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Strategy Submission

Observing the 4Ms in Nursing Care of Older Adults


Lisa Foster



Assistant Professor of Instruction



The University of Akron


Competency Categories:

Evidence-Based Practice, Patient-Centered Care

Learner Level(s):

Pre-Licensure BSN

Learner Setting(s):

Clinical Setting

Strategy Type:

General Strategy

Learning Objectives:

Patient-Centered Care knowledge, skills, and attitudes (KSAs): Knowledge- Integrate understanding of multiple dimensions of patient-centered care Skills- Identify patient preferences and implement them in the plan of care Attitudes- Value seeing what matters most “though patients’ eyes” Evidence-Based Practice knowledge, skills, and attitudes (KSAs): Knowledge- Discuss the role of evidence in determining best clinical practice Skills- Participate in structuring the work environment to facilitate integration of new evidence into standards of practice Attitudes- Value the need for continuous improvement in clinical practice based on knowledge Safety knowledge, skills and attitudes (KSAs): Knowledge- Recognize potential and actual impact of national patient safety initiatives Skills- Apply national patient safety initiatives to focus attention on safety in acute care settings Attitudes- Value relationship between national safety initiatives and implementation in the clinical setting

Strategy Overview:

The purpose of this teaching strategy is to introduce undergraduate nursing students to the John A. Hartford Foundations (JAHF), Institute for Healthcare Improvement (IHI), American Hospital Association (AHA) and the Catholic Health Association of the United States (CHA), 4Ms (what matters, medication, mentation, and mobility) Framework for Age-Friendly Healthcare Systems in which older adults received evidence-based care that is patient-centered, in alignment with their goals and preferences, and is safe, causing them no harm. This strategy best complements a Nursing Care of Older Adults at the junior level in an acute care setting. This teaching strategy will be implemented after nursing students have a simulation in the learning resource center including a geriatric cardiac client who is end-stage CHF and experiences delirium during hospitalization. To prepare for clinical the night before, the students will read the article, Nurses Leading the Way to Age-Friendly Care Using the 4Ms Model. In pre-conference, students will be given a pre-evaluation to assess baseline knowledge about age-friendly care using the 4Ms framework and will view the PowerPoint presentation, Observing the 4Ms in Nursing Care of Older Adults. Students will then be instructed on how to use the Find the 4Ms at your Clinical Site. In post-conference, students will discuss their findings including health screenings.

Submitted Materials:

Additional Materials:

Evaluation Description:

Evaluation of the strategy will be through a pre and post-evaluation. At the beginning of clinical in pre-conference, students will be asked to complete a five-item survey about the 4Ms Framework of Age-Friendly Health Systems and the research article they read to determine the student’s baseline knowledge. At the end of clinical, in post-conference, students will be asked the same five questions to measure changes in their knowledge.
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