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https://www.readbyqxmd.com/read/28650872/barriers-and-facilitators-to-implementing-a-change-initiative-in-long-term-care-using-the-interact%C3%A2-quality-improvement-program
#1
Ruth M Tappen, David G Wolf, Zahra Rahemi, Gabriella Engstrom, Carolina Rojido, Jill M Shutes, Joseph G Ouslander
Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period...
June 23, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28644682/management-of-severe-bupropion-poisoning-with-intravenous-lipid-emulsion
#2
Neeraj Chhabra, Carol DesLauriers, Michael Wahl, Sean M Bryant
BACKGROUND: Bupropion toxicity is characterized by central nervous system and cardiovascular toxicity. Intravenous lipid emulsion (ILE) has been suggested as a treatment by some for the treatment of refractory bupropion toxicity. This recommendation is based largely on published case reports and cases presented at scientific meetings. The objective of this study is to characterize the outcomes of patients with suspected bupropion toxicity in which ILE was administered and the indications for its use...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28641378/staff-perceptions-of-key-factors-guiding-nursing-home-search-and-selection-within-the-veterans-health-administration
#3
Edward Alan Miller, Stefanie Gidmark, Emily Gadbois, James L Rudolph, Orna Intrator
Background and Objectives: Veterans enter nursing homes (NHs) for short-term postacute, rehabilitation, respite, or end-of-life care. They also enter NHs on a long-term basis due to frailty, disability, functional deficits, and cognitive impairment. Little is known about how a particular NH is chosen once the decision to enter a NH has been made. This study identified VA staff perceptions of the key factors influencing the search and selection of NHs within the Veterans Health Administration (VHA)...
June 21, 2017: Gerontologist
https://www.readbyqxmd.com/read/28635539/an-old-challenge-with-new-promises-a-systematic-review-on-comprehensive-geriatric-assessment-in-long-term-care-facilities
#4
Francesco Panza, Vincenzo Solfrizzi, Madia Lozupone, Maria Rosaria Barulli, Francesca D'Urso, Roberta Stallone, Vittorio Dibello, Alessia Noia, Cristina Di Dio, Antonio Daniele, Antonello Bellomo, Davide Seripa, Antonio Greco, Giancarlo Logroscino
Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic process focused on determining the clinical profile, pathological risk, residual skills, short- and long-term prognosis, and the personalized therapeutic and care plan of the functionally compromised and frail older subjects. Previous evidence suggested that the effectiveness of CGA programs may be influenced by the settings where the CGA is performed [i.e., hospital, post-hospital discharge/ long-term care facilities (LTCF), or community/home] as well as the specific clinical conditions of older frail individuals...
June 21, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28633954/resident-challenges-with-daily-life-in-chinese-long-term-care-facilities-a-qualitative-pilot-study
#5
Yuting Song, Kezia Scales, Ruth A Anderson, Bei Wu, Kirsten N Corazzini
As traditional family-based care in China declines, the demand for residential care increases. Knowledge of residents' experiences with long-term care (LTC) facilities is essential to improving quality of care. This pilot study aimed to describe residents' experiences in LTC facilities, particularly as it related to physical function. Semi-structured open-ended interviews were conducted in two facilities with residents stratified by three functional levels (n = 5). Directed content analysis was guided by the Adaptive Leadership Framework...
June 17, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28632666/change-in-calcaneal-bone-strength-in-long-term-care-residents-treated-with-low-intensity-pulsed-ultrasound
#6
Hiroyasu Okuizumi, Kiyoshi Koyano, Kazuya Kurosawa, Naoto Kamide, Ayako Soyano
OBJECTIVE: We examined the effect of low-intensity pulsed ultrasound (LIPUS) on bone strength in osteoporotic elderly residents. MATERIALS AND METHODS: This was a randomized controlled trial. Elderly residents with osteoporosis in a long-term care facility were treated with LIPUS (oscillation frequency 100 KHz) that involved treatment of the heel bone for 2 minutes a day. The selection of the treated heel was decided randomly with a personal computer. The heel bone mineral density before and after treatment was measured by calcaneal quantitative ultrasound (GE-1000 Express)...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632071/impact-of-serious-mental-illness-online-training-for-certified-nursing-assistants-in-long-term-care
#7
Victor Molinari, John V Hobday, Rosalyn Roker, Mark E Kunik, Rosalie Kane, Merrie J Kaas, Chandra Mehrotra, Christine L Williams, Joyce C Robbins, Debra Dobbs
Certified nurse assistants (CNAs) spend the most staff time with nursing home residents, yet they receive little training in addressing the mental health needs of residents with serious mental illness (SMI). Forty CNAs from four long-term-care facilities took the online interactive CARES-(®) Serious Mental Illness(™) training consisting of two modules guided by the Recovery Movement philosophy of care. Responses from pre-post testing, Likert-type items, and open-ended questions indicated that CNAs gained information, changed their perspectives, and had more confidence in dealing with SMI...
September 22, 2016: Gerontology & Geriatrics Education
https://www.readbyqxmd.com/read/28632004/behavioral-interventions-to-reduce-infections-in-pediatric-long-term-care-facilities-the-keep-it-clean-for-kids-trial
#8
Elaine L Larson, Meghan T Murray, Bevin Cohen, Edwin Simpser, Marianne Pavia, Olivia Jackson, Haomiao Jia, R Gordon Hutcheon, Linda Mosiello, Natalie Neu, Lisa Saiman
Children in pediatric long-term care facilities (pLTCF) represent a highly vulnerable population and infectious outbreaks occur frequently, resulting in significant morbidity, mortality, and resource use. The purpose of this quasi-experimental trial using time series analysis was to assess the impact of a 4-year theoretically based behavioral intervention on infection prevention practices and clinical outcomes in three pLTCF (288 beds) in New York metropolitan area including 720 residents, ages 1 day to 26 years with mean lengths of stay: 7...
March 3, 2017: Behavioral Medicine
https://www.readbyqxmd.com/read/28629876/effect-of-antibiotic-stewardship-on-the-incidence-of-infection-and-colonisation-with-antibiotic-resistant-bacteria-and-clostridium-difficile-infection-a-systematic-review-and-meta-analysis
#9
David Baur, Beryl Primrose Gladstone, Francesco Burkert, Elena Carrara, Federico Foschi, Stefanie Döbele, Evelina Tacconelli
BACKGROUND: Antibiotic stewardship programmes have been shown to reduce antibiotic use and hospital costs. We aimed to evaluate evidence of the effect of antibiotic stewardship on the incidence of infections and colonisation with antibiotic-resistant bacteria. METHODS: For this systematic review and meta-analysis, we searched PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and Web of Science for studies published from Jan 1, 1960, to May 31, 2016, that analysed the effect of antibiotic stewardship programmes on the incidence of infection and colonisation with antibiotic-resistant bacteria and Clostridium difficile infections in hospital inpatients...
June 16, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28629468/improving-detection-and-initial-management-of-gestational-diabetes-through-the-primary-level-of-care-in-morocco-protocol-for-a-cluster-randomized-controlled-trial
#10
Bettina Utz, Bouchra Assarag, Amina Essolbi, Amina Barkat, Nawal El Ansari, Bouchra Fakhir, Alexandre Delamou, Vincent De Brouwere
BACKGROUND: Morocco is facing a growing prevalence of diabetes and according to latest figures of the World Health Organization, already 12.4% of the population are affected. A similar prevalence has been reported for gestational diabetes (GDM) and although it is not yet high on the national agenda, immediate and long-term complications threaten the health of mothers and future generations. A situational analysis on GDM conducted in 2015 revealed difficulties in access to screening and delays in receiving appropriate care...
June 19, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28628533/the-association-between-activity-limitation-stages-and-admission-to-facilities-providing-long-term-care-among-older-medicare-beneficiaries
#11
Jibby E Kurichi, Joel E Streim, Dawei Xie, Sean Hennessy, Ling Na, Debra Saliba, Qiang Pan, Pui L Kwong, Hillary R Bogner
OBJECTIVE: This study aimed to examine whether activity limitation stages are associated with admission to facilities providing long-term care (LTC). DESIGN: Cohort study using Medicare Current Beneficiary Survey data from the 2005-2009 entry panels. A total of 14,580 community-dwelling Medicare beneficiaries 65 years or older were included. Proportional subhazard models examined associations between activity limitation stages and time to first LTC admission, adjusting for baseline sociodemographics and health conditions...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28627860/the-world-health-organization-disability-assessment-schedule-2-0-can-predict-the-institutionalization-of-the-patients-with-stroke
#12
Hsiang-Yueh Hu, Wen-Chou Chi, Kwang-Hwa Chang, Chia-Feng Yen, Reuben Escorpizo, Hua-Fang Liao, Shih-Wei Huang, Tsan-Hon Liou
BACKGROUND: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a well-known questionnaire used to evaluate disability. We can not only evaluate disability but also obtain additional information by using the standardized WHODAS 2.0 scores. AIM: To predict the institutionalization of the patients with stroke by using the standardized WHODAS 2.0 scores. DESIGN: Observational study. SETTING: The data of 10,255 patients with stroke were acquired from the Data Bank of Persons with Disabilities (TDPD) in Taiwan...
June 19, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28617165/transplant-professionals-perceptions-of-long-term-care-residents-candidacy-for-kidney-transplantation
#13
Megan Urbanski, Teri Browne, Mythili Ghanta, Serban Constantinescu, Avrum Gillespie, Heather Hammer, Heather Traino
CONTEXT: Given the aging end-stage renal disease (ESRD) population, kidney transplant (KTx) centers may experience an increase in referrals of patients living in long-term care (LTC) settings (eg, skilled nursing facilities, assisted living facilities, group homes, and boarding homes). OBJECTIVE: To identify best practices among KTx professionals when considering individuals in LTC settings for transplantation. DESIGN AND SETTING: A cross-sectional survey administered online to US transplant professionals via e-mail LISTSERVs and other professional networks...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28616815/-prevention-of-nosocomial-infections-and-antibiotic-resistance-in-nursing-homes
#14
REVIEW
Markus Bleckwenn, Judith Hammerschmidt, Claudia Rösing, Manuela Klaschik
BACKGROUND: Nosocomial infections and multidrug-resistant organisms are an increasing problem in nursing homes worldwide; therefore, new approaches for infection control need to be developed. OBJECTIVES: This article gives an overview of infections in nursing homes, their medical treatment and previous measures for infection prevention. MATERIALS AND METHODS: The article is based on a selective literature search including the literature database PubMed...
June 14, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28615088/healthcare-antibiotic-resistance-prevalence-dc-harp-dc-a-regional-prevalence-assessment-of-carbapenem-resistant-enterobacteriaceae-cre-in-healthcare-facilities-in-washington-district-of-columbia
#15
Jacqueline Reuben, Nancy Donegan, Glenn Wortmann, Roberta DeBiasi, Xiaoyan Song, Princy Kumar, Mary McFadden, Sylvia Clagon, Janet Mirdamadi, Diane White, Jo Ellen Harris, Angella Browne, Jane Hooker, Michael Yochelson, Milena Walker, Gary Little, Gail Jernigan, Kathleen Hansen, Brenda Dockery, Brendan Sinatro, Morris Blaylock, Kimary Harmon, Preetha Iyengar, Trevor Wagner, Jo Anne Nelson
OBJECTIVE Carbapenem-resistant Enterobacteriaceae (CRE) are a significant clinical and public health concern. Understanding the distribution of CRE colonization and developing a coordinated approach are key components of control efforts. The prevalence of CRE in the District of Columbia is unknown. We sought to determine the CRE colonization prevalence within healthcare facilities (HCFs) in the District of Columbia using a collaborative, regional approach. DESIGN Point-prevalence study. SETTING This study included 16 HCFs in the District of Columbia: all 8 acute-care hospitals (ACHs), 5 of 19 skilled nursing facilities, 2 (both) long-term acute-care facilities, and 1 (the sole) inpatient rehabilitation facility...
June 15, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28610932/automatic-environmental-disinfection-with-hydrogen-peroxide-and-ion-silver-versus-manual-environmental-disinfection-with-sodium-hypochlorite-a-multicenter-randomized-before-and-after-trial
#16
D Mosci, G W Marmo, L Sciolino, C Zaccaro, R Antonellini, L Accogli, T Lazzarotto, M Mongardi, M P Landini
AIMS: 1. Compare the effectiveness of an automated disinfection system with hydrogen peroxide <8% and silver ion versus a manual method with 0.5% sodium hypochlorite solution to evaluate the reduction of microbial mesophilic contamination and Clostridium difficile (CD) presence; 2. Evaluate the organizational impact of these two technologies in terms of time required for the process. METHODS: A randomized multicenter trial performed in four public and private health facilities in the Emilia-Romagna Region, in different wards including medicine, orthopaedics, long-term care, recovery and functional rehabilitation, which were previously occupied by patients with Clostridium difficile Infection (CDI)...
June 10, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28610686/levels-of-physical-activity-and-sleep-patterns-among-older-people-with-dementia-living-in-long-term-care-facilities-a-24-h-snapshot
#17
Wendy Moyle, Cindy Jones, Jenny Murfield, Brian Draper, Elizabeth Beattie, David Shum, Lukman Thalib, Siobhan O'Dwyer, Cindy M Mervin
OBJECTIVES: To objectively measure over a 24-h period the daytime and nighttime levels of physical activity and sleep patterns of older people with dementia living in long-term care facilities. STUDY DESIGN: Nested within a larger research program, this cross-sectional study involved 415 residents, aged ≥60 years, with a documented diagnosis of dementia, from 28 long-term care facilities in south-east Queensland, Australia. MAIN OUTCOME MEASURES: Residents wore SenseWear(®) activity armbands continuously for 24h, with data recorded for: step count; total energy expenditure; metabolic equivalent of task (MET); and the amount of time spent physically active, lying down, awake, and asleep...
August 2017: Maturitas
https://www.readbyqxmd.com/read/28610649/enhancing-resiliency-for-elderly-populations-shelter-in-place-planning-and-training-at-facilities-serving-elderly-populations-through-the-rhode-island-senior-resiliency-project
#18
Richard Smith, Michael Mozzer, Joseph Albanese, James Paturas, Julia Gold
Elderly populations are disproportionately affected by disasters. In part, this is true because for many older adults, special assistance is needed to mitigate the consequences of disasters on their health and wellbeing. In addition, many older adults may reside in diverse living complexes such as long-term care facilities, assisted living facilities and independent-living senior housing complexes. Planning for each type of facility is different and the unique features of these facilities must be considered to develop readiness to deal with disasters...
June 1, 2017: Journal of Business Continuity & Emergency Planning
https://www.readbyqxmd.com/read/28610564/using-genotyping-to-delineate-tuberculosis-transmission-in-long-term-care-facilities-single-facility-4-year-experience
#19
Wen-Cheng Chao, Pei-Chun Chuang, Don-Han Wu, Chieh-Liang Wu, Po-Yu Liu, Chi-Chang Shieh, Ruwen Jou
BACKGROUND: Residents in long-term care facilities (LTCFs) are vulnerable to tuberculosis (TB) transmission; however, to delineate possible routes of TB transmission in LTCFs is difficult. This study aimed to address the use of regular genotyping surveillance to delineate TB transmission in LTCFs. METHODS: All of Mycobacterium tuberculosis isolates in the reported 620-bed LTCF between July 2011 and August 2015 were genotyped, and we retrospectively compared epidemiological data and genotyping results...
June 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28602461/adapting-systems-of-care-for-people-aging-with-hiv
#20
Eugenia L Siegler, Mark Brennan-Ing
People aging with HIV have medical and psychosocial needs that require more than the HIV services network can provide. HIV providers may lack experience managing multimorbidity or the functional consequences of aging. Social support services may be unable to provide necessary services for people living with HIV (PLWH) who are becoming increasingly frail or facing cognitive impairment. HIV providers will be caring for aging PLWH whose HIV management may seem simple compared with the significant burdens of stigma, mental health needs, social isolation, multimorbidity, and aging-related syndromes...
May 26, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
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