Assessing and managing critically ill older adults: Resources for educators and clinicians

Evaluating the preceptor-preceptee relationship among Pharm D students at the King Saud University School of Pharmacy

OBJECTIVE

To evaluate preceptee satisfaction concerning preceptorship and the preceptor-preceptee relationship among pharmacy students.

METHODS

A cross-sectional study was conducted from May 2017 to August 2017 on senior Pharm D students at King Saud University (KSU) College of Pharmacy. A survey instrument was used to get feedback from students regarding their clinical rotations and internships and to evaluate their satisfaction toward preceptorship to meet the goals of the curriculum. Data were entered into SPSS, version 24.

RESULTS

Of the 52 students surveyed, 36 (69.2%) were female. More than half of respondents were somewhat satisfied with their preceptors and 11.5% were satisfied. Additionally, only 17% of students rated their preceptors as having excellent clinical teaching skills; about 19% of students rated them as "needs improvement." About 40% of students rated their preceptors as very good, concerned, competent, and safe in their care for persons living with serious co-morbidities and diseases. About half of students (48.1%) rated their non-faculty KSU preceptors' teaching behavior as not satisfactory compared with only four respondents with respect to KSU faculty preceptors' teaching behavior.

CONCLUSION

Pharm D students were somewhat satisfied with their preceptors' teaching behaviors in communication skills, practice, and teaching skills as well as feedback and evaluation to students. To enhance the quality of experiential education, preceptors should be trained to develop programs that direct and energize advancement.

Management of delirium in critically ill older adults

Delirium in older adults in critical care is associated with poor outcomes, including longer stays, higher costs, increased mortality, greater use of continuous sedation and physical restraints, increased unintended removal of catheters and self-extubation, functional decline, new institutionalization, and new onset of cognitive impairment. Diagnosing delirium is complicated because many critically ill older adults cannot communicate their needs effectively. Manifestations include reduced ability to focus attention, disorientation, memory impairment, and perceptual disturbances. Nurses often have primary responsibility for detecting and treating delirium, which can be extraordinarily complicated because patients are often voiceless, extremely ill, and require high levels of sedatives to facilitate mechanical ventilation. An aggressive, appropriate, and compassionate management strategy may reduce the suffering and adverse outcomes associated with delirium and improve relationships between nurses, patients, and patients' family members.