services, such as dietary, podiatry or retinal screening. The demonstration focuses on care co-ordination, aiming to ensure efficient management of services, sharing of patient information and improved liaison between community and secondary care services.
This demonstration fits with the current Government position of ‘Better, Sooner, More Convenient’ by supporting the high need older adult in the community and using screening and assessment tools to identify unmet need.
Objectives:
- Provide a pathway for the development of a specialist gerontology registered nurse in a PHO/primary care environment
- Up-skill general practice teams in the management of high need older adults in the community
- Provide systematic proactive screening in primary healthcare for high risk older people
- Provide a comprehensive gerontology assessment in primary healthcare
- Increase care planning using IT-based decision support
- Improve the co-ordination of care for the older adult in the community by ensuring appropriate access to interdisciplinary teams across primary, community and secondary services
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