Mathy Doval Mezey

The protocols in this thoroughly updated edition address key clinical conditions and circumstances likely to be encountered by a hospital nurse caring for older adults. They represent "best practices" for acute care of the elderly as developed by nursing experts around the country as part of the Hartford Foundation's Nurses Improving Care to the Hospitalized Elderly project (NICHE). New to this edition are chapters on evaluating practice guidelines and measuring quality and outcome of care. Although the protocols were developed for acute care, they can be easily modified to work in other practice settings, such as the nursing home or home care.

Second Edition

Geriatric Nursing Protocols for Best Practice

Christine K. Cassel

Melissa M. Bottrell

Judith L. Howe

Kathryn Hyer

The delivery of good medical care often involves professionals from various disciplines working together. Interdisciplinary health care teams can be especially valuable in managing patients with complex medical and social needs, such as older persons in hospital, community, or home settings. Such teams, however, can also complicate or even create problems because of their diverse views and responsibilities. Ethical Patient Care: A Casebook for Geriatric Health Care Teams is designed to teach effective and responsible group decision making to clinicians working in teams to treat older patients. The editors use the case study method to present ethical dilemmas that team members encounter in the management of geriatric patients. Patients with multiple chronic conditions so often require the care of more than one medical specialist, and in the introductory chapters the editors suggest ways to resolve conflicts among patients, health care professionals, and the institutions that support them, including hospitals, HMOs, insurance companies, and the government. The book is then divided into four sections, each dealing with one angle of the team-care picture. The first section treats the diverse ethical imperatives of various professionals, conflicts among disciplinary approaches, and and varying attitudes toward end-of-life- decision making. Section two focuses on the patient and covers patient confidentiality, family decisionmaking and interaction with the healthcare team, issues of patient and team nonadherence to the care plan, and elder abuse and neglect. Section three examines the emerging difficulties of decentralized health care in settings such as hospitals, nursing homes, and the home, including clinician accountability and how ethical dilemmas differ across settings. Section four discusses the problems arising from the increasing responsibility of clinicians to manage costs and serve the interests of hospitals and insurers. Ethical Patient Care is a valuable resource for bioethicists, gerontologists, and the physicians, nurses, social workers, and therapists who care for aging persons.

Mathy Doval Mezey

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