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https://www.readbyqxmd.com/read/28441373/cost-effectiveness-analysis-of-interventions-to-reduce-risk-of-aspiration-in-elderly-cancer-survivors-residing-in-skilled-nursing-facilities
#1
S Mantravadi
BACKGROUND: Aspiration can occur in patients of any age group, but it can be prevented. The primary population at risk is made up of survivors of cancer because of their increased risk of mucositis, mucosal atrophy, and dysphagia associated with chemotherapy, radiotherapy, and the disease process itself. The rate of incidence of aspiration cannot be quantified, because minor cases of aspiration often go unreported. Sequelae ensuing from aspirations can include pneumonia, end-stage kidney disease, dialysis, and death...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28438261/the-affordable-care-act-and-its-association-with-length-of-stay-and-payer-status-for-trauma-patients-at-a-level-i-trauma-center
#2
Vicente Jose Undurraga Perl, Chris Dodgion, Kyle Hart, Bruce Ham, Martin Schreiber, David Zonies
BACKGROUND: We hypothesized that the ACA would shorten length of stay and increase numbers of insured patients without changing trauma patient outcomes. METHODS: A retrospective review of adult trauma patients admitted to a level I trauma center between 2012 and 2014 was performed. Demographics, length of stay, payer status, discharge disposition, and complications before and after the ACA implementation were analyzed. RESULTS: 4448 trauma patients were admitted during the study period...
April 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28431908/implementation-of-a-person-centered-medical-care-model-in-a-skilled-nursing-facility-a-pilot-evaluation
#3
Kathleen Abrahamson, Jaclyn Myers, Arif Nazir
OBJECTIVES: The objective of this study was to evaluate the feasibility and impact of implementing a person-centered medical care model for post-acute care residents within a skilled nursing facility (SNF). DESIGN: A mixed-method (qualitative and quantitative) pilot evaluation. SETTING: An 89-bed SNF located within a large midwestern city. PARTICIPANTS: Forty SNF post-acute patients admitted to the facility during a 6-month period were enrolled in the pilot evaluation...
April 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28425153/nursing-students-preferences-for-clinical-placements-in-the-residential-aged-care-setting
#4
Emma Lea, Annette Marlow, Erika Altmann, Helen Courtney-Pratt
AIMS AND OBJECTIVES: To examine nursing student placement preferences submitted as online comments to a university's placement management system, to inform strategies for positive residential aged care experiences. BACKGROUND: There are predicted shortages of nurses to service an ageing population. Clinical placements undertaken by undergraduate nursing students help shape their attitudes and are a key determinant of career decision-making, yet there is little research about why students prefer particular placement areas...
April 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28421900/the-magnitude-and-factors-related-to-facility-based-maternal-mortality-in-mozambique
#5
Leonardo Chavane, Martinho Dgedge, Olivier Degomme, Osvaldo Loquiha, Marc Aerts, Marleen Temmerman
Facility-based maternal mortality remains an important public health problem in Mozambique. A number of factors associated with health system functioning can be described behind the occurrence of these deaths. This paper aimed to evaluate the magnitude of the health facility-based maternal mortality, its geographical distribution and to assess the health facility factors implicated in the occurrence of these deaths. A secondary analysis was done on data from the survey on maternal health needs performed by the Ministry of Health of Mozambique in 2008...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28413088/a-retrospective-analysis-of-neurocognitive-impairment-in-older-patients-with-burn-injuries
#6
Emily G Holmes, Samuel W Jones, Sarah L Laughon
BACKGROUND: Older adults comprise a growing proportion of the United States population that is at risk for burns. However, few studies have examined cognitive function in this patient population. OBJECTIVE: The purpose of this study was to measure the prevalence and incidence of dementia and delirium in older adults admitted for burn injuries. METHODS: This was an Institutional Review Board-approved, retrospective study of all patients 65 years and older admitted to the University of North Carolina Jaycee Burn Center from 2005-2015...
March 6, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28411287/impact-of-a-connected-care-model-on-30-day-readmission-rates-from-skilled-nursing-facilities
#7
Luke D Kim, Lei Kou, Bo Hu, Eiran Z Gorodeski, Michael B Rothberg
BACKGROUND: About one-fifth of hospitalized Medicare beneficiaries are discharged to skilled nursing facilities (SNFs) for post-acute care. Readmissions are common but interventions to reduce readmissions are scarce. OBJECTIVE: To assess the impact of a connected care model on 30-day hospital readmission rates among patients discharged to SNFs. DESIGN: Retrospective cohort. SETTING: SNFs that receive referrals from an academic medical center in Cleveland, Ohio...
April 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28410511/evaluation-of-intraventricular-colistin-utilization-a-case-series
#8
Brian Gilbert, Christopher Morrison
PURPOSE: Multi-drug resistant organisms (MDROs) are an increasing concern in health systems. Pathogens such as Pseudomonas aeruginosa, Acinetobacter baumanii, and carbapenamase-producing Enterobacteriaceae hold highest mortality rates especially when the central nervous system is involved. When MDROs are cultured treatment options are limited and reliance on medications such as colistin is becoming more prevalent. Penetration of these therapies into the central nervous system is concerning therefore local administration is a potential concomitant therapy...
April 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28399654/long-term-outcomes-following-syme-s-amputation
#9
Elissa S Finkler, Daniel A Marchwiany, Adam P Schiff, Michael S Pinzur
BACKGROUND: The metabolic cost of walking after Syme's ankle disarticulation amputation is minimally more than that for nonamputation. The ability to end weightbearing makes prosthetic fitting relatively simple, and very few patients require extensive rehabilitation or placement in a skilled nursing or rehabilitation facility. In spite of these potential benefits, there is a paucity of objective information on the actual long-term outcomes. METHODS: Fifty-one patients were identified who underwent single-stage Syme's ankle disarticulation amputation with excision of the lateral and medial malleoli by a single surgeon during a 23-year period...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28398964/postacute-care-and-recovery-after-cancer-surgery-still-a-long-way-to-go
#10
Courtney J Balentine, Peter A Richardson, Meredith C Mason, Aanand D Naik, David H Berger, Daniel A Anaya
OBJECTIVE: To determine whether postacute care (PAC) facilities can compensate for increased mortality stemming from a complicated postoperative recovery (complications or deconditioning). BACKGROUND: An increasing number of patients having cancer surgery rely on PAC facilities including skilled nursing and rehabilitation centers to help them recover from postoperative complications and the physical demands of surgery. It is currently unclear whether PAC can successfully compensate for the adverse consequences of a complicated postoperative recovery...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28397510/a-profile-of-perceived-stress-factors-among-nursing-staff-working-with-intellectually-disabled-in-patients-at-the-free-state-psychiatric-complex-south-africa
#11
Maria Conradie, Danelle Erwee, Isabel Serfontein, Maré Visser, Frikkie J W Calitz, Gina Joubert
INTRODUCTION: Nursing staff working with intellectually disabled in-patients experience unique stress factors that can influence their personal well-being and work performance. OBJECTIVES: To compile a profile of stress factors experienced by nursing staff working with intellectually disabled in-patients at the Free State Psychiatric Complex (FSPC). METHODS: This descriptive study included 89 nursing staff members from this environment. A questionnaire was used to collect socio-demographic information and determine personal and occupational stressors...
March 16, 2017: Curationis
https://www.readbyqxmd.com/read/28396033/improving-transitions-of-care-across-the-spectrum-of-healthcare-delivery-a-multidisciplinary-approach-to-understanding-variability-in-outcomes-across-hospitals-and-skilled-nursing-facilities
#12
Giana H Davidson, Elizabeth Austin, Lucas Thornblade, Louise Simpson, Thuan D Ong, Hanh Pan, David R Flum
INTRODUCTION: Improving coordination during transitions of care from the hospital to Skilled Nursing Facilities (SNF)s is critical for improving healthcare quality. In 2014, we formed (Improving Nursing Facility Outcomes using Real-Time Metrics, INFORM) to improve transitions of care by identifying structural and process factors that lead to poor clinical outcomes and hospital readmission. METHODS: Stakeholders from 10 SNFs and 4 hospitals collaborated to assess the current hospital and system-level challenges to safe transitions of care and identify targets for interventions...
April 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28394408/effect-of-clostridium-difficile-prevalence-in-hospitals-and-nursing-homes-on-risk-of-infection
#13
Nina R Joyce, Eleftherios Mylonakis, Vincent Mor
OBJECTIVES: To assess the effect of facility Clostridium difficile infection (CDI) prevalence on risk of healthcare facility (HFC) acquired CDI. DESIGN: Retrospective cohort study. SETTING: Medicare fee-for-service (FFS) claims and skilled nursing facility (SNF) Minimum Data Set 3.0 assessments. PARTICIPANTS: Medicare beneficiaries with 90 days or more of no contact with a HCF before a hospital admission without a CDI diagnosis...
April 10, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28381289/causes-consequences-and-policy-responses-to-the-migration-of-health-workers-key-findings-from-india
#14
Margaret Walton-Roberts, Vivien Runnels, S Irudaya Rajan, Atul Sood, Sreelekha Nair, Philomina Thomas, Corinne Packer, Adrian MacKenzie, Gail Tomblin Murphy, Ronald Labonté, Ivy Lynn Bourgeault
BACKGROUND: This study sought to better understand the drivers of skilled health professional migration, its consequences, and the various strategies countries have employed to mitigate its negative impacts. The study was conducted in four countries-Jamaica, India, the Philippines, and South Africa-that have historically been "sources" of health workers migrating to other countries. The aim of this paper is to present the findings from the Indian portion of the study. METHODS: Data were collected using surveys of Indian generalist and specialist physicians, nurses, midwives, dentists, pharmacists, dieticians, and other allied health therapists...
April 5, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28380346/uncovering-waste-in-us-healthcare-evidence-from-ambulance-referral-patterns
#15
Joseph J Doyle, John A Graves, Jonathan Gruber
There is widespread agreement that the US healthcare system wastes as much as 5% of GDP, yet much less agreement on the source of the waste. This paper uses the effectively random assignment of patients to ambulance companies to generate comparisons across similar patients treated at different hospitals. We find that assignment to hospitals whose patients receive large amounts of care over the three months following a health emergency have only modestly better survival outcomes compared to hospitals whose patients receive less...
March 22, 2017: Journal of Health Economics
https://www.readbyqxmd.com/read/28371024/discharge-disposition-as-an-independent-predictor-of-readmission-among-patients-hospitalised-for-community-acquired-pneumonia
#16
Tien Dong, John F Cursio, Samira Qadir, Peter K Lindenauer, Gregory W Ruhnke
BACKGROUND: Community-acquired pneumonia (CAP) is the most common non-obstetrical reason for hospital admission, the leading infectious cause of death, and a target for public reporting. CAP has thus become a target of quality improvement and pay-for-performance efforts. However, the relationship between discharge disposition and readmission risk has not been investigated. METHODS: We studied CAP patients admitted to the University of Chicago from 11/2011 to 04/2015...
March 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28369785/end-of-life-care-transition-patterns-of-medicare-beneficiaries
#17
Shi-Yi Wang, Melissa D Aldridge, Cary P Gross, Maureen Canavan, Emily Cherlin, Elizabeth Bradley
OBJECTIVES: To characterize the patterns of transitions in care and factors associated with multiple transitions in the last 6 months of life of U.S. decedents (N = 660,132). DESIGN: Retrospective study. SETTING: United States. PARTICIPANTS: Medicare beneficiaries aged 66 and older who died from July to December 2011. MEASUREMENTS: Transitions between healthcare settings (e.g., hospital, skilled nursing facility, inpatient hospice, home hospice, home without hospice) in the last 6 months of life...
April 3, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28369740/do-not-hospitalize-orders-in-nursing-homes-call-the-family-instead-of-calling-the-ambulance
#18
Andrew B Cohen, M Tish Knobf, Terri R Fried
OBJECTIVES: To determine how do-not-hospitalize (DNH) orders are interpreted and used in nursing homes (NHs) once they are in place. DESIGN: Qualitative study using in-depth semi-structured interviews performed from December 2013 to April 2014. SETTING: Eight skilled nursing facilities in Connecticut that ranked in the top 10% or bottom 10% in hospitalization rates from 2008 to 2010. PARTICIPANTS: Nursing facility staff members (N = 31)...
March 30, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28369687/caregiver-integration-during-discharge-planning-for-older-adults-to-reduce-resource-use-a-metaanalysis
#19
Juleen Rodakowski, Philip B Rocco, Maqui Ortiz, Barbara Folb, Richard Schulz, Sally C Morton, Sally Caine Leathers, Lu Hu, A Everette James
OBJECTIVES: To determine the effect of integrating informal caregivers into discharge planning on postdischarge cost and resource use in older adults. DESIGN: A systematic review and metaanalysis of randomized controlled trials that examine the effect of discharge planning with caregiver integration begun before discharge on healthcare cost and resource use outcomes. MEDLINE, EMBASE, and the Cochrane Library databases were searched for all English-language articles published between 1990 and April 2016...
April 3, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28365651/access-to-continuing-education-for-critical-care-nurses-in-rural-or-remote-settings
#20
Lori Hendrickx, Charlene Winters
Caring for the critically ill does not occur solely in large medical centers or urban areas. Nurses practicing in rural or remote settings practice as nurse generalists, caring for a wide range of patients, including those needing critical care. As a nurse generalist, the need for a wide variety of skill sets challenges nurses in rural areas to maintain current practice through continuing education across many content areas. They also may not come in contact with critically ill patients or emergent situations as often as their urban counterparts, which can make remaining comfortable with more advanced skills difficult...
April 2017: Critical Care Nurse
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