geriatric research proposal

In the Geritatric section. I started a thread on "Care Plans an Exercise in Futitlity" that generated a lot of comments from nursing. I can understand the nursing practice act, and federal guidelines that mandate that we use it. But how this theory is actually applied in geriatric settings is confusing. For example in California the nursing practice acts states that the RN is responsible for this process. In a geriatric setting in the Federal guidelines (OBRA) they are refering to the Nursing Care Plans as an Interdisciplinary care plan. In LTC we have LPN's, dietary supervisors, social service designees, activity directors, Physical therapists, dieticians, etc. writing what appears to me to be a Nursing Care plan. Because nurses can be assigned to as many as 30-60 pts. in LTC they really cant utilize this process the way it was intended. When surveyors come in they seem to focus more on what is written in the Care plan then to the actual care being given.

I need to do a paper in my nursing research class on a research proposal on something that I do at work that confuses me and makes me question why I do what I do. I am so confused!!

I need examples of proposals, I am a geriatric nurse and I can't come up with any ideas. I know why I do what I do.

Any ideas?

Help!!!!

One of the nursing homes I used to work at would put a clean class at each pt's bedside, filled with cold water, once a day. A possible research hypothesis would be regarding why put an open glass with cool water by the bedside stand only once per day? Why not have a pitcher of ice water, or large styrofoam glass of ice water at the bedside. The research theory could be: A resident will drink more water if ice water is replenished 2x/day, than if a glass of water is replaced daily. The tool used would have to be pre and post self-report regarding how many glasses of water they drink per day.

Just a thought. Without knowing your work situation, I'm not sure what else would work.

The standard in California is that a pitcher of ice water is placed at each residents bedside at least one time a day and refilled as needed. I believe that there is already data about what temperature liquid needs to be in order for it to be paltable. Cold beverages need to be served cold and hot beverages need to be served hot b/c the closer they reach room temperature the more likely they are to stimulate the gag reflex. Not to mention the type of bacteria stagnant uncovered room temperature could grow.

One of the nursing homes I used to work at would put a clean class at each pt's bedside, filled with cold water, once a day. A possible research hypothesis would be regarding why put an open glass with cool water by the bedside stand only once per day? Why not have a pitcher of ice water, or large styrofoam glass of ice water at the bedside. The research theory could be: A resident will drink more water if ice water is replenished 2x/day, than if a glass of water is replaced daily. The tool used would have to be pre and post self-report regarding how many glasses of water they drink per day.

Just a thought. Without knowing your work situation, I'm not sure what else would work.

what about behaviors related to pain? Are we treating behaviors related to dementia when residents are actually in pain?

believe this or not most intermittent calling out and agitated behaviors are when a resident has to use a toilet. can you imagine knowing you have to use the toilet and having no one take you to the toilet and having to urinate or deficate all over yourself? can you imagine how uncomfortable a resident feels sitting in wet smelly clothing? that is what i think all the fuss is about. i think you're on to something though, the behavors could be related to all kinds of discomfort, such as thirst, being too hot or cold, needing to have a position change, etc. that's where the nursing diagnoses comes into play after identifying the problem like a behavior we are supposed to find the etiology or what is causing it so that we can alleviate it. more often than not we go from identifying a problem to a quick fix. i think when a resident is not responding to the psychotropic med it could very well be from pain. good observation!!!!!!!

what about behaviors related to pain? are we treating behaviors related to dementia when residents are actually in pain?