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nurse prescribing

Alexandra S Creighton, Tanya E Davison, David W Kissane
OBJECTIVE: To synthesize and summarize the studies examining the correlates and predictors of anxiety in older adults living in residential aged care. METHODS: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, five electronic databases were searched using key terms and subject headings, as well as reference lists of relevant papers. The search was limited to peer-reviewed literature published in English. Eligible studies examined the association between at least one correlate/factor and anxiety disorders or symptoms in aged care residents aged 50+ years...
October 17, 2016: International Journal of Geriatric Psychiatry
Nicola D Thompson, Lisa LaPlace, Lauren Epstein, Deborah Thompson, Ghinwa Dumyati, Cathleen Concannon, Gail Quinlan, Tory Witten, Linn Warnke, Ruth Lynfield, Meghan Maloney, Richard Melchreit, Nimalie D Stone
OBJECTIVES: To describe the prevalence and epidemiology of antimicrobial use (AU) in nursing home residents. DESIGN: One-day point prevalence survey. SETTING AND PARTICIPANTS: Nine nursing homes in four states; 1,272 eligible residents. MEASUREMENT: Frequency of antimicrobials prescribed, drug name, start date, duration, route, rationale, and treatment site. AU prevalence per 100 residents overall and by resident characteristic...
October 14, 2016: Journal of the American Medical Directors Association
Catherine Shaw, Brendan McCormack, Carmel M Hughes
BACKGROUND: There is increasing interest in how culture may affect the quality of healthcare services, and previous research has shown that 'treatment culture'-of which there are three categories (resident centred, ambiguous and traditional)-in a nursing home may influence prescribing of psychoactive medications. OBJECTIVE: The objective of this study was to explore and understand treatment culture in prescribing of psychoactive medications for older people with dementia in nursing homes...
March 2016: Drugs—Real World Outcomes
Filipa Alves da Costa, Luísa Silvestre, Catarina Periquito, Clara Carneiro, Pedro Oliveira, Ana Isabel Fernandes, Patrícia Cavaco-Silva
BACKGROUND: Currently, people live longer but often with poor quality of life. The decrease in healthy life-years is partly attributable to the institution of polypharmacy to treat various comorbidities. OBJECTIVES: The objectives of the study were to determine the prevalence and nature of drug-related problems (DRPs) in polypharmacy elderly patients residing in nursing homes and to test the acceptability of a pharmacist's intervention. METHODS: An exposure cohort was constituted in three Portuguese nursing homes, where all polypharmacy (five or more medicines) elderly patients (≥65 years of age) were analysed and then a random stratified sample was extracted to be subject to an intervention...
March 2016: Drugs—Real World Outcomes
Katie J Suda, Rebecca M Roberts, Robert J Hunkler, Thomas H Taylor
OBJECTIVES: Although antibiotic prescriptions are decreasing in the United States, broad-spectrum prescribing is increasing. It is unknown if decreases observed in national antibiotic prescribing differ by provider group. Understanding prescribing trends over time by provider group can be helpful for customizing antimicrobial stewardship efforts. Therefore, the purposes of this study were to describe outpatient antibiotic prescribing by provider group overall and adjusted for population and number of providers...
October 8, 2016: Journal of the American Pharmacists Association: JAPhA
Eva Sönnerstam, Maria Sjölander, Maria Gustafsson
BACKGROUND: Older people are more sensitive to drugs and adverse drug reactions than younger people because of age-related physiological changes such as impaired renal function. As people with dementia are particularly vulnerable to the effects of drugs, it is especially important to evaluate the dosages of renally cleared medications in this group. OBJECTIVE: The aim of this study was to estimate the prevalence of impaired renal function and inappropriate prescriptions on the basis of renal function among older patients with dementia or cognitive impairment...
October 12, 2016: Drugs & Aging
Kevin M Fain, Carlos Castillo-Salgado, David D Dore, Jodi B Segal, Andrew R Zullo, G Caleb Alexander
OBJECTIVE: We quantified transdermal fentanyl prescribing in elderly nursing home residents without prior opioid use or persistent pain, and the association of individual and facility traits with opioid-naïve prescribing. DESIGN: Cross-sectional study. SETTING: Linked Minimum Data Set (MDS) assessments; Online Survey, Certification and Reporting (OSCAR) records; and Medicare Part D claims. PARTICIPANTS: From a cross-section of all long-stay US nursing home residents in 2008 with an MDS assessment and Medicare Part D enrollment, we identified individuals (≥65 years old) who initiated transdermal fentanyl, excluding those with Alzheimer disease, severe cognitive impairment, cancer, or receipt of hospice care...
October 6, 2016: Journal of the American Medical Directors Association
Elisabeth H Ference, Jin-Young Min, Rakesh K Chandra, James W Schroeder, Jody D Ciolino, Amy Yang, Jane Holl, Stephanie Shintani Smith
BACKGROUND: This study investigates differences in antibiotic prescribing rates for pediatric upper respiratory infections (URIs) between physicians and nurse practitioners (NPs). METHODS: Visits by children <18 years old diagnosed with URI to physicians or NPs between 2001 and 2010 were abstracted from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey. Logistic regression analyses examined variations in antibiotic prescribing rates...
October 5, 2016: Annals of Otology, Rhinology, and Laryngology
Guillermo V Sanchez, Adam L Hersh, Daniel J Shapiro, James F Cawley, Lauri A Hicks
We examined US nurse practitioner (NP) and physician assistant (PA) outpatient antibiotic prescribing. Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits, including overall visits (17% vs 12%, P < .0001) and acute respiratory infection visits (61% vs 54%, P < .001). Antibiotic stewardship interventions should target NPs and PAs.
September 2016: Open Forum Infectious Diseases
Nancy M Birtley
Antipsychotic medications pose a significant risk to older adult patients with dementia and are frequently prescribed as first-line treatment for behaviors associated with dementia in skilled nursing facilities (SNFs). SNFs are often cited by the Centers for Medicare & Medicaid for inappropriate antipsychotic medication use. The purpose of the current article is to communicate an evidence-based practice (EBP) clinical protocol that can guide clinicians away from prescribing antipsychotic medications in the treatment of dementia behaviors...
October 1, 2016: Journal of Psychosocial Nursing and Mental Health Services
Jane Winter, Sarah A McNaughton, Caryl A Nowson
Older people living in the community face unique nutritional issues that put them at risk of undernutrition, which is associated with increased morbidity and mortality. Primary healthcare staff such as general practitioners (GPs) and practice nurses (PNs) are well placed to identify nutritional problems early and intervene. The aim of this study was to understand the experiences and current practices in a sample of GPs and PNs with regards to nutritional care of elderly patients. An online survey of GPs and PNs working in regional Victoria was conducted...
October 4, 2016: Australian Journal of Primary Health
Shelly L Gray, Joseph T Hanlon
Use of medications with anticholinergic activity is widespread in older adults. Several studies have highlighted that anticholinergic use may be associated with an increased risk of dementia. The objective of this narrative review is to describe and evaluate studies of anticholinergic medication use and dementia and provide practical suggestions for avoiding use of these medications in older adults. A comprehensive review of the literature, citations from recent reviews and the author's personal files was conducted...
October 2016: Therapeutic Advances in Drug Safety
Y Yankhoba Dramé
In Senegal, health insurance is available only to employees in the private and public sector and to the elderly (through the Sesame program). The rest of the population, especially different categories of vulnerable people, has no health insurance. Their access to healthcare and to medications is thus limited. In this study, we sought to analyze the relation between purchasing power and costs of treatment prescribed in one city. We questioned the customers leaving pharmacies in Ziguinchor, the administrative center of the lower Casamance, in southern Senegal, and analyzed their prescriptions and over-the-counter purchases...
August 1, 2016: Médecine et Santé Tropicales
Abraham A Brody, Bryan Gibson, David Tresner-Kirsch, Heidi Kramer, Iona Thraen, Matthew E Coarr, Randall Rupper
OBJECTIVES: To describe the prevalence of discrepancies between medication lists that referring providers and home healthcare (HH) nurses create. DESIGN: The active medication list from the hospital at time of HH initiation was compared with the HH agency's plan of care medication list. An electronic algorithm was developed to compare the two lists for discrepancies. SETTING: Single large hospital and HH agency in the western United States...
September 27, 2016: Journal of the American Geriatrics Society
Samantha DePadova, Christina Howlett, Kimberly Rivera
Blinatumomab (Blincyto®) has received accelerated approval for treatment of relapsed or refractory acute lymphoblastic leukemia. This article describes the authors' experience with a multidisciplinary collaboration among nursing, pharmacy, prescribers, and support staff, which has proven to be key for safe administration. The approach can be applied to other institutions planning to use blinatumomab.
October 1, 2016: Clinical Journal of Oncology Nursing
William E Mansbach, Ryan A Mace, Kristen M Clark, Isabella M Firth, Jacqueline K Breeden
Reducing off-label antipsychotic medication use for behavioral and psychological symptoms of dementia (BPSD) in nursing home residents has been a centerpiece of government regulation, but without insight into utilization differences based on resident and facility characteristics. To examine whether resident and facility characteristics can predict off-label antipsychotic medication treatment for BPSD, residents prescribed antipsychotic medication (N = 216) from 17 Maryland nursing facilities were randomly selected...
September 23, 2016: Research in Gerontological Nursing
Hilary Piercy, Gill Bell, Charlie Hughes, Simone Naylor, Christine A Bowman
This study aimed to examine what specialist nursing contributes to HIV service delivery across England and how it could be optimised. A three part multi-method qualitative study was undertaken, involving (1) interviews with 19 stakeholders representing professional or service user groups; (2) interviews with nurse/physician pairs from 21 HIV services; and (3) case studies involving site visits to five services. A framework analysis approach was used to manage and analyse the data. There was substantial variability in specialist nursing roles and the extent of role development...
September 22, 2016: International Journal of STD & AIDS
Alaj Hommel, M J Faber, N J Weerkamp, J G van Dijk, B R Bloem, R T Koopmans
BACKGROUND: Orthostatic hypotension (OH) in Parkinson's disease (PD) is a common non-motor sign that can be hard to recognize and treat. OH presence and treatment in institutionalized PD-patients remains unknown. OBJECTIVE: The aim of this study was to explore the prevalence and prescribed treatments of OH in institutionalized patients with PD. METHOD: A cross-sectional study of nursing homes in the south-east of the Netherlands identified 64 residents with PD (inclusion criteria: MMSE >18)...
September 20, 2016: Journal of Parkinson's Disease
Bernd Brüggenjürgen, Frank Andersohn, Jörg Burkowitz, Nadja Ezzat, Maren Gaudig, Stefan N Willich
BACKGROUND: The individual and societal burden of Alzheimer's disease (AD) is substantial. Identifying relevant factors deteriorating AD and inducing need for nursing care would be of high relevance for healthcare planning. OBJECTIVE: The main objective of this study was the identification of predictors of first assignment of a level of long-term care in AD, used as an approximation for disease progression. METHODS: In a retrospective cohort study using data from a large German statutory health and long-term care insurance (SHI) company, co-morbidities and drug exposure were evaluated with respect to their predictive value for disease progression (first day the amount of daily nursing care exceeded 1...
September 17, 2016: Journal of Alzheimer's Disease: JAD
Susan Schwinn, Robin McKay, Shirley Dinkel, Bobbe Mansfield, Brooke Faria Da Cunha, Savanna Cummins, Krystal Brunin
PURPOSE: The purpose of this quality improvement project was to evaluate hypertension (HTN) management in patients 80 years of age and older who reside in a large, long-term care (LTC) facility. DATA SOURCE: A retrospective chart audit was conducted on 75 charts of patients 80 years of age and older and who had a diagnosis of HTN. Using the 2011 American College of Cardiology Foundation/American Heart Association (ACCF/AHA) Expert Consensus Document on Management of Hypertension in the Elderly as a guide, blood pressure readings, significant comorbidities, and antihypertensive medication utilization were analyzed...
September 23, 2016: Journal of the American Association of Nurse Practitioners
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