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https://www.readbyqxmd.com/read/29042263/facility-level-factors-and-outcomes-after-skilled-nursing-facility-admission-for-trauma-and-surgical-patients
#1
Lucas W Thornblade, Saman Arbabi, David R Flum, Qian Qiu, Vanessa J Fawcett, Giana H Davidson
OBJECTIVE: Patients discharged to skilled nursing facilities (SNFs) have worse outcomes than those discharged to home, but whether this is due to differences in facility-level factors in addition to patient characteristics is not known. We aimed to determine whether SNF-level factors including nurse staffing and patient density are associated with outcomes after acute hospitalization for trauma or surgery. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Retrospective study of patients discharged to Medicare-certified SNFs after trauma or major surgery from 2007 to 2009...
October 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29040303/continuing-professional-development-for-medical-nursing-and-midwifery-cadres-in-malawi-tanzania-and-south-africa-a-qualitative-evaluation
#2
Caryl Feldacker, Jillian Pintye, Sheena Jacob, Michael H Chung, Lyn Middleton, Jill Iliffe, H Nina Kim
BACKGROUND: As innovations in the prevention and treatment of HIV and TB advance, continuing professional development (CPD) of health care workers (HCWs) remains a high priority, particularly in sub-Saharan Africa where dual TB/HIV epidemics are compounded by severe HCW shortages. There is further need to examine CPD programs to identify challenges and effective solutions to strengthen HIV/TB-related CPD. METHODS: Qualitative evaluations in Malawi, Tanzania and South Africa (RSA) were conducted using key informant interviews (KIIs) and focus group discussions (FGDs) in each country to identify barriers and enablers of effective HIV/TB-related CPD...
2017: PloS One
https://www.readbyqxmd.com/read/29031542/complications-and-30-day-readmission-rates-after-craniotomy-craniectomy-a-single-institutional-study-of-243-consecutive-patients
#3
Aladine A Elsamadicy, Amanda Sergesketter, Owoicho Adogwa, Michael Ongele, Oren N Gottfried
Early hospital readmission has become a proxy for quality of care and contributes significantly to high health care costs in the United States, with more than $20 billion health care dollars are spent on 30-day readmission annually. Cranial neurosurgical procedures (i.e., craniotomy, craniectomy) are associated with high readmission rates; however, studies examining readmission after cranial procedures are limited and relatively unknown. The aim of this study is to identify the drivers of 30-day unplanned readmission in consecutive patients undergoing craniotomies and craniectomies...
October 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28991827/sepsis-survivors-admitted-to-skilled-nursing-facilities-cognitive-impairment-activities-of-daily-living-dependence-and-survival
#4
William J Ehlenbach, Andrea Gilmore-Bykovskyi, Michael D Repplinger, Ryan P Westergaard, Elizabeth A Jacobs, Amy J H Kind, Maureen Smith
OBJECTIVE: Severe sepsis survivors frequently experience cognitive and physical functional impairment. The degree of impairment and its association with mortality is understudied, particularly among those discharged to a skilled nursing facility. Our objective was to quantify the cognitive and physical impairment among severe sepsis survivors discharged to a skilled nursing facility and to investigate the relationship between impairment and long-term mortality. DESIGN: Retrospective cohort study...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28988350/predictors-of-30-and-90-day-readmission-following-craniotomy-for-malignant-brain-tumors-analysis-of-nationwide-data
#5
Daniel A Donoho, Timothy Wen, Robin M Babadjouni, William Schwartzman, Ian A Buchanan, Steven Y Cen, Gabriel Zada, William J Mack, Frank J Attenello
Hospital readmissions are a major contributor to increased health care costs and are associated with worse patient outcomes after neurosurgery. We used the newly released Nationwide Readmissions Database (NRD) to describe the association between patient, hospital and payer factors with 30- and 90-day readmission following craniotomy for malignant brain tumor. All adult inpatients undergoing craniotomy for primary and secondary malignant brain tumors in the NRD from 2013 to 2014 were included. We identified all cause readmissions within 30- and 90-days following craniotomy for tumor, excluding scheduled chemotherapeutic procedures...
October 7, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28971588/optimising-mobility-through-the-sit-to-stand-activity-for-older-people-living-in-residential-care-facilities-a-qualitative-interview-study-of-healthcare-aide-experiences
#6
Sharon A Kagwa, Anne-Marie Boström, Carla Ickert, Susan E Slaughter
AIMS AND OBJECTIVES: To explore the experience of HCAs encouraging residents living in residential care to complete the sit-to-stand activity and to identify the strategies HCAs used to integrate the activity into their daily work routines. BACKGROUND: Decreased mobility in advanced ageing is further reduced when entering a residential care facility. Interventions such as the sit-to-stand activity have been shown to have a positive effect on the mobility of older people...
October 3, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/28968478/the-direct-anterior-approach-does-not-increase-return-to-function-following-hemiarthroplasty-for-femoral-neck-fracture
#7
Victor R Carlson, Alvin C Ong, Fabio R Orozco, Rex W Lutz, Andres F Duque, Zachary D Post
The purpose of this study was to evaluate functional outcomes for hemiarthroplasty using a direct anterior approach or a direct lateral approach for femoral neck fracture. This retrospective review used data collected from a single institution between 2006 and 2016. Eighty-five and 75 consecutive patients who underwent hemiarthroplasty via a direct anterior approach and a direct lateral approach, respectively, met inclusion criteria. All patients with femoral neck fractures were treated by 1 of 2 fellowship-trained orthopedic surgeons using the direct anterior approach or the direct lateral approach to hemiarthroplasty...
October 2, 2017: Orthopedics
https://www.readbyqxmd.com/read/28968474/increasing-use-of-reverse-total-shoulder-arthroplasty-for-proximal-humerus-fractures-in-elderly-patients
#8
Sean S Rajaee, Dheeraj Yalamanchili, Naudereh Noori, Eytan Debbi, James Mirocha, Carol A Lin, Charles N Moon
This study described surgical treatment patterns for proximal humerus fractures among elderly patients, focusing on reverse total shoulder arthroplasty (TSA), and evaluated how the type of fixation affects inpatient factors (cost, length of stay), transfusion rates, and patient disposition (home vs skilled nursing facility). With Nationwide Inpatient Sample data from 2011 to 2013, the authors identified patients 65 years and older who had proximal humerus fractures and divided them into 3 groups: (1) open reduction and internal fixation (ORIF); (2) hemiarthroplasty; and (3) reverse TSA...
October 2, 2017: Orthopedics
https://www.readbyqxmd.com/read/28967602/impact-of-contextual-factors-on-interventions-to-reduce-acute-care-transfers-ii-implementation-and-hospital-readmission-rates
#9
Kimberly J Rask, Jennifer Hodge, Linda Kluge
OBJECTIVES: Identify contextual and implementation factors impacting the effectiveness of an organizational-level intervention to reduce preventable hospital readmissions from affiliated skilled nursing facilities (SNFs). DESIGN: Observational study of the implementation of Interventions to Reduce Acute Care Transfers tools in 3 different cohorts. SETTING: SNFs. PARTICIPANTS: SNFs belonging to 1 of 2 corporate entities and a group of independent SNFs that volunteered to participate in a Quality Improvement Organization (QIO) training program...
September 26, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28965738/post-acute-care-setting-facility-characteristics-and-post-stroke-outcomes-a-systematic-review
#10
REVIEW
Matthew Alcusky, Christine M Ulbrict, Kate L Lapane
OBJECTIVE: To synthesize research comparing post-stroke health outcomes between patients rehabilitated in skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs). Secondly, to evaluate relationships between facility characteristics and outcomes. DATA SOURCES: PubMed and CINAHL searches spanned January 1, 1998 to October 6, 2016 and encompassed MeSH and free-text keywords for stroke, IRF/SNF, and study outcomes. Human and English limits were used...
September 28, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28958015/advance-care-planning-in-skilled-nursing-facilities-a-multisite-examination-of-professional-judgments
#11
Kristin R Baughman, Ruth Ludwick, David Jarjoura, Denise Kropp, Vimal Shenoy
Background and Objectives: Lack of advance care planning (ACP) may increase hospitalizations and impact the quality of life for skilled nursing facility (SNF) residents, especially African American residents who may be less likely to receive ACP discussions. We examined the professional judgments of SNF providers to see if race of SNF residents and providers, and risk for hospitalization for residents influenced professional judgments as to when ACP was needed and feelings of responsibility for ensuring ACP discussions...
August 22, 2017: Gerontologist
https://www.readbyqxmd.com/read/28953071/applying-machine-learning-to-workers-compensation-data-to-identify-industry-specific-ergonomic-and-safety-prevention-priorities-ohio-2001-to-2011
#12
Alysha R Meyers, Ibraheem S Al-Tarawneh, Steven J Wurzelbacher, P Timothy Bushnell, Michael P Lampl, Jennifer L Bell, Stephen J Bertke, David C Robins, Chih-Yu Tseng, Chia Wei, Jill A Raudabaugh, Teresa M Schnorr
OBJECTIVE: This study leveraged a state workers' compensation claims database and machine learning techniques to target prevention efforts by injury causation and industry. METHODS: Injury causation auto-coding methods were developed to code more than 1.2 million Ohio Bureau of Workers' Compensation claims for this study. Industry groups were ranked for soft-tissue musculoskeletal claims that may have been preventable with biomechanical ergonomic (ERGO) or slip/trip/fall (STF) interventions...
September 25, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28952364/beyond-ada-accessibility-requirements-meeting-seniors-needs-for-toilet-transfers
#13
Su Jin Lee, Jon Sanford, Margaret Calkins, Sarah Melgen, Sarah Endicott, Anjanette Phillips
PURPOSE: To identify the optimal spatial and dimensional requirements of grab bars that support independent and assisted transfers by older adults and their care providers. BACKGROUND: Although research has demonstrated that toilet grab bars based on the Americans with Disabilities Act (ADA) Accessibility Standards do not meet the needs of older adults, the specific dimensional requirements for alternative configurations are unknown. METHODS: A two-phased study with older adults and care providers in residential facilities was conducted to determine the optimal requirements for grab bars...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/28951065/selecting-post-acute-care-settings-after-abdominal-surgery-are-we-getting-it-right
#14
Courtney J Balentine, Glen Leverson, David J Vanness, Sara Knight, Janet Turan, Cynthia J Brown, Herb Chen, Smita Bhatia
BACKGROUND: We investigated whether variation in post-acute care (PAC) services could be explained by surgeons discharging clinically similar patients to different PAC destinations, including home health (HH), skilled nursing facilities (SNF), and inpatient rehabilitation (IR). METHODS: We studied patients having colectomy, pancreatectomy or hepatectomy in the 2008-2011 Nationwide Inpatient Sample. We used propensity matching to determine: 1. Proportion of patients discharged to SNF/IR who could be matched to clinically similar patients discharged with HH...
September 20, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28947467/prevalence-and-associated-factors-of-skin-diseases-in-aged-nursing-home-residents-a-multicentre-prevalence-study
#15
Elisabeth Hahnel, Ulrike Blume-Peytavi, Carina Trojahn, Gabor Dobos, Irina Jahnke, Vera Kanti, Claudia Richter, Andrea Lichterfeld-Kottner, Natalie Garcia Bartels, Jan Kottner
OBJECTIVES: The aim of this study was to measure the prevalence of skin diseases in aged nursing home residents and to explore possible associations with demographic and medical characteristics. DESIGN: Descriptive multicentre prevalence study. SETTING AND PARTICIPANTS: The study was conducted in a random sample of ten institutional long-term care facilities in the federal state of Berlin, Germany. In total, n=223 residents were included. RESULTS: In total, 60 dermatological diseases were diagnosed...
September 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28947117/making-a-measurable-difference-in-advanced-huntington-disease-care
#16
Carol Brown Moskowitz, Ashwini K Rao
Neurologists' role in the care of people with advanced Huntington disease (HD) (total functional capacity <7), often limited by a lack of clinical research to support good practice, includes the following: (1) provide comprehensive health records to an interdisciplinary care staff before admission to a more intense care setting (home health services, day program, assisted living, group home, long-term skilled nursing facility, palliative care); (2) consult with and refer to rehabilitation (occupational therapy, physical therapy, speech and language pathology), behavioral and psychiatric professionals for problem-solving strategies, which must be reviewed with direct care staff before implementation; (3) encourage and support qualitative and quantitative interdisciplinary research studies, and randomized controlled studies of nonpharmacologic interventions; and (4) assist in the development of meaningful measures to further document what works to provide a good quality of life for the patient and family and a comfortable thoughtful approach to a good death...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28945639/associations-among-healthcare-workplace-safety-resident-satisfaction-and-quality-of-care-in-long-term-care-facilities
#17
Ernest Boakye-Dankwa, Erin Teeple, Rebecca Gore, Laura Punnett
OBJECTIVE: We performed an integrated cross-sectional analysis of relationships between long term care work environments, employee and resident satisfaction, and quality of patient care. METHODS: Facility-level data came from a network of 203 skilled nursing facilities in 13 states in the eastern United States owned or managed by one company. K-means cluster analysis was applied to investigate clustered associations between safe resident handling program (SRHP) performance, resident care outcomes, employee satisfaction, rates of workers' compensation claims, and resident satisfaction...
September 22, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28945629/critical-care-resource-utilization-and-outcomes-of-children-with-moderate-traumatic-brain-injury
#18
Theerada Chandee, Vivian H Lyons, Monica S Vavilala, Vijay Krishnamoorthy, Nophanan Chaikittisilpa, Arraya Watanitanon, Abhijit V Lele
OBJECTIVES: To characterize admission patterns, critical care resource utilization, and outcomes in moderate pediatric traumatic brain injury. DESIGN: Retrospective cohort study. SETTING: National Trauma Data Bank. PATIENTS: Children under 18 years old with a diagnosis of moderate traumatic brain injury (admission Glasgow Coma Scale score of 9-13) in the National Trauma Data Bank between 2007 and 2014. MEASUREMENT AND MAIN RESULTS: We examined clinical characteristics, critical care resource utilization, and discharge outcomes...
September 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28942908/integrating-function-directed-treatments-into-palliative-care
#19
REVIEW
Andrea L Cheville, Melissa Morrow, Sean Robinson Smith, Jeffrey R Basford
The growing acceptance of palliative care has created opportunities to increase the use of rehabilitation services among populations with advanced disease, particularly those with cancer. Broader delivery has been impeded by the lack of a shared definition for palliative rehabilitation and a mismatch between patient needs and established rehabilitation service delivery models. We propose the definition that, in the advanced cancer population, palliative rehabilitation is function-directed care delivered in partnership with other clinical disciplines and aligned with the values of patients who have serious and often incurable illnesses in contexts marked by intense and dynamic symptoms, psychological stress, and medical morbidity to realize potentially time-limited goals...
September 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28939460/pharmacotherapy-use-in-older-patients-with-heart-failure-and-reduced-ejection-fraction-after-a-skilled-nursing-facility-stay
#20
Lin Li, Bill M Jesdale, Anne Hume, Giovanni Gambassi, Robert J Goldberg, Kate L Lapane
BACKGROUND: Little is known about guideline-directed pharmacotherapy use in patients with heart failure and reduced ejection fraction (HFrEF) discharged to skilled nursing facilities (SNFs). This study aimed to describe the use of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) and evidence-based β-blocker (EBBB) among older patients with HFrEF within 90 days after the SNF admission and to identify factors associated with receipt of these medications...
September 19, 2017: Journal of Cardiac Failure
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