-—_ I—v—vv .,—- MARKETING THE ROLE 0F THE GERONTOLOGICAL NURSE PRACTITIONER Schoiary Project for the Degree cf M; 89 MICHIGAN STATE UNIVERSITY ' ' DENNIS MARK HELMUS I _ ' ' ‘ 1997 LIBRARY Michigan State University PLACE IN RETURN BOX to remove this checkout from your record. TO AVOID FINES return on or before date due. MAY BE RECALLED with earlier due date if requested. DATE DUE DATE DUE DATE DUE 6/01 c:/ClRC/Dat90ue.p650p. 15 MARKETING THE ROLE OF THE GERONTOLOGICAL NURSE PRACTITIONER By Dennis Mark Helmus A SCHOLARLY PROJECT Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE College of Nursing 1997 ABSTRACT MARKETING THE ROLE OF THE GERONTOLOGICAL NURSE PRACTITIONER By Dennis Mark Helmus In cooperation with Bonnie Holmberg, MSN, 3 World Wide Web (WWW) site was developed to market the role of the Gerontological Nurse Practitoner (GNP). GNPs have not actively marketed themselves through brochures or through use of a world wide web site. Since the role is relatively new, active methods of marketing should be utilized in order to " get the word out". The world wide web is a modern tool highly utilized by marketing professionals in today's marketplace. Elders are online using the world wide web in increasing numbers and are seeking health advice and providers that will maintain their functional status. E.M. Rogers (1995) would class elders on the world wide web as Innovators and are the leaders in diffusion of new information such as the role of the GNP in health care. ACKNOWLEDGEMENTS From beginning to end Dr. Sharon King has been a constant support as I pursued the goal of MSN. Dr. King's support and her wise choice of Professor Patricia Peek for my scholarly project committee are greatly appreciated. Dr. George Allen eagerly has lent his support and counseled me frequently on the mysteries of computing. According to EM. Rogers, Dr. Allen would be considered an Innovator. The Lord is my Rock and my Redeemer and He has revealed Himself to me during the writing of this project through the Promise Keepers men's movement. A latent Christian no more. My wife, Mary, is an angel sent by God early in my life to be a solid foundation for me to build my life. She is ever faithful, loving, kind, persevering, forgiving, and my best friend. iii Table of Contents Introduction ................................................................................ ..1 Statement of Problem ................................................................ . ...... 2 Purpose of this Project .................................................................... . 2 Definiton of Key Concepts .............................................. . ......... 3 Commumcatlon 3 CommunicationChannels......................................................... 3 D1ffusron4 GeriatricNursePractitioner(GNP)..............................................4 Marketing 5 SocraJSystem 5 WorldWideWeb(WWW)....................................................... 6 Conceptual Framework .......................... . ....... . ......... . ................ 6 Relationship of Roger's Framework to Marketing the GNP. .................. 10 Literature Review ..................... . ............................................... 11 MarketingtheRoleoftheGenericNP..........................................11 Difi‘erences/SpecificitiesoftheGNva.NProle..............................13 MarketingtotheElderly..........................................................15 Implications of the Marketing Literature for the Composition and Layout of the GNP Web Site ........................................................................ 18 Methodology .......... . ..................................................................... 19 Hardware 19 iv Software ..........20 Reference Books...... 21 Reference Web Sites.................. .....21 HelpfulGuides on Getting Started............... 22 Getting Connected 22 Development of the 'Marketing the GNP' web site ................................ 24 Evaluation of the 'Marketing the GNP' web site.. ............................. 26 Implications for GNP Practice ......... . ........................................ ...... 29 Implications for Education ............................................................ 29 Implications for Research” ............................. . ............................ . 30 Summary ................................................................................. 31 Appendix A (MSU Pilot electronic mail) ............. ......................... 32 Appendix B (Using Terminal Emulation to Dial in to the Internet) .......... 34 Appendix C (Procedures for Connecting to the Internet) ...................... 36 Appendix D (Steps to conduct a Search with Microsoft InternetExplorer). 40 Appendix E ('Marketing the GNP' site: web pages with html language).... 41 List of References ...................................................................... 52 INTRODUCTION The elderly population, defined as those persons greater than 65 years of age, continues to grow at unprecedented rates. According to Omenn (1990), the elderly cohort will grow to 55 million or 13% of the United States’ population by the year 2000. By the year 2030, 22% or 66 million Americans will be more than 65 years of age. It is not surprising that the number of disabled and chronically ill will also increase in numbers. Older Americans consume 33% of all health care resources according to the American Medical Association (1990) and the complexity of their care requires a practitioner skilled in chronic disease management with primary care skills. The Gerontological Nurse Practitioner (GNP) is a registered nurse with an advanced preparation in primary care who has been prepared with a broad range of skills in research, assessment, planning, continuity of care and interdisciplinary collaboration (Walker & Knapp, 1990). Gerontological nursing is, however, a relatively new field. The first gerontological nursing textbook was written in 1950 (Newton, 1950). The Division of Geriatric Nursing Practice was established within the American Nurses Association in 1966, and the association’s standards for nursing practice in the field were developed in 1965 (Strumpf & Paier, 1984). Furthermore, the role of the Gerontological Nurse Practitioner is an even more recent development. According to Strumpf and Paier (1993), the role of the GNP developed in the late 1960’s. Thus it is not surprising that there is widespread lack of understanding in regard to the role of the GNP and its benefits. STATEMENT OF PROBLEM The role of the GNP has not been marketed to the public; therefore, there is a lack of understanding of the role of the GNP and its benefits to the elderly consumer. Large numbers of elders who would benefit from the specialized services of the GNP remain unaware of their potential benefits. The lack of marketing of the potential benefits of the GNP is made obvious by virtue of the fact that there are no known brochures and only one world wide web site (WWW) (Holmberg, 1997) that explains the role and benefits of the GNP to the potential consumer. PURPOSE OF THIS PROJECT The purpose of this project is to market the GNP role to innovative elderly consumers via a WWW site. Innovators have been shown to be the “first responders” to new ideas (Rogers, 1995) and are needed to begin the adoption of new ideas such as the role of the GNP. Web sites reach innovators and one group of innovators on the WWW happens to be the elderly population who are potential consumers of GNP services. A growing number of seniors are using online services. A recent survey by America On Line (AOL) found that approximately 780,000 people aged 55 and older used AOL to access to the WWW (Moran, 1996). Adler (1996), reported that 30% of individuals 55 to 75 years of age owned a computer. As a relatively new innovation of nursing practice, the GNP must take an active part in diffusing information about GNP benefits throughout the community as to the role benefits. Marketing is a mechanism to diffuse information about new ideas and has been used by generic Nurse Practitioners (NPs) (Gallagher, 1996). Aside from the generic NP, GNPs have not actively marketed themselves, or at least the activity has not been described in the literature. The use of a WWW site has been used to describe the role of the generic NP and GNP but to date no effort has been made to create a web page to market the GNP and its benefits to health care consumers. DEFINITION OF KEY CONCEPTS Communication Rogers (1995) defines communication as “the process by which participants create and share information with one another in order to reach a mutual understanding” (p. 6). Communication Channels Communication channels are the means by which messages get from one individual to another. Two examples of communication channels are mass media, such as radios, television, newspapers and interpersonal or face-to-face exchanges between two or more individuals. A newer form of mass media is hypermedia computer-mediated environments or hypermedia CME. Hypermedia CME are dynamic distributed computer networks exemplified by the World Wide Web or W. Hypermedia combines the elements of radio (audio), television (moving images), newspaper and magazines (text), and the computer (video display terminal) with hypertext links to form the basis for a unique computer-mediated environment (Hoffman & Novak, 1995). Diffusion Diffusion, according to Rogers (1995), is a particular type of communication in which the information that is exchanged is concerned with new ideas. The diffusion process communicates information from one to another or to several others in a social system over time. It is implied that diffusion communication is a process ofconvergenee (or divergence) as two or more individuals exchange information in order to move toward each other (or apart) in the meanings that they give to certain events. The process invohies: 1. an innovation, 2. an individual or other unit of adoption that has knowledge of, or experience with using, the innovation, 3. another individual or other unit that does not yet have knowledge of the innovation, and 4. a communication channel connecting the two units. Geriatric Nurse Practitioner (GNP) According to the National Conference of Gerontological Nurse Practitioners, a Gerontological Nurse Practitioner is a registered nurse with advanced educational preparation who provides a full range of primary care services to older adults. Geriatric Nurse Practitioners, along with all nurse practitioners, practice under the rules and regulations of the Nurse Practice Act of the state in which they work In addition to being certified nationally in the area of geriatrics, the American Academy of Nurse Practitioners recognizes GNPs as expert nurses in geriatric nursing. (American Academy of Nurse Practitioners, 1988). According to Rogers (1995), for purposes of explication, the GNP would be considered an innovation or is “an idea, practice, or object that is perceived as new to an individual or some unit of adoption” (Rogers, 1995, p. 11). Marketing Marketing is a coordinated style of communicating information. It is more than a promotional effort due to the fact that it seeks to identify and respond to the needs and preferences of customers, attempts to get business and keep it, and is a dynamic process embodying "the four P’s": product, price, place, and promotion. (Gallagher, 1996). Marketing is a business strategy that promotes information about a service or product to consumers to entice the consumer to use that given service or product (Nolan et al., 1988). Social System “A set of interrelated units that are engaged in joint problem solving to accomplish a common goal. The members or units of a social system may be individuals, informal groups, organizations, and/or subsytems” (Rogers, 1995, p. 23). Rogers (1995) delineated five groups within each social system that will affect adoption of an innovation: innovators, early adopters, early majority, late majority, and laggards. Innovators take risks and can deal with uncertainty. They play a key role in adoption of an innovation, are usually well educated, more wealthy than the normal population, and cosmopolite in social relations. They are the driving force behind the flow of new ideas to the social system. Marketing targets innovators in the social system because they are the first to adopt new ideas. World Wide Web (WWW) Hoffman and Novak (1995) define the W as a hypermedia computer-mediated environment on the Internet. The W is the first and current global implementation of this environment. Howe (1997) describes the WWW, (also known as W3 or the web), as "an Internet Client-server hypertext distributed retrieval system which originated from CERN High-Energy Physics laboratories in Geneva, Switzerland. The source of the W is is hypertext in HTML format. Hypertext links refer to other documents by their Uniform Resource Locator addresses (URLs). CONCEPTUAL FRAMEWORK Everett M. Rogers, (1995) theory of Diffusion of Innovation is used to guide marketing of the Gerontological Nurse Practitioner role through the use of a World Wide Web site. Rogers, (1995) theory was developed in response to a growing body of studies that explained innovation and diffusion of innovations in the social sciences and in agriculture. The theory attempts to explain why certain innovations are adopted and others are not. Innovation—difi’usion theory suggests that once a need for an innovation has been established, there exist four elements important in diffusing the innovation to potential adopters: the innovation, communication channels, time, and the social system. The process of diffusion is dependent on five characteristics that influence the innovation’s adoptability: relative advantage to adopters, compatibility to existing norms, complexity, trialability, and observability of the innovation. The greater the relative advantage an innovation has, the more readily the innovation will be adopted. The relative advantage to health care institutions of the GNP role has been well established, but the advantage as seen through the eyes of the consumer has not been established because of the small numbers of NPs in relation to physicians (Polfus, 1989). Compatibility is how the product or service conforms or conflicts with the existing values, past experiences and needs of potential adopters (Rogers, 1995). Edmunds (197 8) found that health care consumers were in favor of the nurse functioning in an advanced role. Sultz, Zielezny, Gentry, and Kinyon (1980) found that employers were in favor of nurse practitioners after the benefits of nurse practitioners were seen. Complexity of an innovation inhibits understanding. Understanding the variety of settings, roles and uses of the NP role is intimidating, even for the seasoned health care provider. Experiencing the benefits of care provided by a nurse practitioner first hand aids in comprehension of the role. Observability of an innovation is paramount to adoption as a needed alternative. As the number and variety of settings increases, the GNP role will become increasingly visible to the consumer. Visibility stimulates peer discussion with friends and neighbors which further enhances flow and rate of adoption. Trialability refers to the ability of the consumer to try out an innovation before complete adoption of the innovation. As the public continues to “try out” the services of GNPs, the adoption of the GNP as a viable compliment to physician services will be more widely practiced. The second major element of diffusion of innovation theory is a communication channel. "A communication channel is the means by which messages get from one individual to another." (Rogers, 1995, p. 18). There are two forms of communication channels, mass media and interpersonal channels. Mass media channels are all those means of communicating messages that involve a mass medium such as the newspaper, television, and radio. For purposes of this project a relatively new mass media communication tool, the world wide web (WWW), will be used. Interpersonal channels involve a face-to-face exchange between two or more individuals. Time, as the third element of innovation-diffusion theory, is closely tied to communication. The processes by which an innovation is communicated affects how rapidly the innovation is adopted (Rogers, 1995). Three elements of diffusion over time involve: 1. The innovation-decision process defined as a mental process through which an individual (or decision-making unit) passes from first knowledge of an innovation to forming an attitude about the innovation, to a decision to adopt or reject, to implementation of the new idea, to confirmation of this decision. There are five steps to this process: 1. knowledge, 2. persuasion, 3. decision 4. implementation 5. confirmation. Innovation-decision leads to adoption or rejection of the innovation. 2. Innovativeness or the degree to which an individual is relatively earlier in adopting new ideas than other members of the social system. Five adopter categories ranked on the basis of their innovativeness are: (1) innovators, (2) early adopters, (3) early majority, (4) late majority, (5) laggards. 3. An innovation’s rate of adoption or the relative speed with which an innovation is adOpted by members of a social system. The fourth element in innovation-diffusion is the social system. The nature of the social system will mandate acceptance. The social system of health care consists of health care consumers, professionals, health delivery systems, political/legislative systems, and insurers. Rogers (1995) delineated five groups within each social system that will affect adoption of an innovation: innovators, early adopters, early majority, late majority, and laggards. Innovators take risks and can deal with uncertainty. They play a key role in adoption of an innovation and are usually well educated, more wealthy than the normal population and cosmopolite in social relations. They are the gatekeepers to the flow of new ideas to the social system. Early adopters are respectable leaders. They are locally integrated and usually successful and discrete in their use of new ideas. Early majority are deliberate, seldom hold leadership positions but are interconnected communicators within the system. Their motto is “be not the first by which the new is 10 tried, nor the last to lay the old aside”. The skeptical late majority adopt new ideas just afier the average, possibly more because of economic necessity or peer pressure. They tend to have scarce resources and cannot waste them on losing propositions. Laggards are always the last to adopt. Their point of reference is in the past and they are suspicious of change. They tend to be isolated outside of the social network and must be absolutely convinced of the surety of an innovation before adopting. RELATIONSHIP OF ROGER’S FRAMEWORK TO MARKETING THE GNP Smith and Shamansky (1983) emphasized three important marketing messages incorporated in Roger’s (1995) framework that should be employed when marketing use of NP services. These three concepts are compatibility, relative advantage, and communicability. Compatibility should be emphasized in marketing because the GNP is uniquely trained to care for the elderly through theory and practice. Edmunds (1978) found that health care consumers were in favor of the nurse functioning in an advanced role. In addition, Hawkins and Thibodeau (1983) found that health providers who worked with nurse practitioners were more accepting of the nursing role. A clear image of the GNP must be portrayed to potential consumers of GNP services by completely communicating the GNP role and scope of practice so that informed choice may be made. The more relative advantage an innovation has, the more readily an innovation will be adopted. Research has shown that nurse practitioners can provide cost effective, quality health care (U .8. Congress, 1986; Edmunds, 1978). With relatively few nurse 11 practitioners compared with other health care providers the relative advantage is difficult for the consumer to assess. According to Bigbee and Polfus (1989), the health care system is well aware of the advantages of nurse practitioners "as evidenced by the extensive use of (nurse) practitioners" in various settings. Bigbee and Polfus (1989) further elaborate that nurse practitioners are used in HMO's, public health settings, family planning clinics, college health centers, and other primary care settings. Communicabilty is the ability to communicate innovations to potential adopters through communication channels such as mass media, including radio, television, and newspapers as well as the WW and interpersonal or one-on-one communication. Nurse practitioners are constantly teaching their clients about the role but the mass medium of the W has the potential to reach out to a greater audience. LITERATURE REVIEW MARKETING THE ROLE OF THE GENERIC NP A cross-sectional survey of 388 residents of a northern Illinois county by Pender and Pender (1980) found that 61% of a respondent poll would use NP services if they would become available within that county. The best predictors of intention to use the services were 1. interest in use of prevention and health promotion services for direct pay, 2. education beyond high school, and 3. a low level of life stress. Clients who were under stress, experiencing physical symptoms, or confronting worry- inducing medical situations preferred to see a physician rather than a nurse practitioner 12 for care. Physical examination and screening services for detection of illness were interpreted as areas of service that a nurse practitioner could provide. The profile of the potential user in the study of New Haven, Connecticut (Shamansky, Schilling & Holbrook, 1985), included satisfaction of the interviewee with their present health care provider and a homesize of less than or equal to five people. Dissatisfaction with previous care was seen to be the strongest predictor to use NP versus physician services. Factors associated with dissatisfaction stemmed from lack of providing adequate time and teaching to the consumer. Availability included factors such as the ability to locate and speak with the provider, length of time spent in the waiting room, and the days and hours when appointments could be made. When the practitioner was unavailable, dissatisfaction increased. Cost was also cited as an issue of acceptance of the NP. Coverage by insurance was thought to probably enhance the acceptance of NP services (Pender & Pender, 1980; Hogan & Hogan, 1982). Many NPs are dependent on the physician for billing of Services to third party payers for reimbursement. Smith and Shamansky (1983) found that higher income females were more likely to seek out NP care. Rogers’ (1995) theory of innovation supports this finding. Well-to- do individuals are more innovative due to additional disposable income. It could also be speculated that these same upper middle class women preferred the services of a woman (nurse) versus a physician (man) related to reasons of modesty. Lower income families tend to be disenchanted with the present system of care 13 (Enggist and Hatcher, 1983). According to these researchers, dissatisfaction with present care was the strongest predictor of use of NP services. Dissatisfaction focused on cost and availability of medical services. Factors associated with availability in this study were the ability to locate and speak with one’s provider easily, length of time till appointment, length of time in the waiting room, and days and hours when appointments could be made. Availability according to Rogers (1995) is an integral factor in adoption of innovations. Compatibility is the extent to which an innovation is consistent with existing experiences and values (Rogers, 1995). Physician services were not seen as different from the NP (Enggist & Hatcher, 1983) however, consumers were found to want to know what differentiates NP from physician practice. Here is another marketing message; emphasize the practice of primary care rather than the role of the provider. DIFFERENCES/SPECIFICITIES OF THE GNP vs. NP ROLE One research study was found in the literature (Brands, 1983) that specifically dealt with the acceptance of nurses as primary-care providers by retired persons. The study did not differentiate between NPs and GNPs. Respondents of the survey who selected the nurse as a primary care giver were English speaking, had at least 7 years of formal education beyond high school, a family income of $10,000 or more and agreed with the statement that nurses can do the same things that doctors can. The article concluded by stating that if older people are to be expected to positively react to the innovation of NP (or GNP), they must be informed about the fimctions inherent in the l4 role. The GNP role differs from the role of the generic NP. The GNP is a registered nurse with advanced educational preparation to provide a full range of primary care services to older adults. The GNP utilizes nursing practice and aging theories to guide nursing care of the elderly. Common problems and normal changes of aging are used as a reference source for care. The following is a list of professional practice differences between the role of the GNP versus the NP. This list is based on competency statements for master’s graduates from a National League for Nursing document entitled Gerontology in the Nursing Curriculum (1990). Gerontological research is examined, conducted and evaluated to provide a scientific basis of practice. Preservation of the rights and dignity of the elderly is assured. GNPs employ the nursing process in the care of the elderly. The following are differences in nursing process competencies that the separate the GNP from NP (excerpts continue from the NLN document on Gerontology in the Nursing Curriculum): Assessment: Application of knowledge and research in aging theory to the assessment of the elderly discriminates normal aging from pathology. Examination of the complexities of the aging persons reaction to the environment by holistically assessing physical, psychological, socioeconomic and functional processes 15 of the elder. .PLanalllgi Design the plan of care to promote the attainment and maintenance of health, well-being, quality of life and a peaceful death in collaboration with the elder and family. Implementation: Promote the autonomy of older persons in health-care decision making. Evaluation: Evaluate standards of gerontologic nursing. Contribute specialized knowledge to the interdisciplinary team in evaluation of outcomes of care to the elder. MARKETING TO THE ELDERLY Older Americans are beginning to be viewed as a viable and attractive market segment by marketing professionals (Fugate & Tudor, 1995). The elderly spend 12% of the Gross National Product per year on health care (Self & Wilkinson, 1990). Older adults (65 years of age and older) currently comprise 12.3% of the total American population and, by the year 2000, are expected to increase to 13%, or nearly 35 million persons. By the year 2030, elders will total 21.8% of the population. (US. Bureau of Census, 1988; AARP, 1988). In addition to these impressive statistics the older adult population controls 50% of the after-tax discretionary income (Linden, 1986). According to Minkler (1989), the elderly population will require service for needs and be able to pay for service to an 16 extent that will fuel the vast health and social service industries for years to come. Thus, services for elders will provide the newest growth market in the private sector. The resources that elders spend on health care are used to restore and maintain functional health status, a critical element in life satisfaction. Life satisfaction has been defined by Hochschild (1983) as a positive self image, successful goal achievement, pleasure and purpose in life. Health care providers must position themselves to take advantage of this developing market and to enhance functional health. The Geriatric Nurse Practitioner is uniquely trained to care for the functional health status of the elderly and must take the initiative to market services for elder health promotion Marketing to the elder consumer has been extensively studied (Fugate & Tudor, 1995) and a nmnber of clear messages and implications for the health care marketer have resulted. The following will be a review of the literature and implications for the marketer. Greco ( 1989) studied the representation of the elderly as models in advertisements. Elderly central figures were found to work best in advertisements when the products or services are elderly oriented. However, models in the advertisement were most effective when they were ten to fifteen years younger than the target audience. Phillips and Stemthal's (1977) older but classic work dealt with the elders, age- related cognitive processing differences from their younger counterparts. Those 65 and older have greater exposure to the mass media and declines in learning and information processing were correlated with the aging process. However, these decreases were 17 counterbalanced by using familiar tasks, keeping messages simple, and increasing message frequency. Selection of communication channels by the elderly was studied by Goodman (1992). Elders with higher education and income levels were positively associated with increased media usage rather than interpersonal sources. These elders would be classed as innovators according to Rogers (1995). Concrete metaphors were found by Byrd (1991) to help in linguistic cognition and to assist in recall tasks. Creative and novel analyses of linguistic material were found to diminish with age. Maisto and Queen (1992) found that older adults have difficulty with combined verbal and visual cues. Therefore, visual cues alone enhance learning. Smith and Mochis (1984) found that the elderly in good health or the young elder is more likely to interact with the mass media than the old-old (85 and older). The old- old tend to be less innovative and depend on word of mouth, personal selling or direct mail. In contrast, the young-old are more innovative and would be more likely to use newer technologies such as computers and the WWW. Schewe (1988) reviewed the following aging changes that have implications for marketing: 0 Aging decreases the ability to see small visual details and objects in close proximity. Elders require a uniformly lit background and do not adapt to alternating patterns of light and dark. 0 Hearing loss is more common than vision loss. 18 IMPLICATIONS OF THE MARKETING LITERATURE FOR THE COMPOSITION AND LAYOUT OF THE GNP WEB SITE According to F ugate and Tudor (1995), specific media choices should be based on demographic characteristics. Innovators are a segment of the elder population and use the W. A GNP web site will reach this population and serve as an effective tool in marketing the message that GNP's can assist elders to maintain functional health thus promoting life satisfaction. Elders have significant disposable income and are becoming a known presence on the web. This trend will increase as the "baby boomers" reach retirement age in the coming century. A natural extension of higher education levels of seniors is that seniors are using the computer more. Use of marketing images would best include a picture of a young elder couple in good health performing some type of aerobic exercise such as bicycle riding or walking. A face page designed with this image would enhance entry into the web site contents. The web site should not be complex to use, its message should be simple and direct, and repetition of information would enhance message reception The message content should not be full of links that might detract fi'om learning and information processing. Links, if used, would best be used after the content of the message has been delivered. The wording of the content should be at a more ftmctional level than college level reading. Metaphors could be used to assist in retention and recall of information. 19 Midi files (musical or verbal content) would possibly not be heard and also would detract from learning by the elder. The web site should contain only written, simple information that is easy to understand and process. Visual objects should be kept to a minimum and large print will enhance reception of the printed message. METHODOLOGY The web site "Marketing the Geriatric Nurse Practitioner (GNP)" was developed to educate consumers about the benefits of primary care delivered by the GNP. The web site is meant to be a complement to the Geriatric Nurse Practitioner web site developed by Holmberg (1997) that explains the role of the GNP to other health care providers. The contents of the marketing site include the following as explicated by Mahoney (1994): 1. Product 2. Price 3. Place 4. Promotion In order to create this WWW site the following hardware and software applications were used: Hardware: 0 A personal computer. An IBM compatible 686 pentium desktop computer was used for this project (a 386 desktop could have been used but speed of access 20 and manipulation in the web environment would be diminished). Sixteen megabytes of Random Access Memory (RAM) were used. The monitor used displayed 256 colors for viewing. 0 A modern. The modem is a piece of hardware that connects to the personal computer through a telephone line. It transmits digital information from the personal computer to the WW and back. An internal 28.8 Kbps (Kilobits per second) modem was utilized to make the connection to the Internet provider (either Michnet to Michigan State University (MSU) server or Novagate, a local access provider, when Michnet was not able to be accessed). 0 A telephone line. The modem was directly connected to the home office phone line. One line was used for all access, phone and computer, but this impeded access at times for phone calls. 0 11.3.3.9: The computer's built-in mouse was used as a pointing device to activate commands. Software: 0 Windows 95. An operating system that was factory installed on the desktop computer at the time of purchase. Windows 95 has built-in TCP/IP software that replaces an additional piece of software needed to access the Internet. Windows 95 also is an interface program that allows the user to start programs, save documents, and organize disk reserves (Stinson, 1995). o Micrgoft Word for Windows - version 7. A text-processing program that 21 was factory installed as part of the Office 97 suite. This program has built-in web publishing capabilities giving the user a basic template for a blank web page or a wizard function to make the job of HTML language construction less complex. 0 Ipswitch WS FTP. (Ipswitch WS_FTP) A Windows based application for transferring files between the home based computer and the MSU server system. Ipswitch WS_FTP Pro allows transfer of files between the home computer and the server. It is available from Downloadcom on the WW. 0 Microsoft Internet Explorer. A W browser from Microsoft Corporation was factory installed. Internet Explorer allows for sending electronic mail, reading Usenet news, and exploring of the WWW. 1» Novagate Communications. A local intemet access provider who charges a monthly fee and provides limited or unlimited access time to Internet servers via a local access number. This service was used when local Michnet dial-up was inaccessible. Reference Books C Larson, MA. (1997). Web Publishing with Microsoft Office 97 in g week (lst Ed.) Indianapolis, IN: Samsnet Publishing. 0 Tatters, W. (1996). _T_e_ach vourself Netscafi 2 Web Publishing in a week. Indianapolis, Indiana: Samsnet Publishing. Reference Web Sites HTML Sites 22 0 Introducing HTML 3.2 - (http://www.w3.org/pub/WWW/MflagkgupN/ilbur) 0 National Center for Supercomputing Applications Beginner's Guide to HTML - (http://www.ncsagriuc.edu/General/lntemet/WWW/HTW/PrimerAll.html) 0 W3 Recommendations Process - (thpz//www.W3.org/pub/www/Consortium) o The Bare Bones Guide to HTML 3.2 - (http://www.werbach.com/barebones/barebone.txt) 0 Links to other HTML Guides on the WWW - ( http:/lwww.werbgchcom/web/wwwhelphtmlit guides) Helpful guides on getting started 0 Pilot Accounts Information at Michigan State University - (http://netinfo.msu.edu) 0 Creating a World Wide Web Page - (http:/lwebmsuedu/pilot) 0 Microsoft Internet Explorer - MSN Network - (httpzl/homemicrosoitcoml) Getting Connected 0 Modern Configu__rgtion. Microsoft Windows 95 has an application called 'New Modem Wizard' which simplifies the process of modem setup. See Appendix for setup procedure. 0 Windows 95, Microsoft Word 7.0. and Microsoft Internet Explorer have been configured to be 'seamless' in accessing the web. As documents are typed such as the above http: access sites, the trio of software creates a link that can be accessed from the Word document. 23 o _E_s_ta£blishing_a pilot Jaccount - Appendices A (MSU PILOT Electronic Mail) and B (Using Terminal Emulation to dial in to the Internet), distributed by the Michigan State University Computer Lab, provide information on how to establish a pilot mail account, along with configuration information for use with MichNet dial-in lines. 0 Web Site Authoring - Connect to pilot services and access "Advanced F eatures" and follow the directions. Disk space on the MSU server is made available to create a home page. 0 Setting Up Ipswitch's WSiFTP Professional Program, 1. Download the software from Downloadcom (http://www.download.com/PC/Categorie§_/j. Under categories choose Internet. Under Internet choose FTP. Under FTP go to page 3 and choose WS_FTP. This program can be used with Windows 95. Check system requirements. 2. From a local computer establish a connection with a remote computer. WS_FTP displays the directories and files on the local computer (left side) and the files and directories of the remote computer on the right side. With both systems displayed, the user can easily locate files on one system and copy them to a directory on the other system. 0 Setting up Microsoft Internet Explorer. This program was factory installed to provide more reliable access to the local intemet access provider, Novagatecom. 24 o Transferring index. html to MSU‘s Computer System. In Microsoft Word 7.0 the web creation wizard will be used to create "Marketing of the GNP" site. The document will be stored in 'My Documents' file and given the file name Index.txt. Index.txt will be a blend of Microsoft wizard language for HTML, 'borrowed' HTML text from other sites (using ‘view source' while in other web sites then 'edit copy & paste' from those sites into the Marketing GNP site), and HTML tags from reference books and Web sites. HTML (Hypertext Markup Language) according to FOLDOC (1997) is "a hypertext document format used on the WWW" (See Appendix C for URL). Development of the 'Marketing the GNP' Web Site 0 Mahoney (1994) encourages the use of the 4 P's of marketing: product, price, place, and promotion. These four terms will be used to create a framework for the information placed within the site. Tatters (1996) encourages advanced planning for the web site including: establishing your goals (education of consumers about the GNP), defining an outline (the 4 P's), defining the contents of each page (storyboarding), evaluating the site's performance (include a site 'hit' counter and an e-mail connection to the web master or author). 0 Establishing an outline for the 'Marketing the GNflsitp. Three (3) pages will be used: Page 1: The four P's will be defined using Mahoney (1994) as a reference source. 25 Page 2: Explication of the four P's Page 3: A list of links will be provided to further educate the consumer about the role, education, and marketing of the GNP, and senior computing. 0 'Borrowing’ of features for use within the web site. 1. Bonnie Holmberg's "Role of the GNP" site was used for the page index topic feature. 2. Many features contained in the Microsoft Word 7 .0 web creation software (colored bars and balls). 0 Development of the Site page; Marketing the Geriatric Nurse Practitioner (GNP) Page 1 of the site outlines the four P's with links to Holmberg's role of the GNP site and 'intemal' links to page 2 & 3 explicating the Four P's. The pages within the site use a white background with black and dark blue lettering . The contents list is written in H3 script which is larger type than standard. Page 2 of the site is the explication of the Four P's linked to page 1. Page 3 of the site is a 'links' page and offers the consumer a variety of sites that educate the consumer about the educational preparation of the GNP, various health topics sites related to the GNP and other sites of related interest including marketing on the web and senior computing. 26 EVALUATION OF THE 'MARKETING THE GNP' WEB SITE Bock (http://www.boc,krjfo.com/5is.htm) lists "The 51‘s of a Good Website" as: 1. Information: The web is an information medium that allows the user to put a lot of information up at a low price. The information that is used should be relevant to the people that you want to reach. The information should also have breadth and depth. The 'Marketing the GNP' (hereafter, 'Marketing) site was designed to get information out to the elder at a low price. A basic computer with modem, inexpensive software and an understanding of HTML language construction can be used to construct a good web site. Innovative elders were the target population of this site and throughout construction were kept in mind. The links page provides breadth and depth of different kinds of information through multiple health care, education, marketing and senior tOpics and through its two links with Holmberg's role site. Individual: A great web site allows the individual to get the information he/she wants, when and as he/she wants it. Site design should incorporate as many links as possible. The site should be easy to get information. It should not have a lot of graphics to load on the home page that will slow down the speed of "coming up". Slow speeds (coming up in more than 10 seconds) tend to disinterest the 27 user unless the site’s value is established in the user's mind. Due to this fact, a face page with a picture of a healthy elder couple was not used. Navigation buttons and return mechanisms should make it easy to get around in the site. These navigational systems should be consistent within the site's environment to allow ease of use. Consistency coorelates well with elder learning theory. Large print is more easily read by the elders. Finally, a great web site should allow the user of the site to provide feedback to the author for site evaluation. The 'Marketing the GNP’ site uses an e-mail address and a friendly invitation to the user to interact with the author. The 'Marketing' site is linked extensively allowing the user to find a lot of information about the GNP role, education, and credentialing information. The information is easy to read and has a clean, minimal- graphics environment that allows the home page to quickly "come up". Navigational mechanisms are mostly consistent throughout the 'Marketing' and Holmberg 'GNP role' sites that were meant to be "sister" sites. Oversized (>12 pica) print is used throughout the site to decrease elder eye strain. . Interesting: The information needs to hold the visitors interest and thus must be relevant and useful. Recency of information also helps 28 the site to be revisited. Design elements with audio or animations can be interest builders but to this author can distract from the information flow. - The 'Marketing site was built with the express purpose of communicating the value of the GNP to elder health. The GNP is not a well known provider of health care and benefits of GNP care must be communicated to the elder population. Innovative elders are interested in maintaining their functional health and wellbeing. Holmberg's 'GNP role' site and the 'Marketing site serve the purpose of communicating that information. Design elements were intentionally kept simple and clean but consistent to minimize distractions to the flow of information. . Interactive: A good web site allows the user to have a lot of actions (mouse clicks and links). Actions allow the user to have feedback and control which enhances interactivity. Building in feedback through e-mail response increases interaction and adds a deeper dimension of contact with the information expert creating a greater sense of control and satisfaction. The 'Marketing site is built with many links and interactions that enhance user interactivity and a sense of control. A e-mail link with the author on the home page allows for contact with the information 29 expert. 5. Integrated: Whatever is on the web site should work together with the other materials, and everything else on the site. Common logos, layouts and page designs enhance user comfort and effectiveness. The 'Marketing' site is integrated around 'the 4 P5" of marketing giving the user a sense of solidarity as he/she moves within the three page format. 'Stained glass' balls are used for bullets and same-color bars are used as information breaks consistently throughout the format. IMPLICATIONS FOR GNP PRACTICE GNPs must begin to market themselves in order for the elder public to notice the role and the benefits of enhanced functional status that can be achieved through GNP use. One web site describing the role and one web site marketing the GNP are a start but not enough to " get the word out" about the advantages of GNP use in primary care environments. There continues to be a lack of brochures or other information mechanisms that endorse the GNPs role in promoting elder health. IMPLICATIONS FOR EDUCATION Current curriculum, as explicated by the two education links on this web site, does not include marketing techniques that would increase public exposure to the GNP role and benefits. Educators must begin to favor marketing in curriculum revision so that elders will begin to receive care from elder-oriented providers. Marketing is not a dirty word; it is a reality of economics in a capitalistic society with far too many mediocre 30 choices. The 'Marketing the GNP' site has many educational opportunities built into it for the GNP student. The role of the GNP is explained in detail by Holmberg and linked to the 'Marketing' site under 'Product' on the first page of the site. Students seeking geriatric information only need to 'click' on the 'American Geriatrics Society' link found on the links page and find a wealth of material on virtually every topic in Geriatrics. A confusing topic to the student Nurse Practitioner is the credentialing process. The 'ANCC: American Nurses Credentialing Center’ link describes not only the process for the Geriatric Nurse Practitioner but all other Nurse Practitioners as well. Finally, the student who wishes to begin a study of marketing can visit the 'Wilson Internet Services' site that is rich with marketing information and links. IMPLICATIONS FOR RESEARCH There is a severe lack of literature devoted to marketing the role of the GNP. The literature and research devoted to marketing the generic nurse practitioner is old and not longitudinal. Generic NPs writing and conducting research seemed to be more concerned with women and younger families. This literature needs to be replicated in the more enlightened era of the 19905 (versus the 19705). The information age has potentially changed the values of the elder and their dependence on physicians to deliver all of their care. Research supporting this assumption could enhance marketing efforts of the relatively recent innovation of the GNP in primary care. Other mechanisms that would possibly enhance the 'Marketing the GNP' site and 31 also provide feedback for research purposes would be to include one or all of the following: 1. Construct and complete an on-line survey mechanism to determine who is using the GNP site. 2. Construct a 'GNP chat room' to gather data for research. 3. Create and use a hidden counting mechanism to tally the number of hits on the GNP site. SUMMARY Marketing of the GNP in care of the elderly through the mass media instrument of the world wide web is supported by Rogers (1995) diffusion of innovation research. Use of a web site to market the role and its benefits targets the elder innovator who is online searching for answers to complex functional health problems. Elders must be informed of the GNP role and benefits in order to be cared for by a provider educated in enhancement of elder functional status. Few primary care providers are prepared for the 21St century's challenge of meeting the needs of an aging population. The GNP is equipped to meet the challenge. Appendix A MSU Pilot Electronic Mail MSU PILOT Electronic Mail PILOTusers can exchange email with other email users on the worldwide Internet. Every MSU shrdentandemployeehasanaccountonthePILOTemailsystem. Thisdocumentdescriheshowto activateanduseaPILOTaccotmt. Sometermsyou’llneedtoknow: 010: Computing Information Center, 805 Computer Center. Phone 3554500. The 010 has copies ofall the documents and software mentioned here. MSU Identification number: Students use PID. MSU employees use employee ID (can). For newly admitted students, your PID was included in your admissions letter. For others, this ‘ numberisassignedwhenyour application foraPILOT accountis processed. f PIN: Students use PAN. Employees use PIN. For newly admitted students, your PAN is on the enclosed page that contains your name and address. Others are assigned a PAN when their application is processed. If you don’t know your PIN or PAN, contact the 010. MSUnet ID and password: Your network ID and password. These are created when you activate your PILOT account. They are your authorization keys to many network functions, including PILOT email. You can also use PILOT to change your MSUnet password. What You Need You need communications software and a computer connected to the Internet. The software must be able to do vt100 terminal emulation. Your Internet connection can be either by modem and phone line or by direct connection. Connecting In short, connect your computer to the Internet and then telnet to the address pilocmsuedu Eugndwog sndwng There are two ways to connect to the Internet. Either a dial-in connection or a direct connection. Dial-in Connection If you access the Internet through a commercial service provider such as America Online, contact that provider for help on telnetfing to the Internet address pilot. msu.edu Within Michigan. the Internet and PILOT can be accessed by a local call to a MichNet phone line. “'W‘do’aiment Using Terminal Emulation to Dial fn’ E'WTfiter-n'é‘t.‘ “" Direct Connection From an elf-campus sits connected to the Internet ' 3 0 ll 0 Telnet to the Internet address pilotmsuedu “INNER MMPConHSU'sCampusEther-net Using DOS and PCITCP software: IOIAIO RY At the Czb prompt. enter-z tnpiloanuuedu (MSU students and employees) or At the C:I> prompt, enter: tn msualum.mu.edu (Alumni) MERCER ' Using Windows 96: W56 m 1. Run the telnet application. ' 2. Pull down the Connect menu and select Remote System. ”4.10” 3. Enteroneofthesehostnames: piloLmsraedu (MSU students and employees) msualunamsmcdu (Alumni) Sllllim ._ CU | MSU PILOT ELEM 029644843 fill 13 H AIHIUAIIVI A l I H " M Micro Lab PC ‘ . . I. Ussthe I-ID menu to select PILOT (MSU Email System). Ifnecessary, resetthe PC to display the ID Menu. ° . 2. Enter one of these host names: ‘ pilotnuusdu (MSU students and employees) muolum.msdu (Alumni) MnllicroLabMocorMocontheCcmpusEthenwt . 1. Open (double click) the Telnet application. In the microlabs, Telnet is on the server in the Communications folder. 2. PulldowntheFilemenu. SelectOpchonnection. 8. Enter one of these Session names: ., pllotmsrudu (MSU students and employees) molmmsusdu (Alumni) Activating your Account BeheufingPflMymmMacfimhyomMSUnetmandchomeapmwordTodothisywmdm idenfifiymuedfhPfiOPbyyunMSUfimfifimfimnumbasndymnmeth(mdefinifimabow) 1. Connect to PILOT. When the login: prompt displays, enter pilot. When asked for a password. press Return . 2. Read the screens carefully. Enter your MSU identification number and PIN when asked. 8. EnterasecumpasswordwhenaskedAnMSUnetIDwillhecreated. Onfutureloginsusethis ID and password to enter PILOT. 4. The last activation screen will show your MSUnet ID. Remember it and the password you entered in step 3. Your Internet email address using PILOT is one of the following: yourMSUnetIDOpilotmsu.edu (student or employee account) yourMSUnetIDGmsualummsuedu (alumni account) Using PILOT Getting On-screen Help ‘ The bottom of most PILOT screens describes how to get on-line help. Create and Send Mail I. From the MAIN MENU press m 2. From the MAILBOX screen press as 3. Entertheemail addressofthepersonyou are emailing.TosendtoanotherPILOTusersimply enter their MSUnet ID. (Do ID searches from the MAIN MENU). 4. Enter the subject of your message. 5. Type the body of your message. 6. When done, press the see key. then 1, then s. Read Mail I. From the MAIN MENU press m. 2. Use the arrow keys to select a message you want to read then press Enter. Disconnect QuitPILOT Always exitviatheMAIN MENU. From the MAIN MENU pressq . Help ' . For assistance call the CIC. Consultants are available Monday through Friday. Consulting is also available by email at: consultOmsuedu or helpGpiloLmsu.edu. Informab'on regarding acceptable use of all MSU information technology. including PILOT, in available at: Appendix B Using Terminal Emulation to Dial in to the Internet Eupndwoj sndum) fl 0 S o C 0 NPUIER lAIOllAlORY 35mm 93056.3)“ Hill-l0” PI: 5111mm momma: Using Terminal Em ulation to Dial in to the Internet This document describes how to use terminal emulation software and a modem to connect to MichNet (within Michigan). Once connected to MichNet, you can access MSUnet and the rest of the Internet. For information about access from outside of Michigan, see the section Out of State. What you need You need a computer. modem, phone line, and communications software capable of vt100 terminal emulation. A number of capable commercial and shareware programs are available. Kermit commu- nications sottware works well and is available free from the Computing Information Center (010). See More Help. Configuring your modem and communications software You may need to consult your modem and software documentation for instructions on how to make the following settings. Kermit. as provided by the CIC, is preconfig'ured and does not require addi tional set up. We W linden (DOE) speed ................. 1L! Kbps or highest speed supported Counter (D‘I'E) speed .............. 57.6 xbps or highest speed supported Error correction .................. On - Type of error correction .......... v.42; if v.42 isn't supported. use INN Data cospression .................. On e of data comression .......... v.42 bis; if v.42 bis isn't exported. use RIPS P ow control ...................... C‘l‘S/R‘I'S (also called flow control. or handshaking. If not supported. use XON/xOFF.but be aware that enabling xourxorr may interfere with binary file transfers). Dirk clearing ...................... Dos: Disconnect when D11! is dropped lilac: Ignore UI'R Parity ............................ Off or none Data bits ......................... 0 Stop bits ......................... l Terninal enulation ................ vt100 Other settings .................... Default settings East Lansing MichNet dial-in numbers The East Lansing MichNet dial-in numbers are: ' 517/353-3500 (28.8k speed) 0 517/432-0100 (14.4]: speed) A comprehensive list of dial-in numbers is available from any of the following: The document'llichNet Dial-in Numbers 0 Connect to any MichNet number and search the on-line phone list by entering help at the host. prompt. 0 Using the World Wide Web: http:/lwww.merit.edulmichnetlhow.to.get.connected/midinetnos Connecting I. Use your modem and communications software to dial the selected phone number. 2. At the host: prompt, enter the domain name address of the computer you want to connect to. Examples: host: pilot.msu.edu (PILOT email) host: stuinfo.msu.edu (Student information system) host: ibmgate.msu.edu (Gateway to MSU IBM hosts. Use this address to go to ' magic, enroll, ibm.cl.msu.edu, and ais3270) MMEmFOlfl-Nul I" IS AI ANIIIAIIVE ACllOlllQUAl OHORlUllll INSlllUlIOll o 0 Hill IOAID 0i li'JSIT 3. When prompted for your network ID and password. enter your MSUnet ID (same as your PILOT ID) followed .by Cmsuedu Then enter your PILOT password. Login example: login: smithjanemsuedu Password: (your PILOT password, it won’t display) If you haven't yet activated your PILOT account. enter guestflmsuedu and press Return. Then follow the instructions on Activating Your Account in the MSU PEOT Electronic Mail handout. Login example: ~ login: guestOmsuedu (for people without an active PILOT ID) Password: (no password required) Out of State Outside of Michigan. a dial-in connection to the Internet can be made through many difi'erent Internet service providers (ISPs). An extensive list of ISPs is available at the web site: httpilwww.yahoo.com/Business_and_Economy/Companies/ IntemeLServices/lnternet.Access_Providersl More help Consulting is available by email at consultemsuedu or from the Computing Information Center (CIC), 305 Computer Center, 432-6200. The CIC also distributes preconfigured versions of Mac and MS Kermit free of charge. Appendix C Procedures for Connecting to the Internet 36 Appendix C Procedures for connecting to the Internet 0 Modem Configuration. Use the following procedure to use Microsofi Windows 95 New Modem Wizard: 1. 2. Click on §_ta_r__t Button. Click on Settings Button. Click on Control Panel. Double click on m. Click on Add button to start the New Modem Wizard. Follow the step by step instructions for configuration. 0 Wingows 95 configuration of TCP/IP. Windows 95 comes with TCP/IP software built in. This greatly enhances user friendliness for connection to the Internet. Use the following steps for configuration: 1. 2. Click on the Start button. Click on Settings. Click on Control Panel. Click on Network. Click on Config1_1_ration. Click on TCP/IP. Click on Promrties. 37 8. Click on "Obtain an IP Address Automatically". 9. Click on Q_I_(_. Connecting to Pilot@MSU.edu via a commercial servig provider Using Microsoft Internet Explorer: 1. Click on fig. 2. Click on m. 3. Type in the Internet Address required. (Ex. http:/@ilotmsuedu) 4. Click _Q_K_. Setting up Microsoft Internet Explorer Microsofi Internet Explorer was factory installed, however, upgrades may be obtained from the MSN web site at http://microsofi.com/ie/download. Follow the online instructions. To create html [engage using Micrggft Word. Files for loading to pilot. msu. edu must be written in Hypertext Markup Language (HTML) and saved in text format. Use the following procedure: 1. Click on Lug button. 2. Click on Programs. 3. Click on Microsoft Word. 4. Click on Ej_l_e_. 5. Click on New. 6. Click on Web Pages. 38 Click on Blank Web Page Icon. Click OK. (A blank web page will be constructed. Type in the blank page as you would a normal word processing document. Use Mew/html source to make changes/corrections in html language. Save as Text (.txt) only.) Transferring indeLhtml to MSU's Computer System. Use the following procedure: 1. Click on Slag button. 2. Click on Proms. 3. Click on WS-FTP 95 Pro. The session properties window appears. 4. Under Profile Name fill in select Unix(standard) from options list. 5. Under Host Name/Address fill in pilot.msu.edu. 6. Under user ID, fill in your MSU pilot ID account name (helmusde). 7. Under password, fill in your MSU pilot password. 8. Click apply. 9. Click OK. 10. The WS_FTP95 main screen appears. The lefi side of the screen contains all the 11. C drive files under the local system. The right side of the screen contains your MSU Pilot account files, under the remote system. On the left side of the screen under local system, double click on green arrow. 12. Double click on green arrow again to display contents on C drive. 13. Double click on My documents. 39 14. Click on the index.txt file. 15. Double click on remote system (right side of screen) file called public. 16. Click on arrow pointing right in middle of main screen. 17. On right side of screen, locate indextxt file and click on it. 18. Click on Wbutton on right side of screen. 19. Type in box that appears on screen, 'index.html'. 20. Click OK. The file index.html is now set up on MSU‘s computer system. 21. Exit out of WS_FTP 95 Pro. Appendix D Steps to conduct a Search with Microsoft Internet Explorer 40 Appendix D Steps to conduct a Search with Microsoft Internet Explorer . Double click on Microsoft Internet Explorer. . Click on Search button on toolbar. . Choose and click on browser (Lycos, Yahoo, Infoseek, etc.) . Enter in search topic (Elder, Marketing, Health, Geriatric Nurse Practitioner, etc.) . Click on Search button. . Click on any one of the search topics listed to locate information. Appendix E Marketing the GNP' site: web pages with html langpage Marketing the Geriatric Nurse Practitioner (GNP) Mission Statement This site explains why elders should use the Geriatric Nurse Practitioner (GNP) as a provider for their healthcare needs. Site Contents OProduct - Role of the Geriatric Nurse Practitioner OPrice - _G_NPs do not cost more fiPlace - Where GNPs are found 6Promotion - Links to other Nurse Practitioner sites Thank you for visiting the 'Marketing the GNP' site. I want to hear from you, it is important to me and to the profession I wish to 'market'. Please send me e-mail. Dennis Helm us If you need to have larger print for reading: In Microsoft Internet Explorer click on the toolbar - yiew, Fopt, Largest - and your print will enlarge. Last Update: 6 Nov 1997 42 Marketing the Geriatric Nurse Practitioner (GNP) D D D index.txt Marketing the Geriatric Nurse Practitioner (GNP) 

Mission Statement

This site explains why elders should use the Geriatric Nurse Practitioner (GNP) as a provider for their healthcare needs.

Site Contents

Product - Role of the Geriatric Nurse Practitioner

Price - GNPS do not cost more

43

Place - Where GNPs are found

Promotion - Links to other Nurse Practitioner sites

Thank you for visiting the 'Marketing the GNP' site. I want to hear from you, it is important to me and to the profession I wish to 'market'. Please send me e-mail. Dennis Helmus

 If you need to have larger print for reading:

In Microsoft Internet Explorer click on the toolbar - View, Font, Largest - and your print will enlarge.

Last Update: 6 Nov l997

Marketing the Geriatric Nurse Practitioner (GNP) The GNP is a unique healthcare provider that meets the special care needs of the elderly. Education in aging theory, nursing interventions to meet holistic needs, and maintenance and enhancement of fimctional health are just a few of the GNP's areas of expertise. Page contents Product Price Place Promotion — Product In 1997, Bonnie Holmberg created a web site to explain the role of the GNP to potential consumers. At that time there were no known sites on the world wide web that explained this unique role in nursing. The role of the GNP is relatively new, being developed in the late 1960's to provide more comprehensive and holistic care to a growing elder population. Among the positive outcomes resulting from GNP role development are the following: timely hospital discharge, prevention of hospital readmission, enhanced comfort and pain relief, appropriate care for bowel and bladder problems, care of nutritional deficits, care for depression and altered mental status, healing of pressure sores, and assisting with fiinctional problems such as mobility deficits. Increasing fimctional status is a special skill that GNPs possess. Studies have shown that enhancement of functional status increases life satisfaction in the elderly. In addition, studies have shown that nurse practitioners have high levels of patient satisfaction and excellent relations with patients and their families. Return to Page contents _ Price GNPs do not cost more for healthcare in fact, they may save money by giving more appropriate care to the elderly. Unfortunately there are no known studies that support this claim, but anecdotal evidence is leading state and federal governments to encourage the use of nurse practitioners in the healthcare environment. As a direct result of this new thinking, GNPs are now able to bill Medicare for reimbursement as of this year, 1997. The unique role of the GNP in elder care and returning the elder to functional status is making a difference. Return to Page contents — Place Look for GNPs in a variety of settings. Physician offices in collaborative practice, HMOs, Nursing homes, Foot care clinics, mobile care clinics, hospice and in many other sites and roles. Return to Page contents _ Promotion Care by nurse practitioners has been studied extensively and found to be comparable to physician services. Nurse practitioners can care for up to 80- 90% of the same diagnostic categories as physicians in primary care settings. In addition, GNPs are trained in holistic methods of healthcare delivery, aging theory, and the effects of aging on the body. Return to Page contents — 46 Contents.html D D D D CONTENTS U D (FONT SIZE=6>

Marketing the Geriatric Nurse Practitioner (GNP)

The GNP is a unique healthcare provider that meets the special care needs of the elderly. Education in aging theory, nursing interventions to meet holistic needs, and maintenance and enhancement of functional health are just a few of the GNP's areas of expertise.

Page contents

47

Product

In 1997, Bonnie Holmberg created a web site to explain the role of the GNP to potential consumers. At that time there were no known sites on the world wide web that explained this unique role in nursing.

The role of the GNP is relatively new, being developed in the late 1960's to provide more comprehensive and holistic care to a growing elder population.

Among the positive outcomes resulting from GNP role development are the following: timely hospital discharge, prevention of hospital readmission, enhanced comfort and pain relief, appropriate care for bowel and bladder problems, care of nutritional deficits, care for depression and altered mental status, healing of pressure sores, and assisting with functional problems such as mobility deficits. Increasing functional status is a special skill that GNPs possess. Studies have shown that enhancement of functional status increases life satisfaction in the elderly.

In addition, studies have shown that nurse practitioners have high levels of patient satisfaction and excellent relations with patients and their families.

Return to Page contents

Price

GNPs do not cost more for healthcare in fact, they may save money by giving more appropriate care to the elderly. Unfortunately there are no known studies that support this claim, but anecdotal evidence is leading state and federal governments to encourage the use of nurse practitioners in the healthcare environment. As a direct result of this new thinking, GNPs are now able to bill Medicare for reimbursement as of this year, 1997. The unique role of the GNP in elder care and returning the elder to functional status is making a difference.

48

Return to Page contents

Place

Look for GNPs in a variety of settings. Physician offices in collaborative practice, HMOs, Nursing homes, Foot care clinics, mobile care clinics, hospice and in many other sites and roles.

Return to Page contents

Promotion

Care by nurse practitioners has been studied extensively and found to be comparable to physician services. Nurse practitioners can care for up to 80—90% of the same diagnostic categories as physicians in primary care settings. In addition, GNPs are trained in holistic methods of healthcare delivery, aging theory, and the effects of aging on the body.

Return to Page contents

Links to Nurse Practitioner Sites and other Web Links of Interest. — eSites that provide many links for elder health and resources . Consumer Topics on Aging . American Geriatrics Society eTwo sites that describe GNP education . Michigan State University . University of Arizona eANCC: American Nurses Credentialing Center A site that describes initial certification and recertification requirements for the GNP eWilson Internet Services Web marketing site of interest eSenior Net Senior computer education site 50 Links.html Links

Links to Nurse Practitioner Sites and other Web Links of Interest.

Sites that provide many links for elder health and resources

Two sites that describe GNP education

ANCC: American Nurses Credentialing Center

A site that describes initial certification and recertification requirements for the GNP

Wilson Internet Services

Web marketing site of interest

Senior Net

Senior computer education site

 

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