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Long-term care facility

Michele L Shaffer, Erika M C D'Agata, Daniel Habtemariam, Susan L Mitchell
PURPOSE: Methodological approaches to examine the association between antimicrobial exposure and multidrug-resistant organism (MDRO) acquisition are complex. This report's objectives are to review approaches used in and findings of prior studies in the long-term care setting, illustrate how these challenges were addressed in a recently completed large prospective study, and discuss strategies for future studies. METHODS: Key design and analytic approaches used in studies conducted since 2000 examining the association between antimicrobial exposure and MDRO acquisition in the long-term care setting were reviewed...
September 23, 2016: Annals of Epidemiology
A Parker Ruhl, Minxuan Huang, Elizabeth Colantuoni, Robert K Lord, Victor D Dinglas, Alexandra Chong, Kristin A Sepulveda, Pedro A Mendez-Tellez, Carl B Shanholtz, Donald M Steinwachs, Peter J Pronovost, Dale M Needham
OBJECTIVE: To evaluate the time-varying relationship of annual physical, psychiatric, and quality of life status with subsequent inpatient healthcare resource use and estimated costs. DESIGN: Five-year longitudinal cohort study. SETTING: Thirteen ICUs at four teaching hospitals. PATIENTS: One hundred thirty-eight patients surviving greater than or equal to 2 years after acute respiratory distress syndrome. INTERVENTIONS: None...
September 29, 2016: Critical Care Medicine
Nancy A Hodgson
The review by Bird and colleagues (2016), published in this issue of International Psychogeriatrics, is notable for jointly examining the effect of dementia care interventions on both staff and resident quality outcomes. This is an important contribution to improving dementia care because it recognizes the dynamic and dyadic relationship between residents and their caregivers in residential settings. While evidence exists on the dyadic effect of family caregiver intervention on dementia patient outcomes (Gitlin and Hodgson, 2015), less attention has been given to formal caregivers in institutional settings (Dellefield et al...
October 17, 2016: International Psychogeriatrics
Sami Ridwan, Horst Urbach, Susanne Greschus, Johanna von Hagen, Jonas Esche, Azize Boström
BACKGROUND: Given the young age of onset and the high probability of long-term disability after SAH, the financial impact is expected to be substantial. Primary objective was to highlight subsequent treatment costs after the acute in-hospital stay including rehabilitation and home care in comparison to ischemic stroke. METHODS: The study included 101 patients with aneurysmal SAH treated July 2007 through April 2009. In-hospital expenses were calculated using the German Diagnose Related Groups DRG...
October 12, 2016: World Neurosurgery
Gifty Apiung Aninanya, Natasha Howard, John E Williams, Benjamin Apam, Helen Prytherch, Svetla Loukanova, Eunice Karanja Kamara, Easmon Otupiri
BACKGROUND: Lack of an adequate and well-performing health workforce has emerged as the biggest barrier to scaling up health services provision in sub-Saharan Africa. As the global community commits to the Sustainable Development Goals and universal health coverage, health workforce challenges are critical. In northern Ghana, performance-based incentives (PBIs) were introduced to improve health worker motivation and service quality. OBJECTIVE: The goal of this study was to determine the impact of PBIs on maternal health worker motivation in two districts in northern Ghana...
2016: Global Health Action
Charlotte Griffioen, Eva G Willems, Sanne M Kouwenhoven, Monique A A Caljouw, Wilco P Achterberg
BACKGROUND: Insufficient pain management in vulnerable older persons living in long-term care facilities is common, and opiophobia might contribute to this. As opiophobia and its related factors have not been investigated in long-term care, this study evaluates the degree of knowledge of opioids among elderly-care physicians (ECPs) and ECP trainees, as well as their attitudes and other factors possibly influencing the clinical use of opioids in these facilities. METHODS: A questionnaire was designed and distributed among ECPs and ECP trainees by email, regional symposia, and all three university training faculties for elderly-care medicine in the Netherlands...
October 14, 2016: Pain Practice: the Official Journal of World Institute of Pain
Stephanie A Chamberlain, Matthias Hoben, Janet E Squires, Carole A Estabrooks
BACKGROUND: Unregulated health care aides provide the majority of direct health care to residents in long term care homes. Lower job satisfaction as reported by care aides is associated with increased turnover of staff. Turnover leads to inferior job performance and negatively impacts quality of care for residents. This study aimed to determine the individual and organizational variables associated with job satisfaction in care aides. METHODS: We surveyed a sample of 1224 care aides from 30 long term care homes in three Western Canadian provinces...
October 13, 2016: BMC Health Services Research
Andrew Ahrendt, Eric Sprankle, Alex Kuka, Keagan McPherson
The current study assesses ageism and heterosexism relating to older adult sexual activity within long-term care facilities. To assess caregiver reactions, 153 residential care facility staff members read one of three vignettes. Each vignette described a scenario in which a staff member walks in on two residents (male/female, male/male, or female/female) engaging in sexual activity. Although no main effects were discovered for vignette type, exploratory analyses revealed that the facility where participants were employed was significantly related to their ratings of approval...
October 13, 2016: Journal of Homosexuality
C Barrett Bowling, Laura Plantinga, Rasheeda K Hall, Anna Mirk, Rebecca Zhang, Nancy Kutner
BACKGROUND AND OBJECTIVES: The majority of older adults who initiate dialysis do so during a hospitalization, and these patients may require post-acute skilled nursing facility (SNF) care. For these patients, a focus on nondisease-specific problems, including cognitive impairment, depressive symptoms, exhaustion, falls, impaired mobility, and polypharmacy, may be more relevant to outcomes than the traditional disease-oriented approach. However, the association of the burden of nondisease-specific problems with mortality, transition to long-term care (LTC), and functional impairment among older adults receiving SNF care after dialysis initiation has not been studied...
October 12, 2016: Clinical Journal of the American Society of Nephrology: CJASN
(no author information available yet)
This final rule will revise the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. These changes are necessary to reflect the substantial advances that have been made over the past several years in the theory and practice of service delivery and safety. These revisions are also an integral part of our efforts to achieve broad-based improvements both in the quality of health care furnished through federal programs, and in patient safety, while at the same time reducing procedural burdens on providers...
October 4, 2016: Federal Register
Esther van Kleef, Sarah R Deeny, Mark Jit, Barry Cookson, Simon D Goldenberg, W John Edmunds, Julie V Robotham
BACKGROUND: Early clinical trials of a Clostridium difficile toxoid vaccine show efficacy in preventing C. difficile infection (CDI). The optimal patient group to target for vaccination programmes remains unexplored. This study performed a model-based evaluation of the effectiveness of different CDI vaccination strategies, within the context of existing infection prevention and control strategies such as antimicrobial stewardship. METHODS: An individual-based transmission model of CDI in a high-risk hospital setting was developed...
October 7, 2016: Vaccine
Ellen Ernst Kossek, Matthew M Piszczek, Kristie L Mcalpine, Leslie B Hammer, Lisa Burke
Although work schedulers serve an organizational role influencing decisions about balancing conflicting stakeholder interests over schedules and staffing, scheduling has primarily been described as an objective activity or individual job characteristic. The authors use the lens of job crafting to examine how schedulers in 26 health care facilities enact their roles as they "fill holes" to schedule workers. Qualitative analysis of interview data suggests that schedulers expand their formal scope and influence to meet their interpretations of how to manage stakeholders (employers, workers, and patients)...
August 2016: Industrial & Labor Relations Review
Ewan M Harrison, Catherine Ludden, Hayley J Brodrick, Beth Blane, Gráinne Brennan, Dearbháile Morris, Francesc Coll, Sandra Reuter, Nicholas M Brown, Mark A Holmes, Brian O'Connell, Julian Parkhill, M Estee Török, Martin Cormican, Sharon J Peacock
BACKGROUND: Long-term care facilities (LTCF) are potential reservoirs for methicillin-resistant Staphylococcus aureus (MRSA), control of which may reduce MRSA transmission and infection elsewhere in the healthcare system. Whole-genome sequencing (WGS) has been used successfully to understand MRSA epidemiology and transmission in hospitals and has the potential to identify transmission between these and LTCF. METHODS: Two prospective observational studies of MRSA carriage were conducted in LTCF in England and Ireland...
October 3, 2016: Genome Medicine
J M Ramos, M M García-Navarro, M P González de la Aleja, R Sánchez-Martínez, A Gimeno-Gascón, S Reus, E Merino, J C Rodríguez-Díaz, J Portilla
OBJECTIVE: Seasonal influenza is responsible for high annual morbidity and mortality worldwide, especially in elderly patients. The aim of the study was to analyse the epidemiological, clinical and prognostic features of influenza in octogenarians and nonagenarians admitted to a general hospital, as well as risk factors associated with mortality. METHODS: Retrospective, cross-sectional, descriptive study in patients admitted and diagnosed with influenza by molecular biology in the General University Hospital of Alicante from 1 January to 31 April 2015...
October 7, 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Manijeh Nourian, Farahnaz Mohammadi Shahboulaghi, Kian Nourozi Tabrizi, Maryam Rassouli, Akbar Biglarrian
BACKGROUND: Resilience is a quality that affects an individual's ability to cope with tension. The present study was conducted to determine resilience and its contributing factors in high-risk adolescents living in residential care facilities affiliated to Tehran Welfare Organization in order to help develop effective preventive measures for them. METHODS: The present descriptive study was conducted on 223 adolescents living in 15 different governmental residential care centers in 2014...
October 2016: International Journal of Community Based Nursing and Midwifery
Sarah Mello, Kieran A O'Connor
In recent years, 1,200 long-term care facility (LTCF) beds have been closed in Ireland, resulting in residents being transferred between facilities. The current study examined morbidity and mortality in residents relocated between LTCFs. The outcomes were studied for residents who transferred between LTCFs compared to residents who did not move (i.e., controls). A retrospective analysis was performed recording demographic data and markers of function and frailty. As a measure of morbidity, new antidepressant medication prescriptions and antibiotic drug use were examined...
October 5, 2016: Journal of Gerontological Nursing
Elena Mariani, Yvonne Engels, Raymond Koopmans, Rabih Chattat, Myrra Vernooij-Dassen
AIM: To determine whether the number of residents' preferences and needs together with the actions taken to satisfy them recorded into their 'life-and-care plans' will increase and the process of shared decision-making will improve the residents' psychosocial well-being. BACKGROUND: Shared decision-making is defined as a process where healthcare professionals and patients make decisions together, using the best available evidence. The aims of the present study were to assess the feasibility and acceptability of an SDM framework for care planning in long-term care facilities and its potential effectiveness on the proportion of dementia residents whose own preferences and needs and the related actions, are known, satisfied and documented in their 'life-and-care plans'...
July 2016: Nurs Open
Jullet A Davis
Purpose Globally, in 1980, approximately 5.8 per cent of the world population was 65 years old and older. By 2050, this number will more than triple to 16 per cent. From a leadership perspective, there is at least one challenge (among many others challenges) to consider. This paper (viewpoint) aims to provide support for the growing need for academically prepared managers. Design/methodology/approach This paper is a viewpoint which presents several characteristics of the long-term care (LTC) field that support the need for academically trained leaders...
October 3, 2016: Leadership in Health Services
Dimitri M Drekonja, Michael A Kuskowski, Ruth Anway, Brian D Johnston, James R Johnson
Background.  Antimicrobial resistance among Escherichia coli is increasing, driven largely by the global emergence of sequence type 131 (ST131). However, the clinical significance of ST131 status is unknown. Among veterans, we assessed whether ST131 causes more severe, persistent, or recurrence-prone infections than non-ST131 E. coli. Methods.  Isolates were assessed by polymerase chain reaction for membership in ST131 and relevant subclones thereof (H30R and H30Rx) and by broth microdilution for susceptibility to 11 antibiotics...
September 2016: Open Forum Infectious Diseases
Lenche Neloska, Katerina Damevska, Andjelka Nikolchev, Lidija Pavleska, Biljana Petreska-Zovic, Milenko Kostov
BACKGROUND: Malnutrition is common in elderly and is a risk factor for pressure ulcers. AIM: The aim of the present study was to determine the prevalence of malnutrition in geriatric and palliative patients hospitalised in long-term care facility, and to examine the influence of nutritional status on the prevalence of pressure ulcers (PU). MATERIAL AND METHODS: Descriptive, observational and cross-sectional study including 2099 patients admitted to the Hospital during a 24 month period (January 2013 to December 2014)...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
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