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NH (nursing home)

Theresa I Shireman, Jessica Ogarek, Pedro Gozalo, Tingting Zhang, Vincent Mor, H Edward Davidson, Lisa Han, Monica Taljaard, Stefan Gravenstein
OBJECTIVES: Influenza is a leading cause of avoidable admissions for nursing home (NH) residents. We previously evaluated the effectiveness of a high-dose trivalent influenza vaccine (HD) compared to a standard-dose influenza vaccine (SD) through a cluster-randomized trial of NH residents. Fewer residents from facilities randomized to HD were hospitalized. In this article, we extend our analyses to consider direct medical care costs relative to vaccine costs for HD ($31.82/dose) as compared to SD ($12...
February 15, 2019: Journal of the American Medical Directors Association
Christine A Haynes, Cody N Dashiell-Earp, Neil S Wenger, Wendy M Simon, Samuel A Skootsky, Robin Clarke, Frances A Watts, Anne M Walling
BACKGROUND: Physician Orders for Life-Sustaining Treatment (POLST) can help ensure continuity of do-not-resuscitate (DNR) decisions and other care preferences after discharge from the hospital. OBJECTIVE: We aimed to improve POLST completion rates for patients with DNR orders who were being discharged to a nursing home (NH) after an acute hospitalization at our institution. DESIGN: We implemented an interprofessional quality improvement intervention involving education, communication skills, and nursing and case manager cues regarding POLST use...
February 14, 2019: Journal of Palliative Medicine
James A McKinnell, Raveena D Singh, Loren G Miller, Ken Kleinman, Gabrielle Gussin, Jiayi He, Raheeb Saavedra, Tabitha D Dutciuc, Marlene Estevez, Justin Chang, Lauren Heim, Stacey Yamaguchi, Harold Custodio, Shruti K Gohil, Steven Park, Steven Tam, Philip A Robinson, Thomas Tjoa, Jenny Nguyen, Kaye D Evans, Cassiana E Bittencourt, Bruce Y Lee, Leslie E Mueller, Sarah M Bartsch, John A Jernigan, Rachel B Slayton, Nimalie D Stone, Matthew Zahn, Vincent Mor, Kevin McConeghy, Rosa R Baier, Lynn Janssen, Kathleen O'Donnell, Robert A Weinstein, Mary K Hayden, Micaela H Coady, Megha Bhattarai, Ellena M Peterson, Susan S Huang
Background: Multidrug-resistant organisms (MDROs) spread between hospitals, nursing homes (NH), and long-term acute care facilities (LTACs) via patient transfers. SHIELD OC is a regional public health collaborative involving decolonization at 38 healthcare facilities selected based upon their high degree of patient sharing. We report baseline MDRO prevalence in 21 NH/LTACs. Methods: A random sample of 50 adults for 21 NH/LTACs (18 NHs, 3 LTACs) were screened for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp...
February 11, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Gudmund Ågotnes, Margaret J McGregor, Joel Lexchin, Malcolm B Doupe, Beatrice Müller, Charlene Harrington
Nursing home (NH) residents are increasingly in need of timely and frequent medical care, presupposing not only available but perhaps also continual medical care provision in NHs. The provision of this medical care is organized differently both within and across countries, which may in turn profoundly affect the overall quality of care provided to NH residents. Data were collected from official legislations and regulations, academic publications, and statistical databases. Based on this set of data, we describe and compare the policies and practices guiding how medical care is provided across Canada (2 provinces), Germany, Norway, and the United States...
2019: Health Services Insights
Torstein F Habiger, Wilco P Achterberg, Elisabeth Flo, Bettina S Husebo
OBJECTIVE: To investigate the characteristics of nursing home residents with psychosis and the association with potential underlying factors, such as pain, sleep disturbances, and antipsychotic medication. METHOD: 545 residents with and without dementia from 67 Norwegian nursing home units were included in the cross sectional analyses. Psychosis was the main outcome measure in our study; other outcome measures include quality of life (QoL), ADL function, cognitive function, pain, and antipsychotic medication...
January 31, 2019: International Journal of Geriatric Psychiatry
Lidiane Maria de Brito Macedo Ferreira, Karyna Myrelly Oliveira Bezerra de Figueiredo Ribeiro, Javier Jerez-Roig, José Rodolfo Torres Araújo, Kênio Costa de Lima
Recurrent falls constitute a high risk for morbidity and mortality among older people, especially institutionalized individuals, due to greater frailty and functional decline in this group. The aim of this study was to identify risk factors associated with recurrent falls among institutionalized older persons. A longitudinal cohort study was conducted over a one-year period with a study sample consisting of individuals aged 60 years and over living in 10 Nursing homes (NH) who were able to walk and had preserved cognitive ability...
January 2019: Ciência & Saúde Coletiva
Rüdiger Leutgeb, Sarah Jane Berger, Joachim Szecsenyi, Gunter Laux
OBJECTIVES: Demand for nursing home (NH) care is soaring due to gains in life expectancy and people living longer with chronic illness and disability. This is dovetailing with workforce shortages across the healthcare profession. Access to timely and appropriate medical care for NH residents is becoming increasingly challenging and can result in potentially avoidable hospitalisations (PAHs). In light of these factors, we analysed PAHs comparing NH patients with non-NH patients. DESIGN: Cross-sectional study with claims data from 2015 supplied by a large German health insurance company within the federal state of Baden-Wuerttemberg...
January 21, 2019: BMJ Open
Sabine E Lemoyne, Hanne H Herbots, Dennis De Blick, Roy Remmen, Koenraad G Monsieurs, Peter Van Bogaert
BACKGROUND: Elderly living in a Nursing Home (NH) are frequently transferred to an Emergency Department when they need acute medical care. A proportion of these transfers may be considered inappropriate and may be avoidable. METHODS: Systematic review. Literature search performed in September 2018 using PubMed, Web of Science, the Cochrane Library and the Cumulative Index to Nursing and Allied Health Literature database. Titles and abstracts were screened against inclusion and exclusion criteria...
January 21, 2019: BMC Geriatrics
XiaoMing Zhang, QingLi Dou, WenWu Zhang, CongHua Wang, XiaoHua Xie, YunZhi Yang, YingChun Zeng
OBJECTIVES: We performed a meta-analysis based on prospective cohort studies to synthesize the pooled risk effect and to determine whether frailty is a predictor of all-cause mortality. DESIGN: Systematic review and meta-analysis. SETTING: PubMed, EMBASE, and the Cochrane Library were systematically searched in October 2018. A random effects model was applied to combine the results according to the heterogeneity of the included studies. PARTICIPANTS: Older nursing home residents...
January 10, 2019: Journal of the American Medical Directors Association
Helen W Lach, Alicia J Lozano, Alexandra L Hanlon, Pamela Z Cacchione
OBJECTIVES: Fear of falling (FOF) causes excess disability in nursing home (NH) residents and is associated with vision and hearing impairment. We explored factors associated with FOF in 225 NH residents with vision, hearing or dual sensory impairment. METHODS: We explored age, gender, cognition, depression, social engagement, illness burden, falls, physical function, mobility, falls self-efficacy and outcome expectancy as predictors of FOF using univariate logistic regression modeling, followed by multivariate analysis by group (visual, hearing, dual, total sample)...
January 9, 2019: Aging & Mental Health
Brianne Olivieri-Mui, Jean McGuire, Sean Cahill, John Griffith, Becky Briesacher
As the number of persons living with HIV (PLWH) will continue to increase in the coming years, it is critical to understand factors influencing appropriate nursing home (NH) care planning. This study described the sociodemographic characteristics as well as the antiretroviral therapy treatment and physical and mental health among Medicare-eligible PLWH in NHs. Persons living with HIV were identified and summarized using a 2011-2013 nationwide data set of Medicare claims linked to NH resident health assessments and a prescription dispensing database, comparing new admissions in 2011-2013 with those from 1998 to 2000...
January 2019: Journal of the Association of Nurses in AIDS Care: JANAC
Margot L Schwartz, Julie C Lima, Melissa A Clark, Susan C Miller
CONTEXT: The Nursing Home (NH) culture change (CC) movement, which emphasizes person-centered care, is particularly relevant to meeting the unique needs of residents near the end-of-life (EOL). OBJECTIVES: We aimed to evaluate the NH-reported adoption of person-centered EOL-CC practices and identify NH characteristics associated with greater adoption. METHODS: We used NH and state policy data for 1,358 NHs completing a nationally representative 2016/17 NH Culture Change Survey...
December 19, 2018: Journal of Pain and Symptom Management
Andrew R Zullo, Tingting Zhang, Yoojin Lee, Kevin W McConeghy, Lori A Daiello, Douglas P Kiel, Vincent Mor, Sarah D Berry
BACKGROUND: Bisphosphonates are seldom used in frail, older adults, in part due to lack of direct evidence of efficacy in this population and increasing concerns about safety. OBJECTIVE: We estimated the effects of bisphosphonates on hip fractures, nonvertebral fractures, and severe esophagitis among frail, older adults. DESIGN: Population-based retrospective cohort using 2008 to 2013 linked national Minimum Data Set assessments; Online Survey Certification and Reporting System records; and Medicare claims...
December 21, 2018: Journal of the American Geriatrics Society
L M M de Pooter-Stijnman, S Vrijkotte, M Smalbrugge
Background and goal: Sleep problems and challenging behavioural symptoms are frequently reported among nursing home residents with dementia. Coffee with caffeine is consumed frequently by these residents and can have a negative effect on sleep and behaviour in older persons with dementia. In this interventional study, the effect of caffeine reduction on sleep and challenging behavioural symptoms in nursing home residents with dementia was investigated. Methods: In 21 nursing home residents with dementia living in 1 dementia special care unit, caffeine was gradually eliminated in the afternoon and evening...
2018: European Geriatric Medicine
C Ballard, J M Youakim, B Coate, S Stankovic
BACKGROUND: Pimavanserin is a 5-HT2A receptor inverse agonist/antagonist and is approved in the United States for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis. OBJECTIVE: Evaluate the efficacy of pimavanserin on symptoms of psychosis in patients with Alzheimer's disease (AD). DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Nursing home residents. PARTICIPANTS: Patients with AD psychosis...
2019: Journal of Prevention of Alzheimer's Disease
Irene Aasmul, Bettina S Husebo, Elizabeth L Sampson, Elisabeth Flo
Introduction: The majority of nursing home (NH) patients suffer from complex diseases, including dementia. This makes advance care planning (ACP) particularly important. Objectives: The aim was to investigate the effect of an ACP intervention on communication among NH staff, patient, and family. We further investigated whether the intervention affected nursing staff distress. Methods: The ACP intervention was a part of the 4-month cluster randomized controlled COSMOS trial with a 9-month follow-up. Norwegian NH units ( n = 72), with 765 patients were invited, and eligible units were cluster randomized to usual care or the intervention group...
2018: Frontiers in Psychology
Rebecka Maria Norman, Hilde Hestad Iversen, Ingeborg Strømseng Sjetne
Care workers' work environment is known to be associated with patient and nurse outcomes. To our knowledge no questionnaire is available for assessing this environment for all care workers in the Norwegian nursing-home setting. This paper describes the development, adaptation and assessment of such a questionnaire: the extended Norwegian version of the Brisbane Practice Environment Measure for Nursing Homes (B-PEM-NH). This version was developed and assessed using semistructured interviews, a reference group meeting, translation, adaptation, and pretesting, and psychometric assessment including exploratory and confirmatory factor analyses, and retest...
December 12, 2018: Geriatric Nursing
Tiba Delespierre, Loic Josseran
BACKGROUND: New nursing homes (NH) data warehouses fed from residents' medical records allow monitoring the health of elderly population on a daily basis. Elsewhere, syndromic surveillance has already shown that professional data can be used for public health (PH) surveillance but not during a long-term follow-up of the same cohort. OBJECTIVE: This study aimed to build and assess a national ecological NH PH surveillance system (SS). METHODS: Using a national network of 126 NH, we built a residents' cohort, extracted medical and personal data from their electronic health records, and transmitted them through the internet to a national server almost in real time...
December 13, 2018: JMIR Public Health and Surveillance
Sean Shenghsiu Huang, John R Bowblis
Background and Objectives: To examine whether nursing homes (NHs) provide better quality when unemployment rates rise (countercyclical) and explore mechanisms contributing to the relationship between quality and unemployment rates. Research Design and Methods: The study uses the data on privately owned, freestanding NHs in the continental United States that span a period from 2001 through 2015. The empirical analysis relies on panel fixed-effect regressions with the key independent variable being the county-level unemployment rate...
December 7, 2018: Gerontologist
Mona Diegelmann, Hans-Werner Wahl, Oliver K Schilling, Carl-Philipp Jansen, Eva-Luisa Schnabel, Klaus Hauer
Depressive symptoms are highly prevalent in nursing home (NH) residents. We assume that enjoyability, besides frequency of activities, is an important facet of expanded everyday activities (EEAs; Baltes et al., in: Baltes and Mayer (eds) The Berlin aging study, University of California Press, Berkeley, 2001) and affects residents' depressive symptoms. Furthermore, we assume that associations with depressive symptoms vary for different EEAs, namely contact with co-residents and staff and participation in organized in-home activities...
December 2018: European Journal of Ageing
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