Test Notes PDF

**[Entrustment professional activities]** **Definition** Units of professional practice (tasks or work) that may be entrusted to a learner to execute unsupervised, once he or she has demonstrated the required competence (Ten Cate, 2012) - admitting a patient upon patient's arrival on the ward a...

**[Entrustment professional activities]** **Definition** Units of professional practice (tasks or work) that may be entrusted to a learner to execute unsupervised, once he or she has demonstrated the required competence (Ten Cate, 2012) - admitting a patient upon patient's arrival on the ward and formulate management plans - performing physical examination of the respiratory system and formulating\ management plans - Preforming immediate post op assessment and managing a patient's pain\ after surgery Three key elements - "Entrustable" refers to acts that require trust to be performed without supervision; - "Professional" refers to the occupations with a specific qualification; - "Activities" refer the tasks that are to be performed Definition of EPA? - Shift of focus from - Individual competencies The work that must be done - Performing dressing change Vs managing a patient after surgery - From assessing proficiency - Entrustment Using competency checklist Vs clinical assessment using trust EPA vs Competency A table with text on it Description automatically generated Why is EPAs Adopted in Healthcare Education? - EPAs - Bridge the gap between theory and clinical practice - Support assessment of competencies in the workplace Competency based medical education - Medical education introduced the concept of Entrustable professional activities, to bridge the gap between competency based medical education and clinical education  A diagram of a step-by-step learning process Description automatically generated Advantage of utilising EPA in Healthcare Education - defining the core learning outcomes, where it guides the Educator bridge the development of the required curriculum and designing appropriate assessments to help learners to achieve the intended learning outcomes. Professionals that use EPA - Doctors - Nurses - Pharmacist - AHP student - Dentistry students Main Attributes of EPAs? - Restricted to a limited number of tasks; - Reflect an experience curve; - Acceptance of responsibility and accountability There are total of 7 EPAs - EPA 1 Performing Comprehensive Health Assessment, delivering and evaluating care for patients - EPA 2 Performing Clinical Procedures required of a Registered Nurse - EPA 3 Conducting and receiving shift handover - EPA 4 Conducting patient/Caregiver Education to promote health, prevent disease and complications - EPA 5 Managing Care Transition across settings - EPA 6 Recognising, escalating and providing initial care for patients who requires resuscitation - EPA 7 Performing assessment, delivering and evaluating care for patients requiring palliative care Eight components in each EPA 1. Title of an EPA 2. Specifications and limitations 3. Potential risks in case of failure 4. Most relevant domains of competence 5. Knowledge, skills, attitudes and experiences 6. Sources of information 7. Level of entrustment 8. Expiration date Eg. Performing comprehensive health assessment, delivering and evaluating care for patients (core)  - Spells out the key activities which a registered nurse will need to perform running from gather information through history taking and medical record review to document clinical encounters in the patient's record. - At the same time, the limitations is also spelt out on the EPA does not cover patients who are unstable or critically ill that require resuscitation. A close-up of a document Description automatically generated - Set of sub competencies marked X which are identified to be relevant to the EPA and they will be part of the assessment too.  A close-up of a survey Description automatically generated Illustrate how the sources of information are obtained to support summative entrustment decision. - In this example, you can see that the registered nurse will have to perform 1 case discussion, 1 direct observation, 1 feedback report and 1 reflective journal for their assessments. - As for the component on entrustment level, it has 4 levels. It describes the level of supervision and entrustment expected of the nursing students starting from year 1 - For level 1, it is just observation. For level 2, the entrustment level is direct supervision. The learner will require guidance to 75% of the time to carry out activities. For level3, entrustment level, the learner will require moderate supervision of up to 50% of the activities carried out. - As for level 4, the learner will require minimal supervision, where the learner will be able to report key findings to the supervisor and execute a plan of care with minimal guidance Tools for assessment - Mini clinical examination - Direct observational procedural skills - Case-based Discussion - Multi-source feedback - Case log - Reflection Methods Used to Assess EPA Attainment - Formative Assessment: refers to tools that identify misconceptions, struggles, and learning gaps along the way and assess how to close those gaps. E.g. CBD, Direct Observation Procedural Skills (DOPS), MSF - Summative assessment: evaluates student learning, knowledge, proficiency, or success at the conclusion of an instructional period, like a unit, course, or program. - E.g. CBD, MSF Effective Constructive Feedback - Two-way between the preceptee and preceptor - Given in a respectful environment and Given as soon as possible - Constructive, specific, and based on direct observations - Balanced (positive points, points for improvement) - Limited: 2-3 major points each for positive points and points for improvement - Aimed at a clear and agreed action plan within a time frame Level of Trust and expiry date - For RNs, consider what a newly graduated RN can be trusted to perform - Expiry date is in alignment with the SNB registration requirement; if an RN is\ not in practice for 5 years, you will be required to attend the return to the nursing programme. Must refer to respective organizations' policy and practices Factors Determining Entrustment - Trainee \[4 groups of factors -- next slide\] - Task \[risks, complexity\] - Supervisor \[experience, trusting propensity\] - Context \[help available, time of day\] - Trainee-supervisor relationship General Qualities that Enhance Trust - Agency (self-confident, proactive toward work, team, safety) - Reliability (conscientious, predictable, accountable, responsible) - Integrity (truthful, good intentions, patient-centeredness) - Capability (knowledge & skill; experience; awareness) - Humility (observing limits, willing to ask help, receptive to feedback) - *Useful acronym: think of A RICH entrustment decision* Entrustment based discussion  **[\ ]** **[The impact of AI on nursing practice]** AI - "Artificial intelligence in medicine is the use of machine learning models to help process medical data and give medical professionals important insights, improving health outcomes and patient experiences". - Artificial intelligence in healthcare is the application of artificial intelligence (AI) to copy human cognition in the analysis, presentation, and understanding of complex medical and health care data. It can also augment and exceed human capabilities by providing faster or new ways to diagnose, treat, or prevent disease Big healthcare data A screenshot of a computer screen Description automatically generated Big healthcare data: International - Using AI tool (Smart Data Query) to clean data - mRNA and AI for advanced vaccine innovation Healthcare data analytics: Singapore - Singhealth - Covid \> postponement of surgeries - Use AI to predict operating theatre use - With previous EHS data - Changi Hospital - Examine arrival patterns at AnE - Re-distribute manpower - Shorter wait time, lower workload - Found that phone calls helped patients with poorly controlled diabetes - Re-deploy existing resources - TrustedCare (Singhealth) - Evaluate patients' data for outcomes from surgeries. - NHG, TTSH, NUH, AH, polyclinics - Evaluate population health (at-risk, frequent admitters, services utilized) Challenges - Data complexity - Data access - Regulatory compliance - Data cleaning - Data quality - Unstructured and messy data - Miss data  Patient monitoring (digital monitoring devices) In singapore - Monitor BP, sugar levels - EMPOWER app by Singhealth and NUS - App gives personalized data E.g., to exercise more - Future apps: - Abnormal readings \> alert caregiver **Precision medicine** - International - A close-up of a medical information Description automatically generated - Singapore - National Cancer Centre - After cancer removal uses AI to detect cancer protein - To develop personalized vaccines - Risk prediction - International -  - Singapore A close up of a text Description automatically generated Diagnoses by AI - International - AI chatbots - Language model - Better results than Google search - More time for other tasks - Singapore - Singapore National Eye Centre - Uses AI to screen retinal results - to detect retinopathy - Fast scan results - More time for other tasks - SGH, A\*Star - Uses AI to detect scan abnormalities - with 5 years of scan data - aiTriage by SGH, Duke-NUS school - Uses AI to triage patients at E room - Detect and treat sepsis promptly - Reduce waiting time AI interventions - International A diagram of a chatbot Description automatically generated - Singapore - Mindline by MOHT, MSF, NCSS, IMH, AIC - AI chatbot providing counselling Machine learning models  Machine learning: Unsupervised learning A diagram of clustering and clustering Description automatically generated Machine learning models: reinforcement learning  A diagram of a machine learning Description automatically generated Ethical concern - Privacy - Confidentiality - Decisions made by AI- accountability for wrong decisions? - Limitations of PDPA, AI in Healthcare Guidelines - in view of revolving AI use **[Sustainability in healthcare]** - Synonymous with high quality care which aims to deliver the best possible health outcomes while minimising financial and environmental costs and adding positive social value (Holmes, 2024) - Interventions that consider climate change, sustainability, and nature should be integral to health system functioning. - Placing sustainability offers opportunities to deliver better services, support healthier populations, and save costs. - Environmental sustainability is increasingly recognized as a critical factor in maintaining public health and ensuring the longevity and efficacy of healthcare services. Urgent need for sustainable healthcare - Climate Change and Global Warming - Carbon Footprint from emission of greenhouse gases into the atmosphere with direct impact to air quality and pollution - Health implications such as respiratory, cardiovascular diseases and cancer - Rapid ageing population leading to a more vulnerable population Climate Change and Global Warming - Global Warming has Ended, the Era of Global Boiling has arrived - 2023: Warmest year on record by a large margin -- between 1.34°C and 1.54°C above pre-industrial levels - April 2024: Hottest on record -- Severe heat hit South East Asia with temperature above 40°C Ageing Population globally and locally - Globally - All countries face major challenges to ensure that their health and social systems are ready to make the most of this demographic shift. - In 2050, 80% of older people will be living in low- and middle-income countries - The pace of population ageing is much faster than in the past. - In 2020, the number of people aged 60 years and older outnumbered children younger than 5 years. - Between 2015 and 2050, the proportion of the world\'s population over 60 years will nearly double from 12% to 22%. - Singapore - Singapore is facing a rapidly ageing population; the demographic landscape is undergoing a profound transformation. - By 2030, around 1 in 4 Singaporeans will be aged 65 or above, up from 1 in 10 in 2010 ACTION PLAN FOR SUCCESSFUL AGEING 2023 - In 2015, the Ministerial Committee on Ageing (MCA) launched the first Action Plan for Successful Ageing. - It acts as a whole-of-nation blueprint for Singaporeans to age gracefully and confidently, and comprises over 70 initiatives across various domains including health, social welfare, employment, and infrastructure, supported by technology and innovation. - It was a collective effort --- between government, voluntary welfare organisations, academia, businesses and community leaders --- to redefine ageing and build the best place for Singaporeans to age in - To ensure that our plans for Singapore's ageing landscape remain relevant for seniors of today and tomorrow, the Action Plan was refreshed in 2023 to chart out further shifts in response to a greater diversity in experiences, aspirations, and needs of seniors. Implications of an ageing population on the healthcare industry -- How does an ageing population impact Singapore's healthcare? - As Singapore grapples with a rapidly ageing population, the demographic landscape is undergoing a profound transformation. - In 2022, 18.4 percent of citizens were 65 or older, and projections indicate that by 2030, nearly one in four citizens, or 23.8 percent, will fall into this age group. - With the growing elderly population, healthcare facilities, including hospitals and clinics, are facing mounting pressure. - This will necessitate substantial investment in healthcare resources and a transformation of healthcare services Role of Nurses in Sustainable Healthcare - Environmental Stewardship: Nurses can lead initiatives to reduce the environmental impact of healthcare facilities. This includes waste management, energy conservation, and promoting the use of sustainable resources. - Education and Advocacy: By educating patients and colleagues about sustainable practices, nurses can foster a culture of environmental awareness. They can also advocate for policies that support sustainability in healthcare. - Green Teams: Many healthcare facilities have Green Teams, often led by nurses, that focus on implementing and promoting sustainable practices within the organization. - Sustainable Practices: Nurses can integrate eco-friendly practices into their daily\ routines, such as reducing single-use plastics, recycling, and using energy-efficient equipment. - Research and Innovation: Nurses can contribute to research on sustainable healthcare practices and develop innovative solutions to reduce the environmental footprint of healthcare services (Shaban et al., 2024; Luque-Alcaraz et al., 2024) Implications for practice and Research - Healthcare emissions contribute to climate change and threaten human health - Therefore, nurses have a professional obligation to become environmentally informed, take action to reduce healthcare emissions and support green solutions. - Future research must understand and modify workplace barriers to promote environmentally sustainable staff behaviour and facilitate the green transformation of healthcare systems **[Development in Nursing Practice]**  What makes nursing a profession - Disciplined group of individuals who: - adhere to ethical standards & uphold themselves to these - are accepted by the public as possessing special knowledge and skills that are derived from research, scientific and philosophical facts - are prepared to exercise this knowledge and skills in the interest of others - have its own regulatory body which define, promote, support and regulate the affairs of its members -- required to be licensed to practice - have freedom to exercise professional judgment within regulatory & ethical boundaries (autonomy) - At individual level - Keep acquiring theoretical knowledge and clinical skills that are based on current best evidence -- learning does not stop after BSN - Have high moral grounds -- code of ethics, code of conduct - Contribute to existing nursing knowledge base through research, EBP - Build respect and stature of nursing as a professional - Understand global and national trends and how these will influence own practice - Open mindset, adaptable - At organization/country level - Regulatory compliance - Define and redefine the scope of nursing -- aligned to changing environments - Accountability for quality, appropriateness, value of nursing activities - Build respect and stature of nursing as a profession in the public eye - Produce nurses who can address existing and future global/national health challenges Nursing career and professional development - Opportunities for role expansion, rotation and mentorship - Scholarships, sponsorships, training grants etc for higher degrees and post-\ graduate qualifications specific to career path - Continuing education courses/workshops/seminars specific to career path - Comprehensive competency management framework 10 tips for excelling in nursing career - Never Lose Sight of Your Passion - Towards service, desire to continuously learn - Remember why you join nursing no matter how hard the journey becomes - Critical Thinking and Clarity - Critical thinking skills are core -- helps you prioritise and make decisions - Clarify anything you are unsure of -- ASK, ASK, ASK - Don't miss opportunities to gain more knowledge and skills from more experienced team mates - Learn How to Effectively Communicate - With patients, caregivers, members of multi-disciplinary team, supervisors, peers - Be good listeners -- attentive and not distracted -- BE PRESENT - Be a Supportive & Collaborative Team Member - Build and maintain respectful and reciprocal professional relationships - Offer help to your team mates - Take Initiative - Take responsibility and ownership of your career -- don't wait for opportunities to fall into your lap - Take the initiative to talk to your supervisor about your aspirations - Be asked to be placed in committees/workgroups/councils at unit and/or inst level - Keep an Open Mind to Possibilities/Opportunities - Don't get stuck into one speciality only -- ask for rotations and be open to\ explore - Once you find a specialty you enjoy working in -- you will thrive - Keep an open mind to explore diverse areas and opportunities - Continue Learning - Don't end at your degree - Pursue additional education, specialized certifications, workshops, conferences, seminars, academic literature that will inform your practice - Be purposeful in the development of your skills and knowledge - Identify a Mentor - Formal mentorship program for new nurses besides the clinical preceptor - But you can also identify someone who you admire for his/her professional abilities and ask them to informally mentor you as you progress in your role. - Find Leadership Opportunities - Be a leader within your current role -- many opportunities to practice your leadership skills e.g. member of projects, offering to keep up morale of team, offering to assume tasks from your seniors, offering to help organize year-end party, etc - Enables practice of your leadership skills + shows others you are ready for more advanced responsibilities - Practice Self-Care - Help you maintain your mental and physical well-being - Allow you to perform your role better Global and national mega trends -- Impacting healthcare and nursing practice - Population ageing in Singapore - Longer life expectancy but more frail - Rising chronic disease prevalence - Fewer young people - Higher dependency ratio - Shrinking workforce - Economic consequence - Social consequence - Population decline What determines one's health A diagram of a person\'s body Description automatically generated Nursing 5.0 -- Shaping the future of nursing practice  Nursing 5.0 - Pervasive digital health tech - Reframe nurse-patient interactions - As care model shift to 'health of community', patients are coordinators of own care & nurses become coaches - Novel care delivery - Value add nursing work - Creative, proactive, daring nursing workforce - Reform nursing education to develop digital health leaders/experts; global nurses with global mindset - Preparing nursing workforce that meets tomorrow's health needs -- preventive, home care, pop health - Workplace wellness, mental health - Smart devices -- wearables, remote monitoring, automated systems - AI-enabled, big data - to aid decision making - Digital health - telemed, mobile applications - Expand roles, work in new settings/locations and in new ways - Predict, not react - Person- and community-centred care - More meaningful time with patients F2F &/or remotely - Activated volunteers & patients/NOK as part of caregiving team - To be the Most Trusted profession - Create value, Create capability, Create capacity A diagram of a patient care Description automatically generated Key Technologies Impacting Nursing 2025 1. Artificial Intelligence / Gen AI a. Machine Learning, Natural Language Processing, Rule-based Expert Systems, Robotic Process Automation, AI-powered systems/devices, Chatbots 2. Robotics b. Surgical robots / robot-assisted surgery, Robotics for radiotherapy, Rehabilitation robots, Robotics for Labs, Robotics for Pharmacy, Robotic for MMD / SSU, Robotic prosthetics, Social robots, Autonomous Motorised Robots, Robot 'nurses'/ Robot assistants 3. Virtual Care / Telehealth c. Telemedicine, Remote patient monitoring, Mobile health apps, Virtual care platforms, Wearables and IoT (Internet of Things), Digital pharmacy 4. Mobility d. Mobile devices for staff, EMR, Secure messaging apps, Mobile access to patient data, Mobile clinical apps, Mobile barcode scanning, Mobile documentation, Clinical decision support on mobile devices 5. Assistive Devices e. Digital patient information board 6. Genomics & Personalised Medicine Pros - Improve and expand access to high quality health care, providing evidence-based personalized intervention and monitoring in a holistic, comprehensive and integrated approach -- help HC staff/nurses make the most informed\ decisions in the shortest time - AI powered systems can analyse vast amt of pt data, identify patterns, detect anomalies, early identification of potential risks / adverse events - Freeing nurses to provide direct pt care that is of high value/complexity -- takes over tasks that do not require specilaised nsg skills or knowledge - Reduce errors, improve accuracy, enhance patient care - Improves communication - Increase efficiency - Support safe and highly efficient work environment - Benefits to both patients and staff Consequences (Unintended or otherwise) that we will need to manage - Depersonalisation of patient care - How will face to face interaction change - Over-reliance -- impact on own critical thinking and clinical judgement skills - Cybersecurity - Learning curve/Pace of change -- Early adopters to laggards - AI algorithms -- valid? Reliable? Social bias? - Clinical accountability rests on? - Ethical considerations? - Increase admin burden (if we are not careful) - Alarm fatigue, data overload  **[Taking care of aging population -- nursing practice perspective]** Aging population - The world\'s elderly population is steadily increasing, with projections indicating that by 2050, there will be over 2 billion people aged 60 and older. This shift necessitates a revaluation of healthcare resources and strategies to address the complex needs associated with aging. Challenges in healthcare for the aging population - Staffing Shortages - A growing number of elderly patients requires a larger and more specialized nursing workforce, which can be challenging to recruit and retain - Strain on Healthcare Resources and Infrastructure Increased - Demand - The aging population leads to a higher demand for healthcare services, including hospital beds, medical equipment, and specialized care. - Financial Strain - The rising cost of healthcare for the elderly, combined with limited resources, creates financial pressure on the healthcare system. - Chronic Disease - Elderly patients frequently suffer from multiple chronic diseases such as diabetes, heart disease, and arthritis, necessitating comprehensive, coordinated care approaches to manage their complex health needs effectively - Mental Health - Mental health is a significant concern, with many older adults facing depression, anxiety, and cognitive decline. - Addressing these issues requires specialized training and resources to provide effective mental health support - Plus, not able to adequately mobilize health and social care in the community may result in a hospital discharge delay and once discharged home could result in hospital readmission 3 key shift in Singapore's healthcare system - Beyond hospital to community - Integrate care acress providers and settings - Shift focus towards community care - Beyond quality to value - Ensuring appropriate care - Efficient use of resources and manpower - Beyond healthcare to health - Investing upstream by promoting active aging and healthy living Population health strategies can indeed play a crucial role in addressing the challenges posed by a \"super-aged\" society, which refers to a population where a substantial proportion is over the age of 65. These strategies are essential for promoting the health and well-being of older adults, managing healthcare costs, and maintaining social and economic stability. Cultivating a culture of care for older adults - Singapore has a well-developed healthcare system with a strong emphasis on patient-centered care, and nurses play a pivotal role in ensuring a smooth transition which is crucial and especially it can be complex and challenging for the older adults, who often have multiple chronic conditions - Nursing care is vital during this juncture, as it not only encompasses the provision of clinical care but also the holistic management of health outcomes and emotional well-being. - Singapore with its rapidly aging population, nursing faces numerous challenges including chronic disease management, resource allocation, and the need for tailored approaches to education and support. Aging population -- nursing roles and challenges - Nurses are pivotal in advocating for and delivering comprehensive care tailored specifically to the needs of older adults, ensuring both\ physical and emotional well-being. - The scope of nursing practice for geriatric care encompasses not only clinical skills but also navigating Complexities in Care Delivery. Inclusive of ethical considerations, health promotion, and patient education. - Complex Health Conditions - Older adults often face multiple, concurrent health issues including chronic diseases, cognitive decline, and mental health challenges, making their care particularly complex. - Communication Barriers - Cognitive impairments and sensory deficits can lead to significant communication challenges, requiring nurses to employ specialized techniques to ensure effective interaction. - Ethical Dilemmas - Nursing care for the elderly often involves navigating sensitive ethical dilemmas pertaining to autonomy, consent, and end-of- life decisions, demanding strong ethical reasoning skills. - Workforce Shortages - An insufficient number of trained geriatric nurses exacerbates the challenge of providing quality care, highlighting the need for targeted recruitment and retention strategies. - Community resources - Nurses need to able to know and connect older adults with the various resources available and suitable for older adults in the community Interdisciplinary Collaboration in Geriatric Care - Fostering teamwork for optimal care delivery - Role of other healthcare professionals - Incorporating the expertise of diverse healthcare providers, such as social workers, pharmacists, and physiotherapists, enriches the care plans and addresses the multifaceted needs of aging patients - Shared Decision-making - Engaging older adults in shared decision-making processes fosters autonomy and empowers patients to take an active role in their healthcare, improving satisfaction and adherence to treatment plans. - Team-based care - Collaborative care models leverage the unique skills of various healthcare professionals, leading to improved patient-centered care and enhanced treatment outcomes for older adults - Communication Strategies - Developing effective communication strategies among interdisciplinary teams ensures that critical patient information is shared timely and accurately, minimizing errors and enhancing care delivery Crafting a competency framework expected in Geriatric Care - Ethical considerations - Nurses must navigate complex ethical dilemmas, including issues of autonomy, consent, and end-of-life care, necessitating a robust ethical framework to guide decision- making for vulnerable populations. - Clinical Skills - Nurses are required to possess advanced clinical competencies, including disease management, physical assessment, and medication administration specifically tailored for the geriatric population to ensure effective treatment plans. - Understanding the Physiological and Psychological Aspects of Aging - Older adults experience physiological changes, such as reduced organ function, and psychological challenges, including depression or dementia. Nurses must understand these changes to tailor interventions effectively. - Communications - Effective communication is crucial in building rapport with elderly patients, necessitating the ability to utilize clear language and active listening techniques to address their unique needs and concerns. - Cultural competenciesq - Understanding the diverse cultural backgrounds of elderly patients is essential for delivering respectful and effective care; this includes being mindful of cultural beliefs and practices that may influence health behaviors and preferences. - Integrating Geriatric Content - Curricula should embed geriatric principles across various subjects, ensuring students develop a well- rounded understanding of the unique challenges in elderly care. - Interdisciplinary Collaboration - Collaboration with other healthcare disciplines can enrich geriatric education, providing students with diverse perspectives and enhancing holistic care\ delivery - Competency-Based Education - Adopting a competency-based approach entails defining clear competencies related to geriatric care that nursing students must master before graduation. Nursing Education: Preparing for Geriatric Care - Integrating Geriatric Content - Curricula should embed geriatric principles across various subjects, ensuring students develop a well-rounded understanding of the unique challenges in elderly care. - Interprofessional Education - Collaborative learning experiences with other healthcare disciplines foster teamwork and communication skills necessary for effective geriatric care across various health services - Competency-Based Education - Adopting a competency-based approach entails defining clear competencies related to geriatric care that nursing students must master before graduation. - Simulation training - Hands-on, realistic training scenarios, such as role-playing and simulations, enable nursing students to practice their clinical and communication skills in a safe environment before interacting with real patients. - Lifelong learning - Nurses must commit to continual professional development through advanced cerotifications and ongoing education focused on geriatric care to stay current with best practices and emerging research. Clinical Practicum and Field Experience - Bridging theory with practice - Importance of Hands-On Experience - Direct interaction with elderly patients under supervision allows nursing students to apply theoretical knowledge and develop essential geriatric\ competencies. - Partnerships with Geriatric Care Facilities - Establishing strong partnerships with community geriatric care facilities enhances opportunities for students to gain practical insights and immerse themselves in real-world settings. - Mentorship Programs - Implementing mentorship initiatives connecting students with experienced\ geriatric nurses fosters professional development and enhances learning\ outcomes **Continuing Education and Lifelong Learning**\ Commitment to Professional Growth, Innovating Learning Methods - Importance of Ongoing Training - Regular updates and training opportunities are essential to keep nursing professionals well-informed about the latest trends and best practices in geriatric care. - Workshops and Seminars - Participating in specialized workshops and seminars can significantly enhance nurses\' skills and knowledge in managing geriatric patients and their unique needs. - Certification Programs - Certification programs in geriatric nursing signify a commitment to excellence and provide advanced training to enhance a nurse\'s ability to deliver individualized care. - Case studies with best practices - Analyzing successful nursing interventions that have led to improved\ outcomes for elderly patients provides valuable insights into effective approaches in geriatric care. - Telehealth training - As telehealth becomes integral to healthcare, training nursing students on its use in geriatric contexts prepares them for the future of patient care delivery. - E-learning Platforms - Utilizing e-learning technologies enables flexible and accessible education for nursing students, allowing them to learn geriatric competencies at their own pace. **Policy Implications for Nursing and Aging Care**\ Shaping the Future of Geriatric Services - Healthcare policies - Strong healthcare policies are essential to meet the needs of the aging population by ensuring adequate funding, resources, and programs designed to improve the delivery of geriatric care. - Advocacy for aging population - Nurses play a vital role in advocating for policy reforms that support aging populations by voicing their needs to policymakers and stakeholders, ensuring adequate resource allocation for geriatric health. - Funding and resources - Adequate funding and resource allocation are essential for implementing comprehensive programs\ that improve access, quality, and sustainability of care for older adults. - Regulatory changes - Advocating for regulatory changes in nursing practice ensures that nurses receive the support needed to provide high-quality and equitable care to older adults **[Protection from abuse and harassment on HCWs]** In NHG, Prevention of Abuse and Harassment is based on a structure termed 3R - Recognise - Respond - Report A screenshot of a medical informational presentation Description automatically generated with medium confidence  A screenshot of a medical report Description automatically generated  A diagram of a policy Description automatically generated  A diagram of a diagram Description automatically generated Cluster Effort 1. Strengthening of protocols via unified Group HR Policies for all staff a. Group HR Policy S15A: Protecting Staff against Abuse and Harassment (External Perpetrators) b. Group HR Policy S15B: Protecting Staff against Abuse and Harassment (Internal Perpetrators) 2. Establishment of Staff Protection Function at each NHG institution to tighten implementation of S15A c. identification, response, escalation, consequences 3. More extensive post-incident support for affected staff d. External counselling services offered by third party Employee Assistance Programme (to be rolled out in FY24) e. More support for mental well-being f. More coordinated support for cases escalated to police and/or legal action g. More coordinated management of 'retaliatory' or (repeated) harassing complaint letters from perpetrators 4. Curation/Development of suitable training to better equip staff in recognising, de-escalating and handling abuse and harassment cases  A multicolored chart with text Description automatically generated  A diagram of a person with a medical staff Description automatically generated with medium confidence