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

Aging and the Cardiovascular System

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

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.

 

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

One of the losses that individuals who enter LTC may experience is that of regular participation in faith communities; whether in an LTC facility or still at home, the individual now depends on the faith community coming to that setting. Spiritual practices offer a resource that can help the individual to adapt to LTC and HCBS settings.

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

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.

 

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

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

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.

 

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

Adolescence is usually a time of good health for most people, characterized by specific physical, intellectual, emotional, and social developmental tasks that prepare a young person for a successful transition into adulthood. Nonetheless, a substantial proportion of children and adolescents have one or more disabilities that will uniquely impact that development and transition. It is therefore important for those working with young people to understand the developmental needs of youth with disabilities so that these young people can thrive. In this paper, we review the epidemiology of disability among youth, the developmental stages of adolescence and how they intersect with disability, and the promotion of resilience and healthy transitions to adulthood for youth and their families. We specifically discuss participation in extracurricular activities as a way to support health development and promote resilience among youth with disabilities, and we conclude by providing a specific example of how one school that serves students with visual impairments has modified sports and other activities so that these youth can experience the developmental benefits of participating in such activities.

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

 

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

Although it is the body’s largest organ, skin is often underappreciated. Skin not only provides a protective barrier for the human body, it also plays an active and important role in physiological processes such as thermoregulation and immunological function (Egert & Simmering, 2016). But aging impacts the skin’s function, just as it does the function of other organs. Both intrinsic and extrinsic factors can damage the skin, eroding the older adult’s quality of life. Skin care is therefore especially important for the older adult. The purpose of this paper is to provide the state of the science on skin and skin care as it relates to residents in long-term care facilities.

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

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.

 

Antimicrobial Stewardship and Infection Prevention and Control

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

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.

 

Skin Infections Among Elderly Living in Long-term Care Facilities

In the U.S. today, the population of individuals who are 65 years of age and older is increasing (U.S. Census Bureau, 2018), and nurses, as frontline health care providers, are increasingly becoming a conduit for healthy senior living. This module therefore focuses specifically on adults ≥65 years of age with skin infections, a healthcare concern that is especially important among those who are living in long-term care facilities (LTCF). 

Michelle K. Kotti BSN, MSN, FNP-BC

 

Pain Management of the Geriatric Patient

Pain is a major public health concern that if left untreated can lead to poor health outcomes. Older adults in particular are at high risk for inadequate treatment of pain. Older adults also often have comorbidities that increase their risk for experiencing pain. The purpose of this paper is to identify barriers to pain management in geriatric patients as well as evidenced-based strategies that registered nurses and advanced practice nurses can use to address those barriers. After reading this paper, nurses should be able to identify (1) appropriate tools for assessing pain in geriatric patients with and without cognitive impairment, (2) cultural considerations that should be taken into account in pain assessments, and (3) appropriate steps and resources for determining correct pain medications for the geriatric patient.

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

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.