Every morning starts the same way for Veteran Kenneth Tutt, age 79. At 8:00am he makes a phone call to Nurse Practitioner Rhonda Weinhold. Weinhold is a VA Home-Based Primary Care (HBPC) provider. She has been working with Tutt for four years. Together they review his weight, blood pressure and sugar levels. “There is no doubt in my mind I would not be here if it was not for this program,” said Tutt.
Home-Based Primary Care is a VA program bringing primary health care into Veterans’ homes. HBPC provides integrated, patient-centered care for Veterans with complex medical needs. Veterans in the program are assigned a primary care provider like Ms. Weinhold, based at the Staunton, Va., community-based outpatient clinic. “The families, the caregivers in the home, they really depend on us,” she says. “A lot of our patients consider us part of the family.”
“So Many Medications!”
Recently, Weinhold began something new for Tutt and several other patients that has helped to reduce their medications and resulted in higher satisfaction with their quality of life. Not long ago, she attended a VA Geriatric Scholars Program class, which inspired her to develop a medication management program to review patient medication prescriptions. The idea came in part from a HBPC routine: setting up monthly medication boxes. “We love doing it, but we noticed our patients were on so many medications. We just thought, are there medications we could potentially get rid of that actually might be doing more harm or that are not needed?”
She teamed up with HBPC team member Jena Willis, Doctor of Pharmacy (PharmD), to develop the idea. The review, it turns out, often results in a reduction of medications. Weinhold says it is good because, “Research shows the more medication patients are on, especially for the elderly population, the greater the risk for falls.” In fact, Tutt admits to having fallen at home a few times in the past. They consolidate the medication de-escalation recommendations, adding them to each patient’s electronic health record. Tutt, like most HBPC patients, takes a lot of medications for a variety of health conditions.
asked veterans, “How do you feel about trying to get off some medicine?” Tutt
thought, “It was a terrific idea.” The project has helped Tutt feel he’s got a
better chance of being the person he’s always been. “I’ve been an outdoor
person all my life,” said Tutt, who served in the Navy from 1958 to 1970. “I
garden, I raise flowers. I’ve had to cut back, but I’m still mobile.”
HBPC: Keeping Patients Safe in their Homes
“Our goal with Home-Based Primary Care is patient safety,” said Weinhold. “We’re there to keep them safe in the home and to keep them in the home as long as possible.” As they fine-tuned their process, Weinhold brought others onboard. It was a team effort. Three registered nurses met in person with 80 patients over six months. “We were able to reduce the number of medications an average two medicines per patient,” said Weinhold.
After their success in Staunton, they were able to coordinate with Salem VA Medical Center (VAMC) pharmacy residents’ grand rounds presentation on the de-escalation of therapy for the medical department there. The Salem VAMC is Staunton’s Community-Based Outpatient Clinic’s parent facility. The residents added the information to their presentation as an introduction to the rest of the medical facility. “The most rewarding thing is providing improved quality of life for our patients, whether it’s three more days, three more years, or 30 more years,” said Willis.
Maureen Jerrett is a contract
writer for VA Geriatric Scholars Program
UNIVERSITY PARK, Pa. — An anonymous Penn State donor couple has made a gift of $5 million to endow a scholarship for students with financial need in the College of Nursing. This is the largest single gift the college has received in its six-year history. In addition, the University is matching the gift 1:1, bringing the scholarship endowment total to $10 million. Students from western Pennsylvania and rural regions of the commonwealth will be given first preference for the awards.
“The College of Nursing’s potential for impact on the health of communities across the commonwealth is vast, and these donors have recognized that potential through this remarkable gift,” said Penn State President Eric J. Barron. “Their support will help to address the commonwealth’s pressing need for health care professionals and allow recipients to forge meaningful careers in nursing, transforming their own lives. We’re very grateful for this generous gift.”
College of Nursing undergraduates who must meet the cost of a Penn State degree with loans graduate, on average, with an educational debt of more than $42,500. Recipients of the scholarship, however, will receive annual awards of up to $10,000. This will significantly reduce their debt and allow them more latitude to choose jobs in high-need but lower-paid geographic areas and medical fields that present the most urgent need for nurses.
“The extraordinary couple who made this gift have been impressed by the excellence of Penn State’s nursing programs,” said Laurie Badzek, dean and professor of the College of Nursing. “In particular, they appreciate our work to prepare a generation of nurses with a solid grounding in geriatrics and community health.”
“Nursing is a discipline that touches everyone’s life at some point, and these generous donors are helping to ensure better care across the commonwealth,” said Susan Kukic, director of development and alumni relations for the college. “While they have chosen to remain anonymous, they are important role models whose vision for the future of our students and our college will, I hope, inspire others to consider how they can support excellence in nursing and nursing education.”
For information on this scholarship and the nursing program at Penn State, visit here.
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