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UNH Nursing Professor Awarded National Scholarship to Study Safer Discharge Planning for Elders

Contact Sharon Keeler
UNH Media Relations
(603) 862-1566

July 29, 2003


DURHAM, N.H. -- University of New Hampshire Assistant Professor of Nursing Janice Foust has been awarded a scholarship from the John A. Hartford Foundation's "Building Academic Geriatric Nursing Capacity Scholar" program. She is the first person from the UNH faculty to ever receive this honor.

The program, which began in 2000, aims to create a new group of nursing leaders and scholars to advance the quality of health care to older adults, inform health care policy and build a powerful national network.

One of only eight nurses to receive the post-doctoral scholarship in the prestigious 2003 national competition, Foust will receive $100,000 over two years to support her post-doctoral studies at the University of Pennsylvania and research in the field of geriatric nursing. She will be working with faculty at Penn's Hartford Center of Geriatric Excellence.

Foust's research focuses on safer discharge planning for older adults being sent home from hospitals. Nearly one in five patients had "adverse events" after they were sent home -- most of which could have been prevented or eased with better care -- according to a study conducted by the University of Ottawa and Harvard Medical School.
Most of these problems involved difficulties with medications.

Foust says this is not surprising and may be the result of gaps in the healthcare system that need to be corrected.

"We need to move away from blaming individuals who are doing their best, and focus on improving systems within healthcare," Foust says. "Hospitals, clinics and homecare agencies need to develop better ways to make it easier for the elderly to understand and take their medications properly. Right now the responsibility rests on the individuals and their families."

Foust says the elderly often have numerous medications to track -- she recalls a patient who kept his pills stored in a fishing tackle box -- and this presents a challenge and host of questions. What medications is the patient already taking at home? If the drug is filled generically with a different name than in the hospital, will the patient know it is the same drug? Will the new drug interact with over-the-counter medications?

"We also see patients selectively filling prescriptions because of the high cost," Foust adds. "We need to make it easier for people, and nurses are in a terrific place to be part of the solution."

Foust's research examines both rural and urban experience, focusing on New Hampshire and the Boston area. She is analyzing medication discharge efforts and will conduct interviews and focus groups with home care nurses, discharge planners, physicians, pharmacists and patients. "What we're looking at is system change," Foust says. "What are the common issues? What most likely affects patients? Our goal is to
conduct a pilot intervention program the second year."

For example, Foust says a study conducted by Vanderbilt University, Visiting Nurse Services of New York and others found a nurse-pharmacist team improved medication use among older adult homecare patients.

"Communication is the biggest issue," she says. "Patients need to know how to prepare their medications at home, how to set up a schedule, etc. When instructions are given on discharge, this is not exactly the best learning environment. A nurse-pharmacist team checking in with the patient at home would be a valuable strategy, along with better communication with the patient's primary care physician."

Foust says the Hartford Fellowship will help her further her research and eventually provide better and more cost effective care to high-risk older adults.

"What's most exciting for me is that what we learn will not only help those working in the health field, it will help prepare our students to become better nurses," Foust says.

For more information, Foust can be reached at janice.foust@unh.edu or (603) 862-2989.

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