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Geriatrics Critical Care

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https://www.readbyqxmd.com/read/29157570/building-clinical-education-training-capacity-in-nurse-practitioner-programs
#1
Shirlee M Drayton-Brooks, Paula A Gray, Nichole P Turner, Jamesetta A Newland
Building clinical education training capacity in nurse practitioner programs is critical to build the primary care workforce and to address the access to care problem in the country. Challenges related to obtaining clinical sites and qualified preceptors are well reported, but few practical solutions are presented. Clinical sites and qualified preceptors willing to serve can be found, but nurse practitioner faculty must remove obstacles and strengthen resources by discovering untapped capacity. Nurse practitioner faculty can design, implement, and test innovative clinical models to maximize clinical training capacity...
November 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/29017663/-research-progress-of-frailty-syndrome-in-critically-ill-elderly-patients
#2
Jiahui Dong, Jie Sun, An Zeng, Zhenhui Guo
Frailty syndrome is the core of the comprehensive geriatric assessment of the elderly, which affects the prognosis of elderly critical illness patients and becomes the hotspot of the current geriatric medical research of elderly patients. In critically ill elderly patients, the incidence rate of frailty syndrome is 21%-59%. Frailty syndrome is an independent risk factor in elderly patients with complications, short-term and long-term mortality. Moreover frailty is always accompanied by poor state and affects the health quality of these patients...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28898390/comprehensive-geriatric-assessment-for-older-adults-admitted-to-hospital
#3
REVIEW
Graham Ellis, Mike Gardner, Apostolos Tsiachristas, Peter Langhorne, Orlaith Burke, Rowan H Harwood, Simon P Conroy, Tilo Kircher, Dominique Somme, Ingvild Saltvedt, Heidi Wald, Desmond O'Neill, David Robinson, Sasha Shepperd
BACKGROUND: Comprehensive geriatric assessment (CGA) is a multi-dimensional, multi-disciplinary diagnostic and therapeutic process conducted to determine the medical, mental, and functional problems of older people with frailty so that a co-ordinated and integrated plan for treatment and follow-up can be developed. This is an update of a previously published Cochrane review. OBJECTIVES: We sought to critically appraise and summarise current evidence on the effectiveness and resource use of CGA for older adults admitted to hospital, and to use these data to estimate its cost-effectiveness...
September 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28892951/outcomes-of-mechanically-ventilated-critically-ill-geriatric-patients-in-intensive-care-unit
#4
Vivek Aggarwal, Rajeshwar Singh, Jung Bahadur Singh, Jps Bawa, Nimish Gaur, Sandeep Kumar, I V Nagesh
INTRODUCTION: Increase in life expectancy across the globe has led to rise in geriatric population. Geriatric population is now living longer and healthier. This rise in geriatric population has also led to increase in the geriatric ailments leading to increased number of geriatric patients requiring intensive care including mechanical ventilation. Data on outcomes of geriatric patients requiring mechanical ventilation from India is scarce. AIM: To study the profile and outcome of geriatric patients more than equal to 60 years requiring mechanical ventilation in Intensive Care Unit (ICU)...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28866836/colistin-nephrotoxicity-in-the-icu-is-it-different-in-the-geriatric-patients
#5
Burcu Başarık Aydoğan, Fatma Yıldırım, Avşar Zerman, Kamil Gönderen, Melda Türkoğlu, Gülbin Aygencel
OBJECTIVE: Most significant side effect of colistin therapy which is used for the treatment of multi-drug resistant Gram-negative infections is nephrotoxicity. Our aim was to investigate the differences of colistin nephrotoxicity between the geriatric age group (≥65 years) and the younger age group (<65 years) in critically ill medical intensive care unit (ICU) patients. MATERIAL AND METHOD: The medical records of the 76 patients who were taken colistin therapy due to multi-resistant Gram-negative infections between January 2010 and June 2014 in the our medical ICU were retrospectively investigated...
September 2, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28857647/ems-dispatches-during-hurricanes-irene-and-sandy-in-new-jersey
#6
Joshua Bucher, Jonathan McCoy, Colleen Donovan, Snehal Patel, Pamela Ohman-Strickland, Asa Dewan
BACKGROUND: Hurricanes Irene and Sandy heavily impacted New Jersey. Investigating EMS dispatch trends during these storms may allow us to prepare for future disasters. OBJECTIVES: Our objectives to characterize the types of EMS dispatches immediately before, during, and after landfall compared to a control period. METHODS: This retrospective study was conducted at a large EMS dispatch center that provides first responders, Basic Life Support (BLS), Advanced Life Support (ALS), and critical care transport services to an area with approximately 20 receiving hospitals including a Level I Trauma Center...
August 31, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28832067/comparison-of-overridden-medication-related-clinical-decision-support-in-the-intensive-care-unit-between-a-commercial-system-and-a-legacy-system
#7
Adrian Wong, Adam Wright, Diane L Seger, Mary G Amato, Julie M Fiskio, David Bates
BACKGROUND: Electronic health records (EHRs) with clinical decision support (CDS) have shown to be effective at improving patient safety. Despite this, alerts delivered as part of CDS are overridden frequently, which is of concern in the critical care population as this group may have an increased risk of harm. Our organization recently transitioned from an internally-developed EHR to a commercial system. Data comparing various EHR systems, especially after transitions between EHRs, are needed to identify areas for improvement...
August 23, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28774786/family-caregiving-a-vision-for-the-future
#8
Richard Schulz, Sara J Czaja
The authors of this review both served on the National Academy of Science, Engineering, and Medicine Committee that produced the report, "Caring for an Aging America". In this commentary we summarize key findings and recommendations most relevant to clinicians and researchers in geriatric psychiatry and related disciplines. The report notes the growing prevalence of family caregiving in the United States, especially those caring for high-need patients with multiple chronic conditions, disability, and/or cognitive impairment...
July 4, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28731945/the-changing-paradigm-of-radiotherapy-in-the-elderly-population
#9
Myer Raphael Pfeffer, Philip Blumenfeld
There is increasing awareness of the special needs for care of the elderly cancer patient. Newer precise conformal radiotherapy techniques allow the safe delivery of higher doses of radiotherapy to the target tumor while reducing the dose to surrounding critical organs. This has led to a shortening of radiotherapy protocols for both curative and palliative indications. We review these novel techniques and protocols and the published clinical studies that include elderly patients treated with these techniques...
July 2017: Cancer Journal
https://www.readbyqxmd.com/read/28723252/across-the-continuum-how-inpatient-palliative-care-consultations-are-reported-in-hospital-discharge-summaries
#10
Nikki Miller, John Shuler, Deon Hayley, Jianghua He, Karin Porter-Williamson, Jessica Kalender-Rich
BACKGROUND: Inpatient Palliative Care (PC) consultations help develop a patient-centered and quality-of-life-focused plan of care for patients with serious illness. Discharge summaries (DSs) are an essential tool to maintain continuity of these care plans across multiple locations and providers. METHODS: We conducted a retrospective chart review of selected DSs of patients who received inpatient PC consultations at the University of Kansas Hospital from July 2011 to May 2015...
July 19, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28719564/the-new-apgar-score-a-checklist-to-enhance-quality-of-life-in-geriatric-patients-with-hip-fracture
#11
Joseph Bernstein, Sara Weintraub, Eric Hume, Mark D Neuman, Stephen L Kates, Jaimo Ahn
For geriatric patients with hip fractures, the broken bone is the reason for admission, but only part of the overall disease. Indeed, it may be more helpful to consider the patient having geriatric hip fracture syndrome or sustaining a hip attack, as there are many associated medical, social, psychological, and other problems to which attention must be paid. To that end, we have identified a series of 10 steps, collected into a checklist, that can be undertaken for all patients with geriatric hip fracture. In homage to the maxim "we come into the world under the brim of the pelvis and go out through the neck of the femur," we defined our checklist by the acronym APGAR SCORE, named after the classic checklist of the same name used to assess a newborn child...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28716375/aging-and-post-intensive-care-syndrome-a-critical-need-for-geriatric-psychiatry
#12
REVIEW
Sophia Wang, Duane Allen, You Na Kheir, Noll Campbell, Babar Khan
Because of the aging of the intensive care unit (ICU) population and an improvement in survival rates after ICU hospitalization, an increasing number of older adults are suffering from long-term impairments because of critical illness, known as post-intensive care syndrome (PICS). This article focuses on PICS-related cognitive, psychological, and physical impairments and the impact of ICU hospitalization on families and caregivers. The authors also describe innovative models of care for PICS and what roles geriatric psychiatrists could play in the future of this rapidly growing population...
June 1, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28675566/effects-of-two-different-glutamine-containing-enteral-supplements-on-stool-frequency-and-density-in-elderly-patients-recovering-from-acute-critical-illness
#13
Nobutoshi Fushimi, Munenori Yamada, Hiroki Hachiya, Shun Ito, Takashi Shibuya, Noritsugu Ohashi, Akihiro Mori
AIM: Glutamine has various beneficial functions in the gastrointestinal tract. The present study was designed to investigate the effect of two different glutamine supplements on bowel movement at the start of enteral feeding in elderly inpatients. METHODS: This was a double-blind, prospective, randomized comparison study. A total of 25 patients aged >75 years recovering from a critical illness in a non-intensive care unit and scheduled for tube feeding were recruited...
July 4, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#14
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28599140/instruments-to-evaluate-mobility-capacity-of-older-adults-during-hospitalization-a-systematic-review
#15
REVIEW
Karla Vanessa Rodrigues Soares Menezes, Claudine Auger, Weslley Rodrigues de Souza Menezes, Ricardo Oliveira Guerra
Independent mobility is a key factor in predicting morbidity and determining hospital discharge readiness for older patients. The main objective was identify and appraise relevant instruments for the measurement of mobility of hospitalized geriatric patients. A systematic review was performed in two consecutive steps. Based on the definition of mobility of the International Classification of Functioning (ICF). Step 1 identified mobility measurement instruments used to assess patients 60 years of age and over hospitalized in acute care or intensive geriatric rehabilitation unit...
September 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28556873/nurses-perceptions-and-management-of-urinary-incontinence-in-hospitalized-older-adults-an-integrative-review
#16
Marnie Colborne, Sherry Dahlke
Urinary incontinence (UI) is a geriatric syndrome affecting older adults in long-term and acute hospital care. Most research has focused on nurses' perceptions of UI in long-term care and community settings rather than acute hospital settings. The purpose of the current integrative review was to understand nurses' perceptions and use of continence strategies for hospitalized older adults. Literature published from 1996-2016 was reviewed. Critical appraisal of the articles by two researchers yielded 10 articles that described nine studies...
May 30, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28555704/transdisciplinary-research-in-frailty-knowledge-translation-to-inform-new-models-of-care
#17
M Archibald, A Kitson, D Frewin, R Visvanathan
Transforming care for frail older adults requires more than rigorous research. While preventing, identifying and managing frailty are critical to reducing the personal and health systems impact of frailty worldwide, collaborative approaches to research and research application that reflect stakeholder perspectives and priorities are necessary to create meaningful solutions to frailty-related challenges. In South Australia, a new Centre for Research Excellence in Frailty was recently launched with funding from the National Health and Medical Research Council of Australia...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28498197/overuse-of-health-care-services-in-the-management-of-cancer-a-systematic-review
#18
REVIEW
Shrujal S Baxi, Minal Kale, Salomeh Keyhani, Benjamin R Roman, Annie Yang, Antonio P Derosa, Deborah Korenstein
BACKGROUND: Overuse, the provision of health services for which harms outweigh the benefits, results in suboptimal patient care and may contribute to the rising costs of cancer care. We performed a systematic review of the evidence on overuse in oncology. METHODS: We searched Medline, EMBASE, the Cochrane Library, Web of Science, SCOPUS databases, and 2 grey literature sources, for articles published between December 1, 2011 and March 10, 2017. We included publications from December 2011 to evaluate the literature since the inception of the ABIM Foundation's Choosing Wisely initiative in 2012...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28493647/the-liminality-of-the-patient-with-dementia-in-geriatric-rehabilitation-hospitals
#19
Robin Digby, Susan Lee, Allison Williams
AIM: The aim was to explore the experiences of people with dementia in sub-acute geriatric rehabilitation hospitals to critically evaluate the care received by such patients. BACKGROUND: Globally the number of people with dementia is growing and is expected to impact progressively more on health systems. People with dementia can become deconditioned and deteriorate in cognitive function while in hospital. The unfamiliar environment and people can cause the person to become disorientated which then leads to behavioural symptoms which complicate care...
May 11, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28471238/clinician-perceptions-about-inpatient-occupational-therapy-groups-in-traumatic-brain-injury-rehabilitation
#20
Freyr Patterson, Jennifer Fleming, Emmah Doig
PRIMARY OBJECTIVE: The aim of the study was to explore the experiences and perceptions of clinicians about the benefits, challenges and processes of facilitating inpatient occupational therapy groups in traumatic brain injury (TBI) rehabilitation including peer-to-peer interactions and use of goals. DESIGN AND METHOD: A qualitative methodology, guided by a phenomenological approach was utilized with data collected from focus groups comprising 26 clinicians working in occupational therapy in three inpatient rehabilitation settings: brain injury, spinal injury and geriatric rehabilitation in order to identify aspects unique to brain injury rehabilitation...
2017: Brain Injury: [BI]
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