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https://www.readbyqxmd.com/read/28086869/evaluation-of-an-aged-care-nurse-practitioner-service-quality-of-care-within-a-residential-aged-care-facility-hospital-avoidance-service
#1
Trudy Dwyer, Alison Craswell, Dolene Rossi, Darren Holzberger
BACKGROUND: Reducing avoidable hospitialisation of aged care facility (ACF) residents can improve the resident experience and their health outcomes. Consequently many variations of hospital avoidance (HA) programs continue to evolve. Nurse practitioners (NP) with expertise in aged care have the potential to make a unique contribution to hospital avoidance programs. However, little attention has been dedicated to service evaluation of this model and the quality of care provided. The purpose of this study was to evaluate the quality of an aged care NP model of care situated within a HA service in a regional area of Australia...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28077203/clostridium-difficile-infection-in-older-adults-systematic-review-of-efforts-to-reduce-occurrence-and-improve-outcomes
#2
Leisa L Marshall, Samuel Peasah, Gregg A Stevens
OBJECTIVE: Provide a systematic review of the primary literature on efforts to reduce Clostridium difficile infection (CDI) occurrence and improve outcomes in older adults. DATA SOURCES, STUDY SELECTION, DATA EXTRACTION: PubMed and CINAHL databases were searched for research studies using search terms CDI, CDI prevention, reduction, control, management, geriatric, elderly, adults 65 years of age and older. The MeSH categories Aged and Aged, 80 and older, were used...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28073998/recent-health-care-use-and-medicaid-entry-of-medicare-beneficiaries
#3
Laura M Keohane, Amal N Trivedi, Vincent Mor
PURPOSE OF THE STUDY: To examine the relationship between Medicaid entry and recent health care use among Medicare beneficiaries. DESIGN AND METHODS: We identified Medicare beneficiaries without full Medicaid or use of hospital or nursing home services in 2008 (N = 2,163,387). A discrete survival analysis estimated beneficiaries' monthly likelihood of entry into the full Medicaid program between January 2009 and June 2010. RESULTS: During the 18-month study period, Medicaid entry occurred for 1...
January 9, 2017: Gerontologist
https://www.readbyqxmd.com/read/28069851/less-intense-postacute-care-better-outcomes-for-enrollees-in-medicare-advantage-than-those-in-fee-for-service
#4
Peter J Huckfeldt, José J Escarce, Brendan Rabideau, Pinar Karaca-Mandic, Neeraj Sood
Traditional fee-for-service (FFS) Medicare's prospective payment systems for postacute care provide little incentive to coordinate care or control costs. In contrast, Medicare Advantage plans pay for postacute care out of monthly capitated payments and thus have stronger incentives to use it efficiently. We compared the use of postacute care in skilled nursing and inpatient rehabilitation facilities by enrollees in Medicare Advantage and FFS Medicare after hospital discharge for three high-volume conditions: lower extremity joint replacement, stroke, and heart failure...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069850/spending-on-care-after-surgery-driven-by-choice-of-care-settings-instead-of-intensity-of-services
#5
Lena M Chen, Edward C Norton, Mousumi Banerjee, Scott E Regenbogen, Anne H Cain-Nielsen, John D Birkmeyer
The rising popularity of episode-based payment models for surgery underscores the need to better understand the drivers of variability in spending on postacute care. Examining postacute care spending for fee-for-service Medicare beneficiaries after three common surgical procedures in the period 2009-12, we found that it varied widely between hospitals in the lowest versus highest spending quintiles for postacute care, with differences of 129 percent for total hip replacement, 103 percent for coronary artery bypass grafting (CABG), and 82 percent for colectomy...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28069848/aco-affiliated-hospitals-reduced-rehospitalizations-from-skilled-nursing-facilities-faster-than-other-hospitals
#6
Ulrika Winblad, Vincent Mor, John P McHugh, Momotazur Rahman
Medicare's more than 420 accountable care organizations (ACOs) provide care for a considerable percentage of the elderly in the United States. One goal of ACOs is to improve care coordination and thereby decrease rates of rehospitalization. We examined whether ACO-affiliated hospitals were more effective than other hospitals in reducing rehospitalizations from skilled nursing facilities. We found a general reduction in rehospitalizations from 2007 to 2013, which suggests that all hospitals made efforts to reduce rehospitalizations...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28063274/morbidity-and-functional-outcomes-with-head-and-neck-free-flap-reconstruction-in-patients-aged-90%C3%A2-years-or-older
#7
Adam P Fagin, Savannah Gelesko, Mark K Wax, Daniel Petrisor
PURPOSE: Morbidity of free tissue transfer in the extremes of age is controversial and not well studied in patients aged 90 years or older because of the rarity of these patients and many clinicians' natural hesitancy to perform such a large operation in patients of this group. The purpose of this study was to answer the following clinical question: Do patients aged 90 years or older who undergo free flap reconstruction have worse functional outcomes than their younger counterparts? MATERIALS AND METHODS: We performed a retrospective chart review of patients aged 90 years or older who underwent free flap reconstruction at Oregon Health and Science University Hospital from 2000 to 2015...
December 18, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28061783/improving-the-knowledge-of-labour-and-delivery-nurses-in-india-a-randomized-controlled-trial-of-mentoring-and-case-sheets-in-primary-care-centres
#8
Janet Bradley, Krishnamurthy Jayanna, Souradet Shaw, Troy Cunningham, Elizabeth Fischer, Prem Mony, B M Ramesh, Stephen Moses, Lisa Avery, Maryanne Crockett, James F Blanchard
BACKGROUND: Birthing in health facilities in India has increased over the last few years, yet maternal and neonatal mortality rates remain high. Clinical mentoring with case sheets or checklists for nurses is viewed as essential for on-going knowledge transfer, particularly where basic training is inadequate. This paper summarizes a study of the effect of such a programme on staff knowledge and skills in a randomized trial of 295 nurses working in 108 Primary Health Centres (PHCs) in Karnataka, India...
January 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28055062/cost-of-joint-replacement-using-bundled-payment-models
#9
Amol S Navathe, Andrea B Troxel, Joshua M Liao, Nan Nan, Jingsan Zhu, Wenjun Zhong, Ezekiel J Emanuel
Importance: Medicare launched the mandatory Comprehensive Care for Joint Replacement bundled payment model in 67 urban areas for approximately 800 hospitals following its experience in the voluntary Acute Care Episodes (ACE) and Bundled Payments for Care Improvement (BPCI) demonstration projects. Little information from ACE and BPCI exists to guide hospitals in redesigning care for mandatory joint replacement bundles. Objective: To analyze changes in quality, internal hospital costs, and postacute care (PAC) spending for lower extremity joint replacement bundled payment episodes encompassing hospitalization and 30 days of PAC...
January 3, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28049889/importance-of-pharmaceutical-training-and-clinical-research-at-medical-facilities
#10
Michiaki Myotoku
 To respond to advancements in medical techniques, and to address the separation of medical and dispensary practices, clinical professors are required to educate human resource staff to become highly-skilled pharmacists. For this purpose, it is extremely important for these professors to learn about cutting-edge practical skills and knowledge, as well as to advance their expertise. In addition, they need to conduct clinical research in cooperation with relevant facilities. As our university does not have its own hospital or pharmacy, it is important to provide training for clinical professors in clinical facilities...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/28046080/the-annual-burden-of-seasonal-influenza-in-the-us-veterans-affairs-population
#11
Yinong Young-Xu, Robertus van Aalst, Ellyn Russo, Jason K H Lee, Ayman Chit
Seasonal influenza epidemics have a substantial public health and economic burden in the United States (US). On average, over 200,000 people are hospitalized and an estimated 23,000 people die from respiratory and circulatory complications associated with seasonal influenza virus infections each year. Annual direct medical costs and indirect productivity costs across the US have been found to average respectively at $10.4 billion and $16.3 billion. The objective of this study was to estimate the economic impact of severe influenza-induced illness on the US Veterans Affairs population...
2017: PloS One
https://www.readbyqxmd.com/read/28042369/oral-baclofen-withdrawal-resulting-in-progressive-weakness-and-sedation-requiring-intensive-care-admission
#12
Bret D Alvis, Christopher M Sobey
Baclofen is a common medication used as a muscle relaxant and antispasmodic. Baclofen-withdrawal syndrome has many symptoms such as sedation, somnolence, and weakness but can include psychological symptoms. We present a 62-year-old female whose oral baclofen was not continued at a skilled nursing facility after discharge following inpatient surgery that led to the development of altered mental status and respiratory insufficiency necessitating intensive care unit admission. Abrupt cessation of baclofen, no matter the mode of administration to the patient, can lead to baclofen-withdrawal syndrome...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28034845/thirty-day-readmissions-after-transcatheter-aortic-valve-replacement-in-the-united-states-insights-from-the-nationwide-readmissions-database
#13
Dhaval Kolte, Sahil Khera, M Rizwan Sardar, Neil Gheewala, Tanush Gupta, Saurav Chatterjee, Andrew Goldsweig, Wilbert S Aronow, Gregg C Fonarow, Deepak L Bhatt, Adam B Greenbaum, Paul C Gordon, Barry Sharaf, J Dawn Abbott
BACKGROUND: Readmissions after cardiac procedures are common and contribute to increased healthcare utilization and costs. Data on 30-day readmissions after transcatheter aortic valve replacement (TAVR) are limited. METHODS AND RESULTS: Patients undergoing TAVR (International Classification of Diseases-Ninth Revision-CM codes 35.05 and 35.06) between January and November 2013 who survived the index hospitalization were identified in the Nationwide Readmissions Database...
January 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28032896/extension-for-community-healthcare-outcomes-care-transitions-enhancing-geriatric-care-transitions-through-a-multidisciplinary-videoconference
#14
Grace Farris, Mousumi Sircar, Jonathan Bortinger, Amber Moore, J Elyse Krupp, John Marshall, Alan Abrams, Lewis Lipsitz, Melissa Mattison
OBJECTIVES: To examine whether a novel videoconference that connects an interdisciplinary hospital-based team with clinicians at postacute care sites improves interprofessional communication and reduces medication errors. DESIGN: Prospective cohort. SETTING: One tertiary care medical center and eight postacute care sites. PARTICIPANTS: Hospital-based providers (hospitalists, geriatricians, pharmacists, social workers, medical trainees, and subspecialists) and postacute care clinicians...
December 29, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28024441/the-effects-of-telehealth-use-for-post-acute-rehabilitation-patient-outcomes
#15
Stephanie A Hicks, Verena R Cimarolli
Introduction Previous research has shown that home telehealth services can reduce hospitalisations and emergency department visits and improve clinical outcomes among older adults with chronic conditions. However, there is a lack of research on the impact of telehealth (TH) use on patient outcomes in post-acute rehabilitation settings. The current study examined the effects of TH for post-acute rehabilitation patient outcomes (i.e. discharge setting and change in functional independence) when controlling for other factors (e...
January 1, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28017895/mobbing-among-care-workers-in-nursing-homes-a-cross-sectional-secondary-analysis-of-the-swiss-nursing-homes-human-resources-project
#16
Myriam Tong, René Schwendimann, Franziska Zúñiga
BACKGROUND: As a category of bullying, mobbing is a form of violence in the workplace that damages the employing organization as well as the targeted employee. In Europe, the overall prevalence of mobbing in healthcare is estimated at 4%. However, few studies have explored mobbing among long-term care workers. OBJECTIVES: This study aims to examine the frequency of mobbing in Swiss nursing homes and its relationships with care workers' (i.e. registered nurse, licensed practical nurse, assistant nurse, nurse aide) health status, job satisfaction, and intention to leave, and to explore the work environment as a contributing factor to mobbing...
December 15, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28005689/epidemiology-and-outcomes-of-hospitalized-children-with-necrotizing-soft-tissue-infections
#17
Balagangadhar R Totapally
OBJECTIVE: The purpose of this study was to evaluate the epidemiology and outcome of hospitalized children with a diagnosis of necrotizing soft tissue infections (NSTIs). METHODS: Demographic and outcome data of children 1 month to 18 years of age with a diagnosis of NSTI (ICD-9 diagnosis codes 728.86 and 729.4) were extracted from the Kids' Inpatient Database 2009 and 2012. Univariate and multivariate analyses were done to determine the factors affecting the mortality...
December 21, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28003285/nairobi-newborn-study-a-protocol-for-an-observational-study-to-estimate-the-gaps-in-provision-and-quality-of-inpatient-newborn-care-in-nairobi-city-county-kenya
#18
Georgina A V Murphy, David Gathara, Jalemba Aluvaala, Jacintah Mwachiro, Nancy Abuya, Paul Ouma, Robert W Snow, Mike English
INTRODUCTION: Progress has been made in Kenya towards reducing child mortality as part of efforts aligned with the fourth Millennium Development Goal. However, little advancement has been made in reducing mortality among newborns, which now accounts for 45% of all child deaths. The frequently unanticipated nature of neonatal illness, its severity and the high dependency of sick newborns on skilled care make the provision of inpatient hospital services one key component of strategies to improve newborn survival...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27997281/use-of-compounded-dextromethorphan-quinidine-suspension-for-pseudobulbar-affect-in-hospice-patients
#19
Robert G Wahler, Alfred T Reiman, Joshua V Schrader
BACKGROUND: Pseudobulbar affect (PBA) consists of unprovoked and uncontrollable episodes of laughing and/or crying. In end-of-life situations, PBA symptoms can be especially distressing to family and friends during an already heightened emotional time. Although a commercial product combining dextromethorphan and quinidine (DMQ) is FDA approved for use in PBA, many hospice patients are unable to swallow any solids or semisolids. An alternative formulation for these patients is needed. OBJECTIVE: We present here two cases in which we used a compounded DMQ suspension successfully to treat PBA symptoms in the weeks before the patients' death...
December 20, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27996105/a-cluster-of-group-a-streptococcal-infections-in-a-skilled-nursing-facility-the-potential-role-of-healthcare-worker-presenteeism
#20
Miwako Kobayashi, Meghan M Lyman, Louise K Francois Watkins, Karrie-Ann Toews, Leon Bullard, Rachel A Radcliffe, Bernard Beall, Gayle Langley, Chris Van Beneden, Nimalie D Stone
OBJECTIVES: To determine the extent of a group A streptococcus (GAS) cluster (2 residents with invasive GAS (invasive case-patients), 2 carriers) caused by a single strain (T antigen type 2 and M protein gene subtype 2.0 (T2, emm 2.0)), evaluate factors contributing to transmission, and provide recommendations for disease control. DESIGN: Cross-sectional analysis and retrospective review. SETTING: Skilled nursing facility (SNF). PARTICIPANTS: SNF residents and staff...
December 2016: Journal of the American Geriatrics Society
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