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Geriatric care management

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https://www.readbyqxmd.com/read/29340588/antimicrobial-resistant-klebsiella-pneumoniae-carriage-and-infection-in-specialized-geriatric-care-wards-linked-to-acquisition-in-the-referring-hospital
#1
Claire L Gorrie, Mirjana Mirceta, Ryan R Wick, Louise M Judd, Kelly L Wyres, Nicholas R Thomson, Richard A Strugnell, Nigel F Pratt, Jill S Garlick, Kerrie M Watson, Peter C Hunter, Steve A McGloughlin, Denis W Spelman, Adam W J Jenney, Kathryn E Holt
Background: Klebsiella pneumoniae is a leading cause of extended-spectrum beta-lactamase (ESBL) producing hospital-associated infections, for which elderly patients are at increased risk. Methods: We conducted a 1-year prospective cohort study, in which a third of patients admitted to two geriatric wards in a specialized hospital were recruited and screened for carriage of K. pneumoniae by microbiological culture. Clinical isolates were monitored via the hospital laboratory...
January 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29337017/management-of-diabetes-in-older-adults
#2
G Sesti, R Antonelli Incalzi, E Bonora, A Consoli, A Giaccari, S Maggi, G Paolisso, F Purrello, G Vendemiale, N Ferrara
Type 2 diabetes prevalence is high in older adults and is expected to rise in the next decades. Diabetes in the population of frail older adults is accompanied by functional disability, several comorbidities, and premature mortality. A comprehensive geriatric assessment, including functional, cognitive, mental and social status, is advisable for identifying the glycemic targets and glucose-lowering therapies, focused on patient preferences, needs, and risks. The therapeutic options for older adults with diabetes are like those for the adult population...
December 7, 2017: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
https://www.readbyqxmd.com/read/29327240/geriatric-oncology-in-spain-survey-results-and-analysis-of-the-current-situation
#3
R Gironés, I Morilla, C Guillen-Ponce, M D Torregrosa, I Paredero, E Bustamante, S Del Barco, G Soler, B Losada, L Visa, E Llabrés, B Fox, J L Firvida, R Blanco, M Antonio, F Aparisi, M Pi-Figueras, E Gonzalez-Flores, M J Molina-Garrido, J Saldaña
INTRODUCTION: Geriatric oncology (GO) is a discipline that focuses on the management of elderly patients with cancer. The Spanish Society of Medical Oncology (SEOM) created a Working group dedicated to geriatric oncology in February 2016. OBJECTIVES: The main goal of this study was to describe the current situation in Spain regarding the management of elderly cancer patients through an online survey of medical oncologists. METHODS: A descriptive survey was sent to several hospitals by means of the SEOM website...
December 11, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29324561/nursing-minimum-data-sets-for-documenting-nutritional-care-for-adults-in-primary-healthcare-a-scoping-review
#4
Sasja Jul Håkonsen, Preben Ulrich Pedersen, Merete Bjerrum, Ann Bygholm, Micah D J Peters
OBJECTIVE: To identify all published nutritional screening instruments that have been validated in the adult population in primary healthcare settings and to report on their psychometric validity. INTRODUCTION: Within health care, there is an urgent need for the systematic collection of nursing care data in order to make visible what nurses do and to facilitate comparison, quality assurance, management, research and funding of nursing care. To be effective, nursing records should accurately and comprehensively document all required information to support safe and high quality care of patients...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29318082/a-review-of-a-workers-compensation-database-2003-to-2013-patient-factors-influencing-return-to-work-and-cumulative-financial-claims-after-rotator-cuff-repair-in-geriatric-workers-compensation-cases
#5
Edward Shields, Caroline Thirukumaran, Katia Noyes, Ilya Voloshin
Background: Workers' compensation status is associated with poor outcomes after rotator cuff repair surgery. The purpose of this study was to analyze a database of geriatric workers' compensation patients after surgical repair of the rotator cuff and identify both medical and nonmedical patient factors that influence the time it takes for them to return to work at full duty, including a comparison of arthroscopic and open techniques. Methods: An all workers' compensation database was queried for rotator cuff claims that were surgically managed using arthroscopic, open, or both approaches from 2003 to 2013 in patients aged ≥60...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29317368/interdisciplinary-care-model-independently-decreases-use-of-critical-care-services-after-corrective-surgery-for-adult-degenerative-scoliosis
#6
Owoicho Adogwa, Aladine A Elsamadicy, Amanda R Sergesketter, Michael Ongele, Victoria Vuong, Syed Khalid, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE: Interdisciplinary management of elderly patients requiring spine surgery has been shown to improve short and long-term outcomes. The aim of this study is to determine whether an interdisciplinary team approach mitigates use of intensive care unit (ICU) resources. METHODS: A unique co-management model for elderly patients undergoing lumbar fusion surgery was implemented at a major academic medical center. The Peri-operative Optimization of Senior Health Program(POSH) was launched with the aim of improving outcomes in elderly patients(>65-years-old) undergoing complex lumbar spine surgery...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29316345/factors-related-to-frailty-among-the-elderly-in-south-korea-a-3-year-longitudinal-study
#7
Jin-Kyoung Park, Jong-Eun Lee
PURPOSE: To examine factors associated with frailty among the young-old elderly (YOE) and old-old elderly (OOE). METHODS: This longitudinal study with a 3-year follow-up included 486 participants who received home care services. FINDINGS: Precipitous weight loss and depression in the YOE and worsening of complex mobility and depression in the OOE were associated with worsened frailty over the 3-year period. CONCLUSIONS: To prevent frailty, we suggest weight-loss prevention programs for the YOE, lower-limb exercise programs for the OOE, and depression management programs for both groups...
January 5, 2018: International Journal of Nursing Knowledge
https://www.readbyqxmd.com/read/29314516/southcare-geriatric-flying-squad-an-innovative-australian-model-providing-acute-care-in-residential-aged-care-facilities
#8
Shikha Jain, Peter N Gonski, Jeannette Jarick, Sandra Frese, Sheena Gerrard
This study reviews the outcomes of a model developed to improve the quality of care of residents living within residential aged care facilities (RACF). The Southcare Geriatric Flying Squad saw a total of 640 acutely unwell RACF residents over an 18-month period. Of these, 578 (90.3%) were managed in the RACF avoiding emergency department. Only 35 (5.5%) patients required emergency department transfer and 27 (4.2%) were directly admitted to a medical ward. The service may have reduced emergency presentations by offering rapid assessment and management, choice in place of treatment and level of interventions...
January 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29307208/implementation-issues-relevant-to-outpatient-neurology-palliative-care
#9
Benzi M Kluger, Michael J Persenaire, Samantha K Holden, Laura T Palmer, Hannah Redwine, Julie Berk, C Alan Anderson, Christopher M Filley, Jean Kutner, Janis Miyasaki, Julie Carter
BACKGROUND: There is growing interest in the application of palliative care principles to improve care for patients and families affected by neurologic diseases. We developed an interdisciplinary outpatient clinic for patients and families affected by neurologic disorders to better address the problems faced by our highest need patients. We have developed and improved this program over the past three years and share several of our most important lessons as well as ongoing challenges and areas where we see our clinic evolving in the future...
November 29, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29296131/geriatric-delirium-care-using-chart-audits-to-target-improvement-strategies
#10
Carla A Loftus, Lesley A Wiesenfeld
Background: Our hospital identified delirium care as a quality improvement target. Baseline characterization of our delirium care and deficits was needed to guide improvement efforts. Methods: Two inpatient units were selected: 1) A general internal medicine unit with a focus on geriatrics, and 2) a surgical unit. Retrospective chart audits were conducted for all patients over age 50 admitted during a one-month period to compare delirium care with best practice guideline (BPG) recommendations, and to determine the incidence of missed cases of delirium and negative outcomes in patients with delirium...
December 2017: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/29283905/efficacy-and-safety-of-flexible-endoscopic-management-of-zenker-s-diverticulum
#11
Deepanshu Jain, Abhinav Sharma, Manan Shah, Upen Patel, Nirav Thosani, Shashideep Singhal
Zenker's diverticulum (ZD), a pulsion diverticulum of hypopharynx is a rare but treatable cause of morbidity in geriatric population. Traditionally a surgical disease but due to its associated high morbidity, flexible endoscopy has become a lucrative option. We reviewed 997 patients from 23 original studies who underwent flexible endoscopic diverticulotomy (FED) of ZD. Composite technical and clinical success rate for the study cohort was 99.4% and 87.9%, respectively. Composite failure rate was 10.0% but close to half of them (45...
December 27, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29275990/octogenarians-post-acute-care-use-after-cardiac-valve-surgery-and-recovery-clinical-implications
#12
Elizabeth Edmiston, Mary A Dolansky, Melissa Zullo, Daniel E Forman
Octogenarians receiving cardiac valve surgery is increasing and recovery is challenging. Post-acute care (PAC) services assist with recovery, yet services provided in facilities do not provide adequate cardiac-focused care or long-term self-management support. The purpose of the paper was to report post-acute care discharge rates in octogenarians and propose clinical implications to improve PAC services. Using a 2003 Medicare Part A database, we studied post-acute care service use in octogenarians after cardiac valve surgery...
December 21, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/29251704/improved-outcomes-in-elderly-trauma-patients-with-the-implementation-of-two-innovative-geriatric-specific-protocols-final-report
#13
Eric H Bradburn, Brian W Gross, Shreya Jammula, William H Adams, Jo Ann Miller
INTRODUCTION: Elderly trauma care is challenging due to the unique physiology and comorbidities prevalent in this population. To improve the care of these patients, two practice management guidelines (PMG) were implemented: High Risk Geriatric Protocol (HRGP), which triages patients based on injury patterns and comorbid conditions for occult hypotension, and the Anticoagulation and Trauma Alert (ACT), which is designed to streamline the care of geriatric trauma patients on anticoagulants...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29206692/individualizing-the-care-of-older-heart-failure-patients
#14
George A Heckman, Robert S McKelvie, Kenneth Rockwood
PURPOSE OF REVIEW: The heart failure epidemic is driven mainly by population aging and the improving survival of patients with cardiovascular risk factors. Aging heart failure patients are affected by multiple concurrent comorbidities and geriatric syndromes, the most important of which are frailty and cognitive impairment. The purpose of this review is to provide clinicians with practical advice on how to individualize the care of older heart failure patients. RECENT FINDINGS: Frailty and cognitive impairment are common in older heart failure patients...
December 4, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29203603/silver-diamine-fluoride-changing-the-caries-management-paradigm-and-potential-societal-impact
#15
John Timothy Wright, Alex White
Silver diamine fluoride is a topically-applied agent for managing dental caries. It stops caries lesion progression, turning them black and hard in a high percentage of cases. Populations including pediatric, geriatric, special health care needs, and those with limited access to oral health care can all benefit from silver diamine fluoride. This commentary addresses some of the many questions that have arisen with the availability of SDF and marked gaps in our knowledge.
November 2017: North Carolina Medical Journal
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#16
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
December 1, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29188478/-comprehensive-geriatric-care-for-frail-elderly-at-home-a%C3%A2-feasibility-study
#17
Jonneke Kroes, Laura van Buul, Ruth Veenhuizen, Aafke de Groot, Marja Depla, Winfried Vergeer, Cees Hertogh
OBJECTIVE: To evaluate the feasibility of a study on the content and effect of comprehensive geriatric care (CGC) at home for frail elderly. METHOD: Case managers invited new CGC patients of one care organization for participation in the study. At two moments, questionnaires were conducted on (social) functioning, quality of life, perceived problems, perceived informal caregiver burden, and self-management. Information on received care was collected from the patients' medical records, In addition, a questionnaire was administered to the referring physician...
November 29, 2017: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/29186782/forging-a-frailty-ready-healthcare-system-to-meet-population-ageing
#18
Wee Shiong Lim, Sweet Fun Wong, Ian Leong, Philip Choo, Weng Sun Pang
The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present modus operandi of fragmented, facility-centric, doctor-based, and illness-centered care delivery as clearly unsustainable. In line with the public health framework for action in the World Health Organization's World Health and Ageing Report, meeting these challenges will require a systemic reform of healthcare delivery that is integrated, patient-centric, team-based, and health-centered...
November 24, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29183638/-proposed-development-of-a-geriatric-oncology-unit-times-of-change-our-reality
#19
Francisco Javier Martínez Peromingo, Carlos Oñoro Algar, M Elena Baeza Monedero, Cristina González de Villaumbrosia, Diego Real de Asua Cruzat, Raquel Barba Martín
Age is one of the main risk factors for the development of cancer. It is expected that the progressive aging of the population will have an unprecedented impact on the incidence of various tumours. In fact, the management of elderly cancer patients is already a major public health problem in developed countries. However, elderly patients have systematically been excluded from cancer drug studies or protocol development. This has left health professionals in uncharted territory, without proper tools to address the multiple difficulties that arise in the treatment of these patients...
November 25, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/29181081/care-of-cancer-patients-with-liver-and-bone-metastases-the-place-of-pharmaceutical-care-in-a-balanced-plan-focused-on-the-patient-s-needs-and-goals
#20
Katarzyna A Rygiel, Mariola Drozd, Lucyna Bułaś
Metastatic cancer, especially in the growing population of geriatric patients, presents a big challenge to these patients, as well as to treatment teams and the entire health care system. This article describes some common medical problems faced by patients with metastases to liver and bone, and presents a diagnostic approach, and therapeutic management of various symptoms, relevant to advanced stages of the malignant disease. The article highlights the importance of patient education on various aspects of metastatic cancer, and underscores the unique position of pharmacists practicing pharmaceutical care, which is particularly beneficial in this group of patients with advanced malignancy...
October 2017: Archives of Medical Science: AMS
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