HELP Project Planning Tool

In this section think about…. Will you be able to do all of the HELP

interventions? Will you have to modify any of the original HELP

interventions?How will you go about recruiting, training and

retaining volunteers?What type of attributes will you look for in

volunteers?

Categories of HELP Interventions

Elder Life Specialist Protocols/Volunteer Interventions

Comprehensive Gerontological Assessment, Interventions and Protocols

Interdisciplinary Interventions

Elder Life Specialist Protocols Risk factor ELS Protocol

Cognitive Impairment Daily Visitor /Orientation/

Therapeutic

Activities

Sleep Deprivation Sleep Enhancement

Immobility Early Mobilization

Vision Impairment Vision

Hearing Impairment Hearing

Dehydration Meal Assistance/ Fluid Repletion

Sleep Enhancement Criteria- difficulty falling asleep or sleeps poorly at home or in

hospital Intervention

Avoid sleeping pills Instead:

Back rub (if not contraindicated) Warm blanket Warm drink such as herbal tea or warm milk Soft music

Early MobilizationCriteria- all patients assessed for

early mobilization

Intervention- ELS/CNS consults with

Physiotherapist to determine appropriate mobilization protocol:

Active range of motion exercises 3 times per day

Supervised walking 3 times per day according to PT guidelines

Healthy Eating/Fluid Repletion Criteria-appetite rated as poor Criteria-clinical evidence of Intervention- dehydration and

Assist with set-up of meals Urea X10/Creatinine> 0.7 Encourage food intake Intervention- Encourage fluids Ensure regular mouth care if not

contraindicated Assist with menu completion

Healthy Vision/Healthy Hearing Vision Criteria- if near vision in both eyes

<20/70 Intervention - Eyeglasses clean and on - Magnifying glass

Hearing Criteria-<3 whispers from each ear

on whisper testIntervention

-Hearing aids in and turned on-Consider use of hearing amplifier

Orientation/Daily Visitor/Therapeutic Activities Criteria- all patients are enrolled Intervention-Orient 1 time per day if MMSE >20, orient 3 times per day if MMSE <20 -Explore patient’s interests and possible therapeutic activities -Discuss current events, structured reminiscence, word games

(Inouye et al. N. Engl. J. Med. 1999, March 4 340 (9): 669-676)

In this section you will learn about…Elder Life Clinical Nurse Specialist’s (CNS)

practice roles in HELP

Nursing specific HELP protocols

HELP education strategies

Program operations

CNS’ Role in HELP Clinician; CNS as an expert clinician of older adults

population conducts focused assessments and interventions based risk factors and “geriatric vital signs”; emphasis is on prevention of delirium and functional decline; post-discharge follow up

Consultant; CNS as a consultant shares her knowledge with patients, families , nurses , unit manager, allied health and physicians

Educator ; CNS as a staff coach; a mentor; a resource for staff, patient and families

Leader; CNS as a change agent, role model, patient advocate, resource for staff, coordinator of provider education program and gerontological nursing in-services.

Researcher ; CNS participates in transfer of knowledge

HELP Nursing Protocols Targeted Risk Factor Approach using

protocols

Evaluation of Cognitive Status• Delirium Protocol • Dementia Protocol • Psychoactive Medications Protocol

Sleep Enhancement ProtocolEarly Mobilization Protocol

More Nursing Protocols… Hearing Protocol

Fluid Repletion Protocol

Discharge Planning Protocol

Optimizing Length of Stay Protocol

Additional Areas –

Education strategies employed at HHS…• On demand• Scheduled education sessions for staff and

students• Annual Seniors month education• HHS new staff orientation; yearly staff review

sessions• Orthopedic staff orientation• Seniors HHS Corporate initiative – environment,

culture and clinical processes• Gentle Persuasive Approaches , e-learning • RNAO fellowships (many!)

PROGRAM OPERATIONSRecord and maintain ELNS interventions

progress reports

Serve as a liaison between the program and nursing administration

Track and address quality assurance

Provide clinical and administrative support for ELS and volunteers

Recruitment Training and Retention

HELP Project Planning ToolIn this section think about….How will you go about recruiting volunteers What qualifications will you set for the

volunteer role?(age, personal attributes, previous experience, time commitment, police check, health clearance)

How will you go about training the volunteers?

What strategies will you use to help retain volunteers?

Recruitment Work closely with Volunteer Resources -provides volunteer recruitment, screening and

general training. They also identify hospital volunteers who seem suited to undertake the additional training to become a HELP volunteer.

While the program seeks volunteers of all backgrounds, it has become a sought-after experience for many college/ university students, especially those interested in the health care field.

Look for a mixture of different types of volunteers. If you only draw from the student population you will struggle with covering shift during student downtimes like exams

Volunteer Qualifications Reliable and caring; enjoy working with older people Mature in judgment Discreet, empathetic behavior and ability to exercise

diplomacy intalking to patients, patient’s family and staff. Ability to relate with sensitivity to all patients Ability to work independently and assume

responsibility Ability to refer questions to others as neededMinimum time commitment of 1 shift per week for 6

months

Training Training should be done a minimum of three times a year Volunteers attend 12 hours of classroom training which

includes An overview of the Volunteer Manual and HELP videosGuest speakers which include Physiotherapist to

demonstrate safe mobility with patients , Speech Language Pathologist to help instruct on meal assistance, a Recreation Therapist to provide training in Montessori based activities, and a member of the Alzheimer Society to provide an overview of dementia

12 hours of ward training which includes Includes a detailed tour of the environment-where to find

supplies and how to get informationShadowing a several different experienced volunteers

during their shifts

Retention Consistent and ongoing support

and mentorship from HELP staff Volunteer Recognition