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https://www.readbyqxmd.com/read/28196637/an-outbreak-of-acute-gii-17-norovirus-gastroenteritis-in-a-long-term-care-facility-in-china-the-role-of-nursing-assistants
#1
Chang Cui, Lifeng Pan, Yuanping Wang, Caoyi Xue, Weiping Zhu, Linying Zhu, Chuchu Ye, Xianghua Lu, Haihong Song, Yifei Fu, Qiao Sun
More than 30 residents and nursing assistants in a geriatric nursing hospital developed acute gastroenteritis from December 7th to December 18th, 2014 in Shanghai, China. An immediate epidemiological investigation was conducted to identify the etiological agent of the outbreak, mode of transmission and the risk factors. Cases were investigated according to an epidemiological questionnaire. Samples from cases, highly transmissible environmental surfaces and drinking water were collected for pathogens detection...
February 9, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28192556/changes-in-postacute-care-in-the-medicare-shared-savings-program
#2
J Michael McWilliams, Lauren G Gilstrap, David G Stevenson, Michael E Chernew, Haiden A Huskamp, David C Grabowski
Importance: Postacute care is thought to be a major source of wasteful spending. The extent to which accountable care organizations (ACOs) can limit postacute care spending has implications for the importance and design of other payment models that include postacute care. Objective: To assess changes in postacute care spending and use of postacute care associated with provider participation as ACOs in the Medicare Shared Savings Program (MSSP) and the pathways by which they occurred...
February 13, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28182162/an-investigation-of-quality-improvement-initiatives-in-decreasing-the-rate-of-avoidable-30-day-skilled-nursing-facility-to-hospital-readmissions-a-systematic-review
#3
Michael Mileski, Joseph Baar Topinka, Kimberly Lee, Matthew Brooks, Christopher McNeil, Jenna Jackson
OBJECTIVES: The main objective was to investigate the applicability and effectiveness of quality improvement initiatives in decreasing the rate of avoidable 30-day, skilled nursing facility (SNF)-to-hospital readmissions. PROBLEM: The rate of rehospitalizations from SNF within 30 days of original discharge has increased within the last decade. SETTING: The research team participants conducted a literature review via Cumulative Index of Nursing and Allied Health Literature and PubMed to collect data about quality improvement implemented in SNFs...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28168716/a-deskilling-and-challenging-journey-the-lived-experience-of-indonesian-nurse-returnees
#4
A Kurniati, C-M Chen, F Efendi, R Ogawa
AIM: To illuminate the lived experiences of Indonesian nurses who previously worked as caregivers in Japanese residential care facilities, by exploring the journey of becoming returnees. BACKGROUND: The creation of bilateral agreements between Indonesia and Japan has facilitated the movement of Indonesian nurses to work as caregivers in Japan since 2008. While this decision raised concerns with regard to the degradation of nursing skills, little is known about this issue from the perspective of nurse returnees and how the experience affects their life...
February 6, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28156156/hyperglycemia-and-hypoglycemia-in-patients-with-diabetes-in-skilled-nursing-facilities
#5
Rushad Patell, Denis Nigmatoulline, James Bena, Do Gyun Kim, Barbara Messinger-Rapport, M Cecilia Lansang
BACKGROUND: Endocrinologists are faced with a growing elderly patient population with diabetes (DM), some of whom are in skilled nursing facilities (SNF). Efforts at managing their DM is hampered by concerns for hypoglycemia. This study aimed to determine the frequency of hypo- and hyperglycemia in SNFs, and associated factors. METHODS: We reviewed medical records of 200 consecutive residents admitted to 2 SNFs in the Cleveland area in 2014 with documented DM, aged ≥ 65 years...
February 3, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28141754/integrated-transitions-of-care-for-patients-with-rare-pulmonary-diseases
#6
Kathleen Moreo, Cheri Lattimer, James E Lett, Cherilyn L Heggen-Peay, Laura Simone
PURPOSE/OBJECTIVES: Many continuing education (CE) resources are available to support case management professionals in developing competencies in transitions of care (TOC) that apply generally across disease areas. However, CE programs and tools are lacking for advanced TOC competencies in specific disease areas. This article describes 2 projects in which leading TOC, case management, and CE organizations collaborated to develop CE-accredited interdisciplinary pathways for promoting safe and effective TOC for patients with rare pulmonary diseases, including pulmonary arterial hypertension (PAH) and idiopathic pulmonary fibrosis (IPF)...
March 2017: Professional Case Management
https://www.readbyqxmd.com/read/28139446/patient-frailty-and-discharge-disposition-following-radical-cystectomy
#7
Jeffrey A Pearl, Dattatraya Patil, Christopher P Filson, Shipra Arya, Mehrdad Alemozaffar, Viraj A Master, Kenneth Ogan
BACKGROUND: Patients with bladder cancer who are treated with cystectomy are at high risk for complications and prolonged length of stay. This population tends to be of advanced age with underlying comorbidities, and thus more likely to have decreased physiologic reserve (ie, frailty). Our objective was to evaluate the relationship between frailty and discharge disposition for patients with bladder cancer treated with cystectomy. MATERIALS AND METHODS: Using data from the National Surgical Quality Improvement Program, we identified patients with bladder cancer undergoing cystectomy (2011-2014)...
January 5, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28135830/a-randomized-trial-of-heart-failure-disease-management-in-skilled-nursing-facilities-snf-connect-lessons-learned
#8
Andrea Daddato, Heidi L Wald, Carolyn Horney, Diane L Fairclough, Erin C Leister, Marilyn Coors, Warren H Capell, Rebecca S Boxer
BACKGROUND/AIMS: Conducting clinical trials in skilled nursing facilities is particularly challenging. This manuscript describes facility and patient recruitment challenges and solutions for clinical research in skilled nursing facilities. METHODS: Lessons learned from the SNF Connect Trial, a randomized trial of a heart failure disease management versus usual care for patients with heart failure receiving post-acute care in skilled nursing facilities, are discussed...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28131543/predictors-of-functional-recovery-following-periprosthetic-distal-femur-fractures
#9
John A Ruder, Gavin P Hart, Jeffrey S Kneisl, Bryan D Springer, Madhav A Karunakar
BACKGROUND: Treatment options for periprosthetic distal femur fractures include open reduction internal fixation (ORIF) and distal femoral replacement (DFR). The purpose of this study was to evaluate the complications, and functional recovery (ambulatory status, living situation, mortality) in patients undergoing operative treatment (DFR and ORIF) of periprosthetic distal femur fractures. METHODS: A retrospective review of 58 patients with distal femoral periprosthetic fractures treated with either ORIF or DFR was conducted...
December 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28122626/developing-a-dementia-specific-health-state-classification-system-for-a-new-preference-based-instrument-ad-5d
#10
Kim-Huong Nguyen, Brendan Mulhern, Sanjeewa Kularatna, Joshua Byrnes, Wendy Moyle, Tracy Comans
BACKGROUND: With an ageing population, the number of people with dementia is rising. The economic impact on the health care system is considerable and new treatment methods and approaches to dementia care must be cost effective. Economic evaluation requires valid patient reported outcome measures, and this study aims to develop a dementia-specific health state classification system based on the Quality of Life for Alzheimer's disease (QOL-AD) instrument (nursing home version). This classification system will subsequently be valued to generate a preference-based measure for use in the economic evaluation of interventions for people with dementia...
January 25, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28121593/variant-post-acute-care-needs-measuring-to-be-managed
#11
Carter Paine
Areas of the country with high concentrations of long-term acute care hospitals or inpatient rehabilitation facilities often have much higher utilization rates, even if a skilled nursing facility or home health provider could provide care comparable in quality and at a much lower price.
January 2017: Managed Care
https://www.readbyqxmd.com/read/28118530/current-risk-adjustment-and-comorbidity-index-underperforms-in-predicting-post-acute-utilization-and-hospital-readmissions-after-joint-replacements-implications-for-comprehensive-care-for-joint-replacement-model
#12
Amit Kumar, Amol Karmarkar, Brian Downer, Amit Vashist, Deepak Adhikari, Soham Al Snih, Kenneth Ottenbacher
OBJECTIVE: Compare the performances of comorbidity indices: Charlson, Elixhauser, and the Centers for Medicare & Medicaid Services (CMS) risk adjustment model Hierarchical Condition Category (HCC), in predicting post-acute discharge settings and hospital readmission for patients after joint replacement. METHODS: Retrospective study of Medicare beneficiaries with total knee replacement (TKR) or total hip replacement (THR) discharged from hospitals in 2009-2011 (N=607,349)...
January 24, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28110561/delivering-high-quality-hip-fracture-rehabilitation-the-perspective-of-occupational-and-physical-therapy-practitioners
#13
Natalie E Leland, Michael Lepore, Carin Wong, Sun Hwa Chang, Lynn Freeman, Karen Crum, Heather Gillies, Paul Nash
AIM: The majority of post-acute hip fracture rehabilitation in the US is delivered in skilled nursing facilities (SNFs). Currently, there are limited guidelines that equip occupational and physical therapy practitioners with a summary of what constitutes evidence-based high quality rehabilitation. Thus, this study aimed to identify rehabilitation practitioners' perspectives on the practices that constitute high quality hip fracture rehabilitation. METHODS: Focus groups were conducted with 99 occupational and physical therapy practitioners working in SNFs in southern California...
January 23, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28104069/outcomes-among-older-patients-receiving-implantable-cardioverter-defibrillators-for-secondary-prevention-from-the-ncdr-icd-registry
#14
Jarrod K Betz, David F Katz, Pamela N Peterson, Ryan T Borne, Sana M Al-Khatib, Yongfei Wang, Carolina Malta Hansen, David D McManus, Jehu S Mathew, Frederick A Masoudi
BACKGROUND: Clinical trials of implantable cardioverter-defibrillators (ICDs) for secondary prevention of sudden cardiac death were conducted nearly 2 decades ago and enrolled few older patients. OBJECTIVES: This study assessed morbidity and mortality of older patients receiving ICDs for secondary prevention in contemporary clinical practice. METHODS: We identified 12,420 Medicare beneficiaries from the National Cardiovascular Data Registry ICD Registry undergoing first-time secondary prevention ICD implantation between 2006 and 2009 in 956 U...
January 24, 2017: Journal of the American College of Cardiology
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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