Disseminating Geriatric Content to Specialty Nurses: The Web Fellow Project

American Nephrology Nurses’ Association 

The American Nephrology Nurses’ Association (ANNA; www.annanurse.org) has put its older adult link on its home page, on the left-hand margin, creating a permanent place within the association’s Web site.

In ANNA’s case, the “Spotlight on Older Adults” begins with a welcome letter from Web Fellow Terran Mathers, DNS, RN, who invites the association’s 12,000 members to consider that “an aging population and kidney disease are global concerns.” From there, visitors have access to links to a wide array of information and information sources on caring for older patients.

Dr. Mathers, a nephrology nurse for 27 years and founder of the ANNA chapter in Mobile, Alabama, is a volunteer Web Fellow. She teaches community nursing, psychiatric nursing, gerontology, and nutrition at Spring Hill College in Mobile. In October 2004, she attended the first meeting of the NCA project and found that its goals tied in with ANNA’s goals of better integrating gerontology into its meetings.

“The organization has always tried to talk about the older population, but NCA brought it to the forefront,” says Dr. Mathers. “Any nurse needs to know first what is normal to distinguish what is abnormal; and, with older adults, kidney problems can present in different ways.” She adds that, with the older adult, hypertension and diabetes are common chronic illnesses that can cause kidney problems, although there is also some loss of kidney function with normal aging.

To set up the ANNA older adult page, Mathers looked at what other associations had done and shared her ideas with ANNA’s executive director and the Web site overseers. The result was a Web page that lists many resources, including links to ANNA’s own resources as well as GeroNurseOnline. The Web site includes the “Try This” series of assessment tools produced by the Hartford Institute, information about upcoming meetings, and a “Focus of Care” section that highlights gerontologic care of significance to older nephrology patients. The association has added to its existing information on long-term care learning modules, “End-of-Life Decision-Making and the Role of the Nephrology Nurse” and “Stage 5 Chronic Kidney Disease—Hemodialysis in the Long-Term Care Setting.” The newest modules are those dealing with depression and chronic illness. All of these may be obtained by clicking on “ANNA Resources” under the GeroCare Links column.

The best thing about the new site, says Dr. Mathers, is that the information is fresh even though maintenance of the site is minimal. Like other NCA members, ANNA draws heavily on resources from other organizations. It has advertised the site through a booth at its annual nephrology nursing conference and in the bimonthly ANNA UPDATE booklet by means of a cover story. Feedback has been overwhelmingly positive.

Asian American Pacific Islander Nurses Association 

A relatively small association, the Asian American Pacific Islander Nurses Association (AAPINA; http://www.aapina.org/) packs a big punch with its “Gero Site.” Melen McBride, PhD, RN, is both volunteer Web Fellow and newsletter editor for the growing association of 200-plus members, which launched its gero-page of the organization Web site in early January 2007.

When AAPINA decided to become part of the Web Fellow program, Dr. McBride was the logical choice to develop the geriatric component of the site. Based in Manhattan Beach, in Los Angeles County, California, Dr. McBride is associate director emeritus and a gerontological nurse consultant who continues to work at the Stanford Geriatric Education Center, Stanford University. The webmaster for the larger AAPINA Web site, Asako Katsumata, a doctoral student at the University of Illinois, serves as a second Web Fellow, providing the technological expertise.

To ensure that the site would be maintained once it was launched, the AAPINA board agreed to form a geriatric interest group within the organization, so that group members could contribute information on an ongoing basis. Since she completed the basic design of the geriatric Web component, Dr. McBride has focused on seeking new information to post.

“We have a very mixed group in terms of practice areas, so it’s important that our members have access to very basic information about normal changes in aging and assessment issues to help them when they encounter an older patient,” she says.

Like ANNA, AAPINA has chosen to include a link to its older adult page on the homepage’s left-hand navigational bar. Once in the “Gero Site,” visitors can view events at universities around the country, resources, a bibliography, links to enable networking with geriatric experts, and a feedback form.

A key focus of Dr. McBride’s work is health literacy, an important need among the Asian American and Pacific Islander patient population. She points out that just being Asian or Pacific Islander does not necessarily make an Asian American or Pacific Islander nurse culturally proficient especially among the 50 to 60 Asian American ethnic groups.

“There is limited English proficiency for many patients, and education must often take place in their own language,” says Dr. McBride, who developed the section on ethnogeriatrics for GeroNurseOnline.org. “There is also a need to appreciate the relationship of cultural beliefs to the ability of older persons to be active participants in their health care.”

Thus Dr. McBride has posted materials on the Web site that link nurses to resources at the Stanford Geriatric Resource Center, a federally funded training center on ethnogeriatrics. Its educational programs and resources focus on health, aging, and cultural issues of older ethnic minority groups including Asian American and Pacific Islander elders.

For some members who are living in intergenerational homes or who are long-distance caregivers, even overseas, the information serves a personal as well as a professional purpose. Dr. McBride indicates that members are astounded by the amount of information on the site.

Academy of Medical-Surgical Nurses 

For associations that have a significant amount of geriatric educational material to distribute, the Web Fellows program has created a supportive environment in which to assemble that information and bring it to their memberships in a comprehensive way. The Academy of Medical-Surgical Nurses (AMSN; http://amsn.inurse.com), one of the earliest groups to join NCA, is such an organization. During the course of the project, the organization has grown from 4000 to 6500 members, due largely to a movement by hospitals to certify more medical-surgical nurses in their effort to achieve magnet status.

The AMSN has appointed a volunteer Web Fellow, Joan Waldron, who works closely with the association’s webmaster. Now that the geriatric page is up and running, Ms. Waldron spends about 4 hours a month keeping it up to date. The geriatric part of the Web site is found by clicking the “Resources” tab on the top of the homepage.

“We all knew we were taking care of older patients, but the Web Fellow program gave us ideas on how to get the word out,” says Sally Russell, education director of AMSN. “NCA gave us a structure.”

Ms. Waldron communicates regularly with a Web-planning committee and with Ms. Russell to ensure that the site addresses any new initiatives in the association or relevant legislation. Much of AMSN’s geriatric content and its links are provided by a geriatric special interest group, which is also working with the association’s board of directors on drafting statements about the group’s beliefs about taking care of the older adult. According to Ms. Russell, the AMSN has always strived to inform its members of issues pertaining to care of the geriatric patient or to Medicare/Medicaid changes. However, she credits NCA with making available such resources as the “Try This” series and other links that would have taken much time and effort to research from scratch.

Education about the older adult is especially important for medical-surgical nurses, says Ms. Russell, because they tend to see older adults as sick and often poor, because that is who comes to the hospital. However, many people are living longer in the community, and part of the association members’ goal must be to keep them there.

As an example, Ms. Russell says that nurses might forget to look for melanoma in an older person because they assume that an 80-year-old’s skin is supposed to look different from a younger person’s skin. “There is a lot of education that is still needed about what are normal versus abnormal changes in aging,” she says, adding that the association is growing so quickly, there is a new crop of nurses at each annual meeting with whom to share this education and new information.

There is much evidence that members are using the geriatric resources on the Web site, says Ms. Russell, especially from the number of members who request contact hours after having read geriatric journal articles there—which is much higher than it was 5 years ago. The association hopes to add more specific geriatric content to the page as well as videos and more interactivity.