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Skilled-nursing facilities

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https://www.readbyqxmd.com/read/29788192/initial-assessment-of-the-risk-assessment-and-prediction-tool-in-a-heterogeneous-neurosurgical-patient-population
#1
Matthew Piazza, Nikhil Sharma, Benjamin Osiemo, Scott McClintock, Emily Missimer, Diana Gardiner, Eileen Maloney, Danielle Callahan, J Lachlan Smith, William Welch, James Schuster, M Sean Grady, Neil R Malhotra
BACKGROUND: Bundled care payments are increasingly being explored for neurosurgical interventions. In this setting, skilled nursing facility (SNF) is less desirable from a cost perspective than discharge to home, underscoring the need for better preoperative prediction of postoperative disposition. OBJECTIVE: To assess the capability of the Risk Assessment and Prediction Tool (RAPT) and other preoperative variables to determine expected disposition prior to surgery in a heterogeneous neurosurgical cohort, through observational study...
May 21, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29783026/a-prolonged-and-large-outbreak-of-invasive-group-a-streptococcal-disease-within-a-nursing-home-repeated-intra-facility-transmission-of-a-single-strain
#2
S A Nanduri, B J Metcalf, M A Arwady, C Edens, M A Lavin, J Morgan, W Clegg, A Beron, J P Albertson, R Link-Gelles, A Ogundimu, J Gold, D Jackson, S Chochua, N Stone, C Van Beneden, K Fleming-Dutra, B Beall
OBJECTIVES: Multiple invasive group A streptococcal (GAS) infections were reported to public health by a skilled nursing facility (Facility A) in Illinois between May 2014 and August 2016. Cases continued despite interventions including antibiotic prophylaxis for all residents and staff. Two other geographically close facilities reported contemporaneous outbreaks of GAS. We investigated potential reasons for ongoing transmission. METHODS: We obtained epidemiologic data from chart review of cases and review of facility and public health records from previous investigations into the outbreak...
May 18, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29781684/husbands-participation-in-birth-preparedness-and-complication-readiness-and-associated-factors-in-wolaita-sodo-town-southern-ethiopia
#3
Minyahil Tadesse, Andualem T Boltena, Benedict O Asamoah
BACKGROUND:  The poor emphasis on the role of husbands in birth preparedness and complication readiness (BPCR) is a major factor that should be addressed in tackling maternal mortality. AIM:  To assess the level of husbands' participation in BPCR and associated factors. SETTING:  Wolaita Sodo town, Southern Ethiopia. METHODS:  A community based cross-sectional study was conducted among 608 husbands of pregnant women and nursing mothers...
April 11, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29778455/planning-post-discharge-destination-for-gastrointestinal-surgery-patients-room-for-improvement
#4
Courtney J Balentine, Kelly Kenzik, Daniel I Chu, Melanie S Morris, Sara J Knight, Cynthia J Brown, Smita Bhatia
BACKGROUND: We compared short-term recovery for patients discharged to inpatient rehabilitation versus skilled nursing facilities after gastrointestinal surgery. MATERIALS & METHODS: We conducted a propensity-matched cohort study of 12,939 adults discharged to inpatient rehabilitation or skilled nursing facilities after colectomy, pancreatectomy or hepatectomy at hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program from 2011 to 2014...
May 16, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29766017/outcomes-according-to-discharge-location-for-persons-who-inject-drugs-receiving-outpatient-parenteral-antimicrobial-therapy
#5
Helen T D'Couto, Gregory K Robbins, Kevin L Ard, Sarah E Wakeman, Justin Alves, Sandra B Nelson
Background: Opioid use disorder poses a significant public health risk. Persons who inject drugs (PWID) suffer from high mortality and morbidity secondary to serious infectious diseases, often requiring prolonged courses of outpatient parenteral antibiotics. The goal of this study was to determine the outcomes of PWID discharged to home or to a skilled nursing or rehabilitation facility (SNF/rehab) with parenteral antibiotic treatment under an outpatient parenteral antimicrobial therapy (OPAT) program...
May 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29760552/patients-receiving-chiropractic-care-in-a-neurorehabilitation-hospital-a-descriptive-study
#6
Robert D Vining, Stacie A Salsbury, W Carl Cooley, Donna Gosselin, Lance Corber, Christine M Goertz
Objectives: Individuals rehabilitating from complex neurological injury require a multidisciplinary approach, which typically does not include chiropractic care. This study describes inpatients receiving multidisciplinary rehabilitation including chiropractic care for brain injury, spinal cord injury (SCI), stroke, and other complex neurological conditions. Design: Chiropractic services were integrated into Crotched Mountain Specialty Hospital (CMSH) through this project...
2018: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/29751966/outcomes-in-nursing-home-patients-with-traumatic-brain-injury
#7
Stephanie N Lueckel, Cyrus M Kosar, Joan M Teno, Sean F Monaghan, Daithi S Heffernan, William G Cioffi, Kali S Thomas
BACKGROUND: Traumatic brain injury is a leading cause of death and disability in the United States. In survivors, traumatic brain injury remains a leading contributor to long-term disability and results in many patients being admitted to skilled nursing facilities for postacute care. Despite this very large population of traumatic brain injury patients, very little is known about the long-term outcomes of traumatic brain injury survivors, including rates of discharge to home or risk of death in long-term nursing facilities...
May 9, 2018: Surgery
https://www.readbyqxmd.com/read/29748087/trends-in-hospital-snf-relationships-in-the-care-of-medicare-beneficiaries
#8
Joshua M Liao, R Tamara Konetzka, Rachel M Werner
Improving the value of post-acute care at skilled nursing facilities (SNFs) has become a Medicare policy priority. Anecdotally, hospitals have responded by formally acquiring or pursuing tighter informal connections with SNFs. We evaluated the trend in connections between US acute care hospitals and Medicare-certified SNFs between 2000 and 2013 using vertical integration and two novel network-based measures (number of SNF partners, and discharge concentration). Among 4441 hospitals and 17,215 SNFs, hospitals with weaker connections with SNFs were more often non-profit, major teaching hospitals with a larger number of discharges and beds...
May 7, 2018: Healthcare
https://www.readbyqxmd.com/read/29746689/impact-of-hospital-context-on-transitioning-patients-from-hospital-to-skilled-nursing-facility-a-grounded-theory-study
#9
Barbara J King, Andrea L Gilmore-Bykovskyi, Tonya J Roberts, Korey A Kennelty, Jacquelyn F Mirr, Michael B Gehring, Melissa N Dattalo, Amy J H Kind
Background: Twenty-five percentage of patients who are transferred from hospital settings to skilled nursing facilities (SNFs) are rehospitalized within 30 days. One significant factor in poorly executed transitions is the discharge process used by hospital providers. Objective: The objective of this study was to examine how health care providers in hospitals transition care from hospital to SNF, what actions they took based on their understanding of transitioning care, and what conditions influence provider behavior...
May 8, 2018: Gerontologist
https://www.readbyqxmd.com/read/29733754/staff-perceived-conflict-between-resident-centered-care-and-quality-in-the-skilled-nursing-facility-are-both-possible
#10
Victoria Parker, Ryann L Engle, Melissa K Afable, Denise A Tyler, Katelyn Gormley, Kelly Stolzmann, Michael Shwartz, Jennifer L Sullivan
OBJECTIVES: The purpose of this study was to understand if and how Veterans Affairs (VA) nursing home (CLC) staff experience difficulty in providing care that is both resident-centered (RCC) and concordant with quality standards. METHODS: Twelve VA CLCs were selected for site visits, stratified based on rankings on a composite quality measure (calculated from various indicators) and resident-centered care (RCC) progress (based on a culture change tool). Staff were interviewed about efforts and barriers to achieving goals in RCC and quality, and the interview transcripts systematically analyzed for themes...
April 23, 2018: Clinical Gerontologist
https://www.readbyqxmd.com/read/29730719/training-in-youth-friendly-service-provision-improves-nurses-competency-level-in-the-great-lakes-region
#11
Carine Weiss, Yajna Elouard, Jana Gerold, Sonja Merten
OBJECTIVES: This survey investigates whether relevant training and availability of guidelines improve self-reported competencies of nurses in the provision of youth-friendly sexual and reproductive health services in South-Kivu Province in the Democratic Republic of the Congo, Burundi, and Rwanda. METHODS: A quantitative baseline survey was conducted among nurses in randomly selected health facilities. Nurses providing youth-friendly sexual and reproductive health services were asked to self-rate their competencies with regards to technical knowledge, clinical, and communication skills...
May 5, 2018: International Journal of Public Health
https://www.readbyqxmd.com/read/29730235/national-trends-and-outcomes-in-dialysis-requiring-acute-kidney-injury-in-heart-failure-2002-2013
#12
Ashish Correa, Achint Patel, Kinsuk Chauhan, Harshil Shah, Aparna Saha, Mihir Dave, Priti Poojary, Abhishek Mishra, Narender Annapureddy, Shaman Dalal, Ioannis Konstantinidis, Renu Nimma, Shiv Kumar Agarwal, Lili Chan, Girish Nadkarni, Sean Pinney
BACKGROUND: Dialysis-requiring acute kidney injury (D-AKI) is a serious complication in hospitalized heart failure (HF) patients. However, data on national trends are lacking after 2002. METHODS: We used the Nationwide Inpatient Sample (2002-2013) to identify HF hospitalizations with and without D-AKI. We analyzed trends in incidence, in-hospital mortality, length of stay (LoS) and cost. We calculated adjusted odds ratios (aOR) for predictors of D-AKI and for outcomes including in-hospital mortality and adverse discharge (discharge to skilled nursing facilities, nursing homes, etc)...
May 3, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29724207/next-of-kin-involvement-in-improving-hospital-cancer-care-quality-and-safety-a-qualitative-cross-case-study-as-basis-for-theory-development
#13
Inger Johanne Bergerød, Bjørnar Gilje, Geir S Braut, Siri Wiig
BACKGROUND: Next-of-kin are an extension of healthcare professionals in all stages of cancer care. They offer care activities such as interpretations of symptoms, and reporting of negative or adverse effects of treatment, without any professional knowledge or skills. Their participation is often expected from healthcare professionals, managers, or the patient. However, there is limited knowledge of next-of-kin's role in and contribution to quality and safety improvement in hospital cancer care...
May 3, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29719034/measuring-functional-status-in-hospitalized-older-adults-through-electronic-health-record-documentation
#14
Liron Sinvani, Andrzej Kozikowski, Vidhi Patel, Colm Mulvany, Christopher Smilios, Guang Qiu, Meng Zhang, Gisele Wolf-Klein, Renee Pekmezaris
OBJECTIVES: Hospitalization-associated disability affects up to 60% of older adults; however, standardized measures of function are not routinely used and documented. We sought to determine whether nursing documentation in electronic medical records can be used to determine mobility status and associated clinical outcomes. METHODS: A retrospective study of 2383 medical patients aged 75 years and older was conducted at a large academic tertiary hospital in New York...
April 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29704979/improving-emergency-health-care-workers-knowledge-competency-and-attitudes-toward-lesbian-gay-bisexual-and-transgender-patients-through-interdisciplinary-cultural-competency-training
#15
Sarah Bristol, Teresa Kostelec, Ryan MacDonald
INTRODUCTION: Emergency staff members have a unique role in providing episodic care to marginalized populations. The lesbian, gay, bisexual, and transgender (LGBT) community is a marginalized population that is routinely encountered by ED staff. Implicit prejudice may influence emergency staff interactions and contribute to distrust of health care providers by some members of the LGBT community. The purpose of our study is to evaluate aggregate ED health care team member's knowledge and attitudes toward lesbian, gay, bisexual, and transgender people pre- and post-cultural competency training education...
April 25, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29697778/quality-of-post-acute-care-in-skilled-nursing-facilities-that-disproportionately-serve-black-and-hispanic-patients
#16
Maricruz Rivera-Hernandez, Momotazur Rahman, Dana B Mukamel, Vincent Mor, Amal N Trivedi
Background: Understanding and addressing racial and ethnic disparities in the quality of post-acute care in skilled nursing facilities is an important health policy issue, particularly as the Medicare program initiates value-based payments for these institutions. Methods: Our final cohort included 649,187 Medicare beneficiaries in either the fee-for-service or Medicare Advantage programs, who were 65 and older and were admitted to a skilled nursing facility following an acute hospital stay, from 8,375 skilled nursing facilities...
April 25, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29691843/a-systems-approach-to-identify-factors-influencing-adverse-drug-events-in-nursing-homes
#17
Ali Azeez Al-Jumaili, William R Doucette
The objectives of the study were to identify the incidence rate and characteristics of adverse drug events (ADEs) in nursing homes (NHs) using the ADE trigger tool and to evaluate the relationships between resident and facility work system factors and incidence of ADEs using the System Engineering Initiative for Patient Safety (SEIPS) model. The study used 2 observational quantitative methods, retrospective resident chart extraction, and surveys. The participating staff included Directors of nursing, registered nurses, certified nurse assistants (CNAs)...
April 24, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29691152/readmission-patterns-over-90-day-episodes-of-care-among-medicare-fee-for-service-beneficiaries-discharged-to-post-acute-care
#18
Addie Middleton, Yong-Fang Kuo, James E Graham, Amol Karmarkar, Yu-Li Lin, James S Goodwin, Allen Haas, Kenneth J Ottenbacher
OBJECTIVE: Examine readmission patterns over 90-day episodes of care in persons discharged from hospitals to post-acute settings. DESIGN: Retrospective cohort study. SETTING: Acute care hospitals. PARTICIPANTS: Medicare fee-for-service enrollees (N = 686,877) discharged from hospitals to post-acute care in 2013-2014. The cohort included beneficiaries >65 years of age hospitalized for stroke, joint replacement, or hip fracture and who survived for 90 days following discharge...
April 21, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29685884/incidence-risk-factors-and-sequelae-of-post-kidney-transplant-delirium
#19
Christine E Haugen, Alexandra Mountford, Fatima Warsame, Rachel Berkowitz, Sunjae Bae, Alvin G Thomas, Charles H Brown, Daniel C Brennan, Karin J Neufeld, Michelle C Carlson, Dorry L Segev, Mara McAdams-DeMarco
Background Frail kidney transplant (KT) recipients may be particularly vulnerable to surgical stressors, resulting in delirium and subsequent adverse outcomes. We sought to identify the incidence, risk factors, and sequelae of post-KT delirium. Methods We studied 125,304 adult KT recipients (1999-2014) to estimate delirium incidence in national registry claims. Additionally, we used a validated chart abstraction algorithm to identify post-KT delirium in 893 adult recipients (2009-2017) from a cohort study of frailty...
April 23, 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29685397/outcomes-of-outpatient-parenteral-antimicrobial-therapy-in-patients-with-injection-drug-use
#20
Mohsen Vazirian, Jason M Jerry, Nabin K Shrestha, Steven M Gordon
BACKGROUND: Historically, there has been a restrictive approach toward outpatient parenteral antimicrobial therapy (OPAT) in patients with injection drug use (IDU) due to the fear that they might utilize the intravenous catheter to inject illicit substances. OBJECTIVE: We tested the hypothesis that patients with current IDU on OPAT would have less favorable treatment outcomes compared to those without current IDU. METHODS: In this retrospective cohort chart review study of Cleveland Clinic OPAT registry, we identified patients with current IDU by both electronic and manual review...
March 3, 2018: Psychosomatics
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