WHITE PAPERS

Advanced Practice Registered Nurses (APRNs) in Texas Nursing Facilities (NFs)

The Center for Excellence in Long Term Care Advisory Board in collaboration with the Texas Health and Human Services Commission Quality Management Program is working to address the issue of quality in Texas nursing homes. There is a need for nursing leadership at the bedside while improving revenue to the home for use to improve staff outcomes. We have spent the last year working on a model of care in Texas that helps the homes to hire patient centered care providers who may bill for their healthcare services. If revenue is sufficient, the excess can be used to improve staff to patient ratios, but our main objective is to improve the quality of care provided to the resident and their families. The Advanced Practice Registered Nurse model of care is our recommendation at this time. We are working to gain revenue to test this model and improve quality. Please read the attached white paper.

 

TOPICAL PAPERS

Sarah Allison-Kolb RN, P/MHNP, PhD
Psychiatric Nurse Practitioner

Communication and Mental Illness

Sarah Allison-Kolb has over 20 years of specialization in the psych/ mental health field, both as an academic and as an advanced practice nurse. For the last 5 years, she has worked as nurse practitioner on a long-term care unit for older adults in a state hospital, where she is a prescriber  and collaborator on a multidisciplinary team that provides milieu management to older adults with severe mental illness. Prior to working in the in-patient setting, she worked as psychotherapist with diverse patient populations using therapeutic techniques aimed at emphasizing quality of life and reducing mental health problems in clients and couples with various diagnoses and counseling needs. In her academic career, she has focused and published several articles in the areas of  codependency, binge eating and heart disease.  Dr. Allison received her nurse practitioner certification from the University of Texas Health Science Center in Houston, Texas, and her Ph.D. from the University of Texas Medical Branch in Galveston.

 

Carol D. Gaskamp PhD, RN
Clinical Associate Professor, University of Texas at Austin School of Nursing

Faith Community Nurses and Residents in Long-Term Care Settings: Bridging Community and Home

Dr. Carol Gaskamp retired as a Clinical Associate Professor and Assistant Dean for Undergraduate Programs at the UT School of Nursing in 2020. She received a PhD in Nursing from the University of Kansas in 2000. Dr. Gaskamp joined the public health nursing and nursing administration faculty of The University of Texas at Austin School of Nursing in 2001. Her nursing career has been in nursing education and community health nursing practice and administration. A native of Houston, Texas, she lived in the Midwest (Iowa, Wisconsin, and Kansas) from 1976 to 2001. Providing care to the aging and elderly was a large component of her county health nursing practice in rural Wisconsin and Kansas. Dr. Gaskamp’s research area is quality of life, the connection between spirituality and health, and faith community nursing.

 

Ronnie Walker, PhD, RN, NE-BC, CNE
Clinical Assistant Professor, CEASLTC Assistant Director for Gerontological Mental Health Practice, University of Texas at Austin, School of Nursing (see bio below)

Janice Hernandez, DNP, RN, FNP-C
Clinical Assistant Professor, University of Texas at Austin, School of Nursing

Activities of Daily Living and Personal Care for Older Adults Diagnosed with mental illness in Long-term Care 

Dr. Hernandez is a Clinical Assistant Professor at the UT School of Nursing and serves as Division Chair of The Holistic Adult Health Division. She received her Doctor of Nursing Practice Degree at The University of Texas at Austin and currently teaches in the undergraduate and graduate level at the UT school of nursing and is committed to educating culturally competent nursing leaders to serve the community.  Dr. Hernandez is also the academic sponsor for the The Hispanic Nursing Student Association dedicated to serving the community, supporting college students who want to pursue a degree in nursing by hosting internal/external transfer workshops as well as mentoring high school students who are interested in the nursing field. Dr. Hernandez is proud to be the President of Texas DNP - An organization representing Doctor of Nursing Practice graduates, students, and faculty in Texas. Texas DNP advances the health of individuals, families, and communities by promoting evidence-based practices and advocating for patient access, quality and safety. She was recently nominated to participate in the University of Texas Executive Management and Leadership Program, Spring 2020. The goal of the program is to develop expertise among university leaders to meet the business, leadership, and organizational challenges ahead for UT Austin.

 

Tracie Harrison, BSN, MSN, PhD, RN, FAAN, FGSA
Professor, Director of the Center for Excellence in Aging Services and Long-Term Care, University of Texas at Austin, School of Nursing

Health Within Illness

Dr. Harrison’s research interests include the intersection be-tween age related change and functional impairment and how that affects social role performance and subsequent health out-comes. Her policy research interests surround the federal and state laws that affect the long-term health related policies providing benefits and/or services to people aging in long-term care and their respective communities with disabilities, including worker’s compensation, Medicare and Medicaid related legislation.

 

Amber Hoberg, MSN, APRN, PMHNP-BC

Long Term Care and Mental Illness

Amber Hoberg,MSN, APRN,PMHNP-BC is a board-certified psychiatric nurse practitioner working the past 9 years with the adult and geriatric populations. Her background, as a Psychiatric Advanced Practice Registered Nurse, includes psychiatric evaluations, brief psychotherapy, and medication management for individuals with significant mental health conditions and cognitive impairment in the nursing home, inpatient hospital, and group home settings. She is a member of the American Psychiatric Nurses Association and is involved locally with the San Antonio Psychiatric Advanced Nurse Practitioner organization.

Philip D. Houck, MD, MSc, FACP, FACC
Associate Clinical Professor of Medicine, Texas A&M Health Sciences Center

Aging and the Cardiovascular System

Dr. Houck is an aged Cardiologist Associate Clinical Professor of Medicine at Texas A&M University currently working at Baylor Scott & White Health.  He is a retired Air Force Lt Col, and started his academic career at Penn State University in Engineering Science and later received a Master’s Degree in Biomedical Engineering from Northwestern.  He liked Chicago so much he attended Northwestern University Medical School now the Feinberg School of Medicine.  His research interests include weather and myocardial infarction, increasing circulating stem cells, electrical remodeling of the heart, and understanding lymphatic function to improve heart failure therapies.  Dr. Houck’s career goal is to establish a theoretical scientific foundation for medicine and biology by proposing fundamental laws of biology and a model of health and disease.  These guiding principles can answer difficult questions such as why women out live men? Why is there a young female advantage? Why diabetes II is a disease of modern invention?  Why do we age?  Dr. Houck’s passion is to serve as an example, and mentor for students, residents, and fellows helping them to mature into clinicians.  Success is achieved when these young doctors  question what they have been taught.

 

Karen Johnson PhD, RN

Karen E. Johnson PhD, RN, FSAHM, FAAN
Associate Professor, University of Texas, School of Nursing

Dr. Johnson is an associate professor, a Robert Wood Johnson Foundation Nurse Faculty Scholar Alumna (2014 cohort), and a Fellow in the Society for Adolescent Health and Medicine and the American Academy of Nursing. She joined the School of Nursing in 2012 as an Assistant Professor in Public Health Nursing after completing her PhD in Nursing and a four year pre-doctoral fellowship in adolescent health at the University of Minnesota. She also holds a BS in Nursing from the Univeristy of Colorado and a BA in Sociology from Colorado State University. She is an adolescent health and public health nursing researcher.

Chelsea Jackson BSN, RN
School Nurse, Texas School for the Blind and Visually Impaired

Considerations for promoting healthy development and extracurricular activity involvement among adolescents with disabilities

 

Michelle K. Kotti BSN, MSN, FNP-BC

Skin Infections Among Elderly Living in Long-term Care Facilities

 

Kimberlee Maus MSN, RN
Director of Nursing, Austin Oaks Hospital

Clinical Case Studies of Crisis Management of Older Adults Diagnosed with Mental Illness in Long Term Care

Kimberlee Maus has served as the Director of Nursing for several years treating adults diagnosed with mental illness. She is currently the Director of Nursing at Austin Oaks Hospital located in Austin, Texas. She has dedicated her 20+ year nursing career to helping those diagnosed with mental and increasing mental health awareness.

 

Karen Ranus
Executive Director, NAMI Central Texas

Resources and Supports for Staff

Karen Ranus has served as the Executive Director of NAMI Central Texas since 2014. She sits on the Travis County Behavioral Health & Judicial Advisory Committee, the Travis County Psychiatric Stakeholder’s Group and the Steering Committee for the Austin State Hospital System Redesign and serves as one of ten 2020 McBee Fellows with the Austin Area Research Organization. Karen has developed and implemented mental health programs to address the needs of faith communities, law enforcement, workplaces and parents of teens. She has been recognized by the Austin Young Chamber as a ChangeMaker and recently received national recognition from the Charles Schwab Corporation. Karen believes in the power of storytelling to engage people in important conversations on mental health. She is a frequent speaker in the community on a variety of mental health topics where she often shares her own family's story to help others overcome the shame and stigma still prevalent in the community.

 

Jessica Ruiz MSN, RN, NEA-BC

Jessica Ruiz MSN, RN, NEA-BC
Director of Strategic Projects, Stonegate Pharmacy

Jessica has worked in a variety of health care organizations and achieved successive promotions due to her work ethic, integrity, knowledge and responsibility. She has continuous devotion to community health across the lifespan and quality of care initiatives. In 2013 she was nationally certified as a Nurse Executive, Advanced, by American Nurses Credentialing Center. She served on Texas TEAM, a state action coalition to promote the Future of Nursing Report from the Institute of Medicine. She also served as the Diversity Champion for Central Texas with the Texas Nurses Foundation APIN II Grant. Jessica was appointed to a Texas Board of Nursing Taskforce to study implications of the growth of nursing education programs in Texas and long term care nursing staffing.

Patricia Bethancourt MSN, RN
Director of Clinical Services, AseraCare

Linda H. Yoder Linda Yoder PhD, MBA, RN, AOCN, FAAN

Linda H. Yoder PhD, MBA, RN, AOCN, FAAN
Professor, University of Texas at Austin

Dr. Yoder was an Army Nurse Corps officer for 28 years, retiring at the rank of Colonel. She has been at the School of Nursing for 13 years, teaching graduate healthcare systems management courses as well as advising and coaching Master’s and Doctoral students.

Dr. Yoder is an outcomes researcher and has spent most of her career working and conducting research in hospitals. Her areas of research have included examining patient care problems, the nursing work environment, career development relationships of nurses, and quality of life in patients with chronic illnesses, such as cancer, cardiovascular, and pulmonary disease as well as burn survivors. Dr. Yoder continues to collaborate with active duty military researchers, serving as a research mentor to new investigators. She also collaborates extensively with the hospital systems in the greater Austin area.

Facilitation of Change in Antipsychotic Prescription/Practice Habits by Long-term Care Administrators

 

Amanda J. Simonton, PhD, APRN, PMHNP-BC
Clinical Assistant Professor, University of Texas at Austin, School of Nursing

Clinical Considerations for Substance Use Issues in Long-Term Care Facilities

Amanda J. Simonton is a Clinical Assistant Professor at The University of Texas at Austin School of Nursing and a Psychiatric Mental Health Nurse Practitioner in Austin, TX. She has been a Registered Nurse since 2013 and previously worked as a bedside nurse on the Intermediate Care Unit at Seton Medical Center Austin and Psychiatric Emergency Department at University Medical Center Brackenridge. She has been a nurse practitioner since 2018 and has primarily worked in outpatient, residential, and medically monitored withdrawal facilities to treat individuals with dual-diagnosed – substance use and mental health disorders. She earned her Bachelor of Science in Nursing ('13), Master of Science in Nursing (’18), and Doctor of Philosophy (’20) through the School of Nursing at the University of Texas at Austin. She is active in presenting at the annual conferences for Texas Nurse Practitioners and the American Psychiatric Nurses Association. She is currently involved on the Policy Council for Texas Nurse Practitioners and the Board of Directors – Texas Chapter for the American Psychiatric Nurses Association. Her research and clinical interests are to improve the lives of individuals with substance use disorders, particularly opioid use disorder, by utilizing evidence-based care and best-practices in the field of psychiatry and psychology. She is passionate about educating students and healthcare providers on evidence-based practice for patients with psychiatric and substance use disorders.

 

Cherie Simpson PhD, MBA, RN, ACNS-BC, PT
Clinical Nurse Specialist, Senior Adult Specialty Healthcare, P.A.

Review of Federal and State Actions for the Protection of People with Severe Mental Illness and Intellectual and Developmental Disabilities: The Relevance to Nursing Facilities

State of the Science of Skin and Skin Care for the Long-Term Care Setting

Antimicrobial Stewardship and Infection Prevention and Control

Exacerbations of Mental Illness

Cherie Simpson is a Clinical Nurse Specialist in Holistic Adult Health and a graduate of the University of Texas School of Nursing. She has worked with Senior Adults Specialty Healthcare and Research for approximately 10 years. Besides working with SASH she is on faculty at the University of Texas at Austin School of Nursing and conducts research in areas of sleep, caregiving and depression in aging women.

 

Jen Steenbergen, LMSW
Director of MDT Development, Ellis County Children’s Advocacy Center

Person Centered Approaches to Care

Jen has been a social worker for 19 years. She received her BA in Forensic Psychology at John Jay College of Criminal Justice in New York City and a Masters in Social Work from the University of Texas in Austin. Jen has worked in acute psychiatric hospitals, substance use treatment, the Texas Youth Commission, residential treatment centers and foster care. She has experience with administering psychological testing batteries (IQ, academic, attention, autism spectrum; memory and others) and has done extensive peer reviewed research on brain functioning, trauma and emotional regulation. She has worked with Collin and Dallas counties drug courts. Jen has worked with a team to write legislation. She was a professor at Richland College in Dallas, Texas and is currently the Director of MDT Development at the Ellis County Children’s Advocacy Center.

 

Janiece L. Walker PhD, MSN, RN
Assistant Professor in the Johns Hopkins School of Nursing and principal faculty in the Johns Hopkins Center of Innovative Care in Aging

Pain Management of the Geriatric Patient

Janiece L. Taylor, Ph.D., RN  is an Assistant Professor in the Johns Hopkins School of Nursing and principal faculty in the Johns Hopkins Center of Innovative Care in Aging. Her research focus is on identifying and addressing factors related to disparities in disability outcomes among minorities and women as they age. Dr. Taylor received her MSN and PhD from the University of Texas at Austin School of Nursing. Her dissertation work was focused on predictors of disability among older African American women with osteoarthritis, which was funded by NIH/NINR (1F131NR014399-01) and the National Hartford Center of Gerntological Nursing Excellence Scholars program.  She completed a two-year postdoctoral fellowship in the Johns Hopkins University Interdisciplinary Training Program in Biobehavioral Pain Research. She is currently has funding from  the Robert Wood Johnson Harold Amos Medical Faculty Program and the Johns Hopkins Claude D. Pepper Older Americans Independence Center to test an intervention addressing pain and depressive symptoms among older African American women with physical function limitations and frailty.

 

Ronnie Walker, PhD, RN, NE-BC, CNE
Clinical Assistant Professor, CEASLTC Assistant Director for Gerontological Mental Health Practice, University of Texas at Austin, School of Nursing

Life Course Theory to Study Mental Health Issues in Long-term Care Settings

Dr. Verónica García Walker’s work in the area of psychiatric mental health with children and adolescents has spanned over 20 years in a variety of settings including both in-patient and out-patient settings. In 2002, she was hired to manage two psychiatric neurobehavioral units that served adolescents and children at Meridell Achievement Center in Liberty Hill, Texas. Meridell is a specialized residential treatment center for children and adolescents. Dr. García-Walker was recruited in 2006 from Meridell to teach mental health nursing courses in the graduate and undergraduate nursing programs at The University of Texas at Austin. At this time she also was invited to be an instructor for a course in health-professional Spanish language that included content on the Hispanic culture.

Dr. Garcia-Walker completed her PhD in Nursing at The University of Texas at Austin. She is now involved in the research of older adults diagnosed with schizophrenia (OADWS) using Life Course theory in an effort to learn about their perceptions of aging. The purpose of this research is to inform interventions that address their special needs. The research will ultimately assist nursing practice in improving current negative health care outcomes among OADWS, working toward their improved health, increased disease prevention, and improved quality of life.