E. Capezuti, D. Zwicker, M. Mezey, T. Fulmer, D. Gray-Miceli, and M. Kluger. New York: Springer Publishing Company; 2007. $75. ISBN 978-0-8261-1103-6 (hardback). 736 pp.
This volume represents a significant update of acclaimed earlier editions of Geriatric Nursing Protocols for Best Practice (1999, 2003) that evolved from care protocols developed in the Nurses Improving Care for Health System Elders program. The third edition builds on this base, introducing 13 new topics and detailing the evidence to support suggested interventions.
The first chapter introduces the internationally developed AGREE (Instrument for Appraisal of Guidelines for Research and Evaluation) review framework and outlines the well-grounded strategy used to identify and assess the evidence underpinning each protocol. Throughout the text, cited references are coded to indicate the strength of their evidence, enabling readers to appreciate the level of support for recommended strategies.
The 27 protocol chapters address assessments (eg, cognition, function), specific conditions (eg, urinary incontinence, excessive sleepiness), legal and ethical matters (eg, decision making, advanced directives), safety concerns (eg, iatrogenesis, adverse drug effects, falls, restraints), and site or population-specific issues (eg, critical care, family care givers). Where content overlaps, authors have avoided repetition by judicious cross-referencing.
Reviews of background information, screening tools, and interventions are well developed yet concise. Tables frequently recapitulate the essentials of targeted assessments and summarize important interventions. Useful case studies illustrate how protocols must be tailored to the complex arrays of issues facing older adults. Most chapters conclude with an outline of the protocol, typically including the goal, overview, background, assessment, interventions, evaluation/outcome, and follow-up monitoring. A useful addition to this edition is the list of resources (mostly Internet based) at the end of each chapter. References are comprehensive and, as appropriate, indicate the level of evidence, providing a sound initial bibliography to guide further examination of covered topics.
Although most information is relevant to multiple settings, content foregrounds the acute care setting, and there are still significant topics yet to be included, for example, transitions to long-term care and abuse and neglect. Nevertheless, given the quantity and quality of information contained in this single volume, this is a "must-have" reference for clinicians, researchers, and educators, geriatric specialist or not, whose practice involves the nursing care of older adults.