Skilled-nursing facilities

Introduction Falls from beds (FFBs) among outpatient elderly individuals are a prevalent issue, particularly for those aged 65 and above. This presents a notable health challenge with consequences that extend beyond personal well-being, placing a considerable strain on healthcare systems. Fall-related injuries often result in reduced independence, increased morbidity, and, in severe instances, fatalities. It is crucial to address these outpatient falls to safeguard the health and independence of the elderly population...

BACKGROUND: The burden of maternal and child mortality is high in the Democratic Republic of the Congo (DRC). While health workers (HWs) with adequate knowledge and practice of maternal and child health (MCH) are crucial to reduce this burden, the skill level of HWs in charge of MCH in the DRC is currently insufficient. This study aimed to assess the knowledge and practice of HWs towards MCH in Kasai and Maniema, two DRC provinces with very high maternal mortality ratios and under-5 mortality rates...

Nearly one quarter (600,000) of all neonatal deaths worldwide per year occur in India. To reduce neonatal mortality, the Indian Ministry of Health and Family Welfare established neonatal care units, including neonatal intensive care units and specialized neonatal care units to provide immediate care at birth, resuscitation for asphyxiation, postnatal care, follow up for high-risk newborns, immunization, and referral for additional or complex healthcare services. Despite these efforts, neonatal mortality remains high, and measures taken to reduce mortality have been severely challenged by multiple problems caused by the Covid-19 pandemic...

BACKGROUND: A key aspect of Australia's response to the COVID-19 pandemic was to control transmission through legislated quarantine and isolation of overseas returning travellers and potentially infectious community members. In New South Wales, Special Health Accommodation (SHA) was rapidly established as a comprehensive health service for individuals that were at risk of having COVID-19, were confirmed to have COVID-19 or for those with complex health needs that were deemed inappropriate for management in Police managed Quarantine Hotels...

BACKGROUND: The escalating global prevalence of burnout among healthcare professionals poses a serious health concern. Recent studies focus on prevalence and predictors of burnout among healthcare providers, emphasizing the need for well-being interventions. This study investigates burnout and coping mechanisms among healthcare professionals in central Uganda, addressing the dearth of knowledge about coping strategies specific to the region. METHODS: An analytical facility cross-sectional study was conducted in five healthcare facilities in central Uganda between June to July 2023...

Objective Infections from methicillin-resistant Staphylococcus aureus are increasingly treated in longterm care facilities, but long-term care pharmacies face high costs in the provision of sterile vancomycin for intravenous administration. This study compares pharmaceutical costs of outsourced, compounded, and room temperature premixed vancomycin formulations in a long-term care pharmacy. Design This retrospective observational study reviewed 124 orders of vancomycin. Means for total pharmacy preparation time, pharmacist labor time, and extrapolated time over complete course of treatment were compared for three vancomycin preparations: outsourced, compounded by pharmacy, and room temperature premixed vancomycin formulations...

INTRODUCTION: The growing burden of an aging population has raised concerns about demands on healthcare systems and resources, particularly in the context of surgical and cancer care. Delirium can affect treatment outcomes and patient recovery. We sought to determine the prevalence of postoperative delirium among patients undergoing digestive tract surgery for malignant indications and to analyze the role of delirium on surgical outcomes. METHODS: Medicare claims data were queried to identify patients diagnosed with esophageal, gastric, hepatobiliary, pancreatic, and colorectal cancers between 2018 and 2021...

Transitional care teams have been shown to improve patient safety. We describe a novel transitional care team with a clinical pharmacist as team leader initiated amid the COVID-19 pandemic. The program focused on Veterans with 2 planned transitions of care: hospital to skilled nursing facility (SNF) and from SNF to home. Ninety older Veterans were enrolled, and 79 medication errors and 80 appointment errors were identified. We conclude that a pharmacist-led program can improve safety in patients with 2 planned transitions of care...

BACKGROUND: Since 2021, the Centers for Medicare and Medicaid Services have mandated that patients have open access to their medical records. Many institutions use online portals, which allow patients to access their health information and communicate with care teams. Our research aimed to evaluate demographic patterns for online patient portal utilization in patients undergoing total knee arthroplasty (TKA). Further, we assessed if and how portal engagement contributes to perioperative outcomes...

INTRODUCTION: One of the targets for the third sustainable development goals is to reduce worldwide maternal mortality ratio (MMR) to less than 70 deaths per 100,000 live births by 2030. To address issues affecting women and the newborns during childbirth and postnatal period, concerted efforts from governments and their stakeholders are crucial to maximize the use of technology to enhance frontline health professionals' skills to provide the emergency obstetric and newborn care (EmONC)...

IMPORTANCE: Two in 5 US hospital stays result in rehabilitative postacute care, typically through skilled nursing facilities (SNFs) or home health agencies (HHAs). However, a lack of clear guidelines and understanding of patient and caregiver preferences make it challenging to promote high-value patient-centered care. OBJECTIVE: To assess preferences and willingness to pay for facility-based vs home-based postacute care among patients and caregivers, considering demographic variations...

BACKGROUND AND PURPOSE: Falls are the leading reason for injury-related emergency department (ED) visits for older adults. The Geriatric Acute and Post-acute Fall Prevention Intervention (GAPcare), an in-ED intervention combining a medication therapy management session delivered by a pharmacist and a fall risk assessment and plan by a physical therapist, reduced ED revisits at 6 months among older adults presenting after a fall. Our objective was to evaluate the relationship between measures of function obtained in the ED and clinical outcomes...

BACKGROUND: A culture centered on relationships and communication is necessary to improve the quality of life of older adults living in nursing homes. OBJECTIVES: To examine the effects of a storytelling program by examining the cognitive, emotional, and psychosocial changes in older adults in facilities and explore staff experience of changes in care. METHODS: This mixed method study delivered a 6-week storytelling program based on relationship-centered care for residents of nursing homes (aged >65 years)...

OBJECTIVES: We, the Department of Community Medicine, have been training healthcare providers for palliative care in the hospital and community setting. There were many difficulties in providing proper palliative care. The objective is to explore the various difficulties faced by Junior Residents, auxiliary nurse and midwife (ANM) and medical social workers (MSWs) during the home visits of palliative care patients and to address those difficulties in future visits. MATERIALS AND METHODS: The study was conducted in our peripheral institutions such as the Rural Health Training Centre and the Urban Health Training Centre among Junior Residents, ANMs and MSWs who had provided palliative care for the patients...

BACKGROUND: Midwifery specialisation was introduced in 1993 as a response to escalating maternal and neonatal mortalities and shortage of physicians in rural parts of South Africa. Basic midwives enrolled into a postgraduate midwifery qualification to extend their knowledge and skills which enabled them to manage complicated obstetric conditions. The postgraduate midwifery qualification rendered them midwife specialists upon completion of the course. Yet, MS remain underutilised in clinical facilities due to limiting practice regulations and fear of medico-legal litigations, leading to forfeiture of skills...

BACKGROUND: In the course of caring, nurses often experience the death of patients, and this experience has an effect on the nurse. Every nurse responds to this experience in a different way, and it can be either a negative emotional response, or a positive emotional response. As part of their curriculum, R425 first-year student nurses are placed in clinical facilities to acquire competency in nursing skills, and here they may be exposed to patients dying. R425 is a South African Nursing Council regulation relating to the approval of and the minimum requirements for the education and training of a nurse (General, Psychiatric, and Community) and Midwife, leading to registration...

(1) Background : Cardiogenic shock (CS) is associated with high morbidity and mortality. Frailty and cardiovascular diseases are intertwined, commonly sharing risk factors and exhibiting bidirectional relationships. The relationship of frailty and non-acute myocardial infarction with cardiogenic shock (non-AMI-CS) is poorly described. (2) Methods : We retrospectively analyzed the National Inpatient Sample from 2016 to 2020 and identified all hospitalizations for non-AMI-CS. We classified them into frail and non-frail groups according to the hospital frailty risk score cut-off of 5 and compared in-hospital outcomes...

Patients requiring mechanical ventilation (MV) beyond 21 days, usually referred to as prolonged MV, represent a unique group with significant medical needs and a generally poor prognosis. Research suggests that approximately 10% of all MV patients will need prolonged ventilatory care, and that number will continue to rise. Although we have extensive knowledge of MV in the acute care setting, less is known about care in the post-ICU setting. More than 50% of patients who were deemed unweanable in the ICU will be liberated from MV in the post-acute setting...

IMPORTANCE: In 2013, Medicare implemented payments for transitional care management (TCM) services, which provide increased reimbursement to clinicians providing ambulatory care to patients after discharge from medical facilities to the community. OBJECTIVE: To determine whether the introduction of TCM payments was associated with an increase in timely postdischarge follow-up. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional interrupted time-series study assessed quarterly postdischarge visit rates before (2010-2012) and after (2013-2019) TCM implementation 100% sample of Medicare fee-for-service beneficiaries discharged to the community after a hospital or skilled nursing facility stay...

BACKGROUND: Robotic-arm assistance continues to gain popularity in total hip arthroplasty (THA) for its potential to improve component placement accuracy and patient outcomes. Nonetheless, there is limited data on the impact of robotic-assisted THA (RA-THA) on hospital length of stay (LOS) and discharge location. This study thus aimed to compare LOS, discharge location, and readmission rate for propensity-matched cohorts of RA-THA versus manual THA (M-THA). METHODS: A retrospective review of a multi-hospital database was performed to identify patients who underwent THA between January 2016 and December 2021 from surgeons who performed both RA-THA and M-THA at 77 geographically diverse hospitals...