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https://www.readbyqxmd.com/read/30103692/implementing-advance-care-planning-in-nursing-homes-study-protocol-of-a-cluster-randomized-clinical-trial
#1
Trygve Johannes Lereim Sævareid, Lillian Lillemoen, Lisbeth Thoresen, Reidun Førde, Elisabeth Gjerberg, Reidar Pedersen
BACKGROUND: Close to half of all deaths in Norway occur in nursing homes, which signals a need for good communication on end-of-life care. Advance care planning (ACP) is one means to that end, but in Norwegian nursing homes, ACP is not common. This paper describes the protocol of a project evaluating an ACP-intervention in Norwegian nursing homes. The aims of this research project were to promote the possibility for conversations about the end of life with patients and relatives; promote patient autonomy; create a better foundation for important decisions in the case of medical emergencies and at the end of life; and gain experiences in order to find out what characterizes good ACP and good implementation strategies...
August 13, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/30101762/ozonation-of-nursing-home-wastewater-pretreated-in-a-membrane-bioreactor
#2
Danièle Mousel, Johannes Pinnekamp
Nursing home (NH) wastewater was pretreated in an ultrafiltration membrane bioreactor (MBR) and subsequently ozonated in a pilot plant in order to evaluate the elimination of pharmaceutically active compounds (PhACs). Dosing of the pre-treated wastewater with 5 mg ozone (O3 ) L-1 led to the elimination of >50% for nearly all investigated PhACs in the ozonation plant, whereas dosing 10 mg O3 L-1 increased elimination to >80%. A total hydraulic retention time of 12.8 min proved sufficient for PhAC elimination...
August 2018: Water Science and Technology: a Journal of the International Association on Water Pollution Research
https://www.readbyqxmd.com/read/30094828/burden-of-invasive-methicillin-resistant-staphylococcus-aureus-infections-in-nursing-home-residents
#3
Cheri Grigg, Danielle Palms, Nimalie D Stone, Nicole Gualandi, Wendy Bamberg, Ghinwa Dumyati, Lee H Harrison, Ruth Lynfield, Joelle Nadle, Susan Petit, Susan Ray, William Schaffner, John Townes, Isaac See
OBJECTIVES: To describe the epidemiology and incidence of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in nursing home (NH) residents, which has previously not been well characterized. DESIGN: Retrospective analysis of public health surveillance data. SETTING: Healthcare facilities in 33 U.S. counties. PARTICIPANTS: Residents of the surveillance area. MEASUREMENTS: Counts of NH-onset and hospital-onset (HO) invasive MRSA infections (cultured from sterile body sites) identified from the Centers for Disease Control and Prevention Emerging Infections Program (EIP) population-based surveillance from 2009 to 2013 were compared...
August 10, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/30094824/burden-of-depressive-symptoms-over-2-decades-and-risk-of-nursing-home-placement-in-older-women
#4
Amy L Byers, Li-Yung Lui, Eric Vittinghoff, Kenneth E Covinsky, Kristine E Ensrud, Brent Taylor, Kristine Yaffe
OBJECTIVES: To determine the association between cumulative burden of depressive symptoms and risk of nursing home (NH) placement over 2 decades. DESIGN: Prospective cohort study with data linked to Medicare claims files. SETTING: Clinic sites in Baltimore, Maryland; Minneapolis, Minnesota; and the Monongahela Valley near Pittsburgh, Pennsylvania. PARTICIPANTS: Initially community-dwelling women aged 65 and older (N=3,646)...
August 9, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/30094823/long-term-nursing-home-entry-a-prognostic-model-for-older-adults-with-a-family-or-unpaid-caregiver
#5
Jennifer L Wolff, John Mulcahy, David L Roth, Irena S Cenzer, Judith D Kasper, Jin Huang, Kenneth E Covinsky
OBJECTIVES: To comprehensively examine factors associated with long-term nursing home (NH) entry from 6 domains of older adult and family caregiver risk from nationally representative surveys and develop a prognostic model and a simple scoring system for use in risk stratification. DESIGN: Retrospective observational study. SETTING: National Long-Term Care Surveys 1999 and 2004 and National Health and Aging Trends Study 2011 and linked caregiver surveys...
August 9, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/30092581/a-point-prevalence-study-of-delirium-in-italian-nursing-homes
#6
Valeria Morichi, Massimiliano Fedecostante, Alessandro Morandi, Simona Gabriella Di Santo, Andrea Mazzone, Enrico Mossello, Mario Bo, Angelo Bianchetti, Renzo Rozzini, Ermellina Zanetti, Massimo Musicco, Alberto Ferrari, Nicola Ferrara, Marco Trabucchi, Antonio Cherubini, Giuseppe Bellelli
BACKGROUND: Delirium is a common geriatric syndrome. Few studies have been conducted in nursing home (NH) residents. The aim of this project was to perform a point prevalence study of delirium in Italian NHs. METHODS: Data collected in 71 NHs are presented. Inclusion criteria were age ≥65 years and native Italian speaker. Exclusion criteria were coma, aphasia, and end-of-life status. Sociodemographic and medical data were recorded. Delirium was assessed using the Assessment Test for Delirium and Cognitive Impairment (4-AT)...
August 9, 2018: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/30078768/factors-related-to-use-of-potentially-inappropriate-psychotropic-drugs-in-2-343-residents-of-19-nursing-homes
#7
Max Prudent, Renaud Parjoie, Damien Jolly, Moustapha Dramé, Sarah Badr, Jean-Luc Novella, Rachid Mahmoudi
To identify factors that influence use of potentially inappropriate psychotropic drugs among elderly residents living in nursing homes (NH). Cross-sectional, multicentre study among 65+ years NH residents, based on queries performed on the PATHOS database and on prescription information from residents' medical data. Medications were coded using the Anatomical Therapeutical Chemical classification. Psychotropic agents were classed using Delay and Deniker's classification, and the Beers Criteria (Beers list 2015 update) were used to identify potentially inappropriate psychotropic drugs (PIPs)...
August 3, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/30076943/functional-status-in-patients-requiring-nursing-home-stay-after-radical-cystectomy
#8
Katie S Murray, Megan Prunty, Alex Henderson, Tyler Haden, Naveen Pokala, Bin Ge, Mark Wakefield, Gregory F Petroski, David R Mehr, Robin L Kruse
OBJECTIVE: To evaluate the ability to perform activities of daily living (ADLs) in patients who required nursing home (NH) care after radical cystectomy (RC), as this surgery can impair patients' ability to perform ADLs in the post-operative period. METHODS: Patients undergoing RC were identified in a novel database of patients with at least 2 NH assessments linked with Medicare inpatient claims. The NH assessment included the Minimum Data Set (MDS)-ADL Long Form (0-28; higher score equals greater impairment), which quantifies activities of daily living...
August 1, 2018: Urology
https://www.readbyqxmd.com/read/30066481/increasing-prevalence-of-assisted-living-as-a-substitute-for-private-pay-long-term-nursing-care
#9
Benjamin C Silver, David C Grabowski, Pedro L Gozalo, David Dosa, Kali S Thomas
OBJECTIVE: Given the tremendous growth in assisted living (AL) over the past 20 years, it is important to understand how expansion has affected the demand for long-term care (LTC) provided in nursing homes (NHs). We estimated the effect of a change in county-level AL beds on the prevalence of private-pay residents and private-pay resident days at the NH-level. DATA SOURCES: National census of large AL providers (25+ beds), and Minimum Data Set combined with Medicare enrollment records and claims from 2007 and 2014...
July 31, 2018: Health Services Research
https://www.readbyqxmd.com/read/30056015/indwelling-urethral-versus-suprapubic-catheters-in-nursing-home-residents-determining-the-safest-option-for-long-term-use
#10
Kristen E Gibson, Sara Neill, Elizabeth Tuma, Jennifer Meddings, Lona Mody
BACKGROUND: Long-term infectious complications associated with type of indwelling urinary catheter are unknown. AIM: To compare catheter-associated urinary tract infection (CAUTI) rates and multidrug resistant organism (MDRO) colonization between nursing home (NH) residents with indwelling urethral and suprapubic catheters. METHODS: Participants included 418 NH residents with an indwelling device enrolled in a prospective Targeted Infection Prevention (TIP) study between 2010-2013...
July 26, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/30056012/potentially-inappropriate-prescribing-in-belgian-nursing-homes-prevalence-and-associated-factors
#11
Pauline M S Anrys, Goedele C Strauven, Veerle Foulon, Jean-Marie Degryse, Séverine Henrard, Anne Spinewine
BACKGROUND/OBJECTIVES: Our aim was to describe the prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) in Belgian nursing homes and to identify characteristics of residents, general practitioners (GPs), and nursing homes (NHs) that are associated with the number of PIMs and PPOs. DESIGN: A cross-sectional study. SETTING: and Participants: Nursing home residents (NHRs), aged ≥65 years, not in palliative care were included in 54 Belgian NHs participating in the COME-ON study...
July 25, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/30055821/documented-systematic-and-individualized-communication-with-the-attending-physician-for-fall-risk-reduction-injury-mitigation-care-planning
#12
David A Smith
Falls are common in nursing homes (NHs) and may result in serious injury to the resident as well as legal and regulatory liability for the NH. Some of these falls and injuries might be avoided if attending physicians were involved in risk reduction. I developed a communication tool to solicit from attending physicians specific risks for patients most likely to experience a fall and injury, and to consider strategies to reduce those risks. The communication tool addresses medications, osteopenia, vitamin D deficiency, vision, hearing, gait/balance/peripheral sensation, injury mitigation, altered mental status, restraints, and philosophy of treatment...
August 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/30055517/race-and-mental-health-disorders-impact-on-older-patients-nursing-home-admissions-upon-hospital-discharge
#13
Yu Sunny Kang, Nancy A Miller, Huey-Ming Hm Tzeng, Ting Zhang
INTRODUCTION: Despite policy efforts to reduce unwanted nursing home (NH) admissions, NH residents increasingly are being admitted from hospitals, with a significant share diagnosed with mental health disorders. OBJECTIVES: We examined interactive effect of Black race and mental health disorder's impact on older patients' (age 65 and older) NH admission upon hospital discharge. MATERIAL AND METHODS: We analyzed 186,646 older patients using pooled data from the 2007 through 2010 National Hospital Discharge Survey...
September 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/30047810/nursing-home-chain-affiliation-and-its-impact-on-specialty-service-designation-for-alzheimer-disease
#14
Justin Blackburn, Qing Zheng, David C Grabowski, Richard Hirth, Orna Intrator, David G Stevenson, Jane Banaszak-Holl
Specialty care units (SCUs) in nursing homes (NHs) grew in popularity during the 1990s to attract residents while national policies and treatment paradigms changed. Alzheimer disease has consistently been the dominant form of SCU. This study explored the extent to which chain affiliation, which is common among NHs, affected SCU bed designation. Using data from the Online Survey Certification and Reporting (OSCAR) from 1996 through 2010 with 207 431 NH-year observations, we described trends and compared chain-affiliated NHs with independent NHs...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/30038781/antibiotic-resistance-in-swiss-nursing-homes-analysis-of-national-surveillance-data-over-an-11-year-period-between-2007-and-2017
#15
Philipp Kohler, Rosamaria Fulchini, Werner C Albrich, Adrian Egli, Carlo Balmelli, Stephan Harbarth, Delphine Héquet, Christian R Kahlert, Stefan P Kuster, Christiane Petignat, Matthias Schlegel, Andreas Kronenberg
Background: We evaluated data from isolates of nursing home (NH) patients sent to the Swiss centre for antibiotic resistance (ANRESIS). We focussed on carbapenem-resistance (CR) among Gram-negative pathogens, extended-spectrum cephalosporin-resistant (ESC-R) Escherichia coli / Klebsiella pneumoniae , methicillin-resistant Staphylococcus aureus (MRSA), and glycopeptide-resistant enterococci (GRE). Methods: NH patient isolates from 01/2007 to 10/2017 were extracted...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/30037742/bayesian-analyses-showed-more-evidence-for-apathy-than-for-depression-being-associated-with-cognitive-functioning-in-nursing-home-residents
#16
Ruslan Leontjevas, Lily Fredrix, Martin Smalbrugge, Raymond T C M Koopmans, Debby L Gerritsen
OBJECTIVES: Depression, apathy, and cognitive impairments are widespread in nursing home (NH) residents. Scarce research that explicitly compares apathy to depression suggests that the association between apathy and cognitive functioning is stronger than the association between depression and cognitive functioning. This study in Dutch NH residents aimed to use Bayesian methods for comparing the evidence for the relationship of cognitive performance with apathy to that with depression...
July 20, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/30032997/perceptions-of-family-decision-makers-of-nursing-home-residents-with-advanced-dementia-regarding-the-quality-of-communication-around-end-of-life-care
#17
Mark Toles, Mi-Kyung Song, Feng-Chang Lin, Laura C Hanson
OBJECTIVES: (1) Compare family decision-makers' perceptions of quality of communication with nursing home (NH) staff (nurses and social workers) and clinicians (physicians and other advanced practitioners) for persons with advanced dementia; (2) determine the extent to which characteristics of NH residents and family decision-makers are associated with those perceptions. DESIGN: Secondary analysis of baseline data from a cluster randomized trial of the Goals of Care intervention...
July 19, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/30004139/randomised-clinical-trial-efficacy-of-strategies-to-provide-oral-hygiene-activities-to-nursing-home-residents-with-dementia-who-resist-mouth-care
#18
Rita A Jablonski, Ann M Kolanowski, Andres Azuero, Vicki Winstead, Corteza Jones-Townsend, Maria L Geisinger
OBJECTIVES: The purpose of this study was to test the efficacy of MOUTh (Managing Oral Hygiene Using Threat Reduction), a nonpharmacologic, relationship-based intervention vs. control on 2 primary outcomes for nursing home (NH) residents with dementia who resisted mouth care: (i) reduction in the occurrence and intensity of care-resistant behaviours (CRBs) and (ii) improvement in oral health. Two secondary outcomes were also examined: (i) the duration of mouth care and (ii) the completion of oral hygiene activities...
July 13, 2018: Gerodontology
https://www.readbyqxmd.com/read/30001817/prehospital-advanced-cardiac-life-support-by-emt-with-a-smartphone-based-direct-medical-control-for-nursing-home-cardiac-arrest
#19
Changsun Kim, Hyuk Joong Choi, Hyungjun Moon, Giwoon Kim, Choungah Lee, Jin Sung Cho, Seongjung Kim, Kyoungmi Lee, Hanjoo Choi, Wonjung Jeong
OBJECTIVE: To compare the survival to discharge between nursing home (NH) cardiac arrest patients receiving smartphone-based advanced cardiac life support (SALS) and basic life support (BLS). METHODS: The SALS registry includes data on cardiac arrest from 7 urban and suburban areas in Korea between July 2015 and December 2016. We include adult patients (>18) with out-of-hospital cardiac arrest (OHCA) of medical causes and EMS attended and dispatched in. SALS is an advanced field resuscitation including drug administration by paramedics with video communication-based direct medical direction...
July 9, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30001250/a-new-data-resource-to-examine-meals-on-wheels-clients-health-care-utilization-and-costs
#20
Mingyang Shan, Roee Gutman, David Dosa, Pedro L Gozalo, Jessica A Ogarek, Sarah Kler, Kali S Thomas
BACKGROUND: Access to social services (eg, nutrition) can impact older adults' health care utilization and health outcomes. However, data documenting the relationship between receiving services and objective measures of health care utilization remain limited. OBJECTIVES: To link Meals on Wheels (MOW) program data to Medicare claims to enable examination of clients' health and health care utilization and to highlight the utility of this linked dataset. RESEARCH DESIGN: Using probabilistic linking techniques, we matched MOW client data to Medicare enrollment and claims data...
July 11, 2018: Medical Care
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