When it comes to helping older adults thrive, University of Wisconsin Oshkosh alumna and nurse practitioner Maria Brenny-Fitzpatrick, ’05 MSN, is committed to the cause.
The nursing graduate oversees the Acute Care for Elders (ACE) Interdisciplinary Consult Team at UW Hospital and Clinics in Madison. The team’s goal is to assure the safest and highest quality of care for the geriatric patients at UW Hospital.
“The geriatric population is at high risk for complications that can lead to longer hospital stays, long-term disability, nursing home placement and increased morbidity and mortality,” said Brenny-Fitzpatrick.
By working together, the ACE team helps prevent hospital-related complications and helps the patient maintain functional independence, she added. The team consists of geriatricians, an advance practice nurse, a social worker, pharmacist and a physical therapist.
To date, the program, now in its third year, has helped nearly 500 patients.
“Too often, independent older adults find themselves in the hospital after a fall or other medical emergency, and refuse physical therapy due to their pain,” Brenny-Fitzpatrick said. “But refusing therapy often leads to more serious problems — their appetite and thirst decline, and they become malnourished and dehydrated.”
Over time, their inactivity and its accompanying effects decrease the patient’s chances of returning to the comforts of home. Often, nursing home care becomes their only option. The role of the ACE team is to ensure that the patient receives the optimum therapies, medications and care.
The ACE program, which Brenny-Fitzpatrick was hired to begin in 2005, offers an enhanced element of care for hospitalized older adults.
Physicians initiate a request for an ACE consultation, ideally upon admission. The ACE team meets with the patient and family, reviews medications, therapies and the overall plan of care.
After the daily ACE team meeting, recommendations are communicated back to the requesting physician, nurses and staff. Recommendations may cover such topics as medications, changes in mental status, dementia, delirium, mobility and nutritional concerns.
An article about the collaborative efforts of Brenny-Fitzpatrick, a nurse resident and her nurse manager was published in the nursing magazine Advance for Nurses.
The project, completed by UW Madison nurse resident Fawn Havarangsi-Nawaphan, focused on sleep’s impact on older patients’ recovery. Brenny-Fitzpatrick was her advisor.
“We found that sleeping pills tend to cause memory loss with these patients,” Brenny-Fitzpatrick said. “And many older patients already have problems with their memory.”
So Brenny-Fitzpatrick worked with the student and her immediate supervisor, Linda Walton, to find solutions to enhance sleep without medications.
“Geriatric sleep was a perfect topic for Fawn’s research project, since she was working nights,” she said.
From topic selection, they did a medical library and literary search.
“We sat down multiple times to review the articles Fawn found, and summarized her findings into a one-page document.”
That document is still being used as a permanent reference at the bedside.
The best approach, Havarangsi-Nawaphan found, is to simulate the home environment as much as possible. She manipulated the unit’s environment to reduce noise—a common sleep disruptor.
Surprisingly, the common sense approach worked wonders. Most noise, according to the patients, was caused by staff talking in the hallways. Posted signs reminded staff to keep their voices down, and patients slept better.
She also borrowed techniques from luxury day spas, such as aromatherapy, warm blankets, back rubs and eye masks.
Helping patients sleep is only one of Brenny-Fitzpatrick’s many success stories.
“As a team, we have been successful in not only improving the care of our geriatric patients, but we also are committed to a mission of educating each of the disciplines on the specialized care of the geriatric patient,” she said.
Brenny-Fitzpatrick is proud that nursing, medical and other interdisciplinary health care workers who spent time in the ACE program are now implementing what they have learned in numerous institutions nationwide.
The ACE team also has received national attention and has caught the interest of the American Geriatric Society at its national conventions.
Yet for Brenny-Fitzpatrick, helping the patient is her most precious reward.
“Perhaps what I have found to be most rewarding is when I look at the roster of nearly 500 patients and believe we have improved the health care experience for each of these patients and their families,” she said.
Her education at UW Oshkosh is a foundation for her daily work, she added.
“I can honestly say that my graduate education at UW Oshkosh helped prepare me very well for this job. I can’t think of one course which I haven’t drawn material for this position.”
Related article: www.uwhealth.org/storage/pub_HealthLink_Winter_2007.pdf