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Long-term Care Settings (long-term + care_setting)
Selected AbstractsWill Psychiatry Survive in the Long-Term Care Setting?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2009Richard J. Goldberg MD No abstract is available for this article. [source] Computerized Physician Order Entry with Clinical Decision Support in the Long-Term Care Setting: Insights from the Baycrest Centre for Geriatric CareJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2005Paula A. Rochon MD Although computerized physician order entry (CPOE) has been successfully implemented in many acute care hospitals, few descriptions of its use in the long-term care (LTC) setting are available. This report describes the experiences of one LTC facility in developing and implementing a CPOE system with clinical decision support (CDS). Even when a facility has the necessary resources and "institutional will," many challenges are associated with the implementation of this application. The system was designed to meet the needs of healthcare providers in the LTC setting, in particular by informing prescribing decisions, reducing the frequency of prescribing and monitoring errors, and reducing adverse drug event rates. Based on experience adopting this technology early, 10 insights are offered that it is hoped will assist others who are considering the implementation of CPOE systems with CDS in the LTC setting. [source] Evidence-Based Recommendations for the Assessment and Management of Sleep Disorders in Older PersonsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2009AGSF, Harrison G. Bloom MD Sleep-related disorders are most prevalent in the older adult population. A high prevalence of medical and psychosocial comorbidities and the frequent use of multiple medications, rather than aging per se, are major reasons for this. A major concern, often underappreciated and underaddressed by clinicians, is the strong bidirectional relationship between sleep disorders and serious medical problems in older adults. Hypertension, depression, cardiovascular disease, and cerebrovascular disease are examples of diseases that are more likely to develop in individuals with sleep disorders. Conversely, individuals with any of these diseases are at a higher risk of developing sleep disorders. The goals of this article are to help guide clinicians in their general understanding of sleep problems in older persons, examine specific sleep disorders that occur in older persons, and suggest evidence- and expert-based recommendations for the assessment and treatment of sleep disorders in older persons. No such recommendations are available to help clinicians in their daily patient care practices. The four sections in the beginning of the article are titled, Background and Significance, General Review of Sleep, Recommendations Development, and General Approach to Detecting Sleep Disorders in an Ambulatory Setting. These are followed by overviews of specific sleep disorders: Insomnia, Sleep Apnea, Restless Legs Syndrome, Circadian Rhythm Sleep Disorders, Parasomnias, Hypersomnias, and Sleep Disorders in Long-Term Care Settings. Evidence- and expert-based recommendations, developed by a group of sleep and clinical experts, are presented after each sleep disorder. [source] Nurses' Perceptions of Safety Culture in Long-Term Care SettingsJOURNAL OF NURSING SCHOLARSHIP, Issue 2 2009Laura M. Wagner RN Abstract Purpose: To describe perceptions of workplace safety culture among nurses employed in long-term care (LTC) settings. Design: A cross-sectional survey. Respondents were licensed nurses (N=550) with membership in gerontological nursing professional organizations in the United States (n=296), Canada (n=251), and other (n=3). Methods: An anonymous, self-administered, mail-in questionnaire, which included the Hospital Survey on Patient Safety Culture as well as questions about individual and institutional characteristics. The survey included key aspects of safety culture, such as work setting, supervisor support, communication about errors, and frequency of events reported. Findings: Nurse-managers reported significantly more positive safety culture perceptions compared with licensed staff nurses. Additionally, licensed nurses employed in government-run facilities had significantly less positive safety culture perceptions compared with those working in nonprofit organizations. Conclusions: Interventions designed to improve safety culture in LTC settings should be focused on the concerns of licensed staff nurses and the improvement of communication between these nurses and their managers. Clinical Relevance: Enhancing safety culture in long-term care settings may facilitate improvements in resident safety. Assessment of workplace safety culture is the first step in identifying barriers that nurses face to provide safe resident care. [source] Nutritional status and health outcomes for older people with dementia living in institutionsJOURNAL OF ADVANCED NURSING, Issue 5 2007Meei-Fang Lou Abstract Title.,Nutritional status and health outcomes for older people with dementia living in institutions Aim., This paper is a report of a study to determine changes over a 3-month period among older people with dementia living in long-term care settings, related to: (1) changes in body mass index, and (2) health outcomes and associated factors. Background., Nutritional deficiencies are common problems among older people, but frequently unrecognized, both in long-term care settings and in the community. Method., A cross-sectional design with repeated measures of body weights and medical record reviews was adopted. The study was conducted in 2003 in two long-term care facilities for older people with dementia in Taiwan. Fifty-five residents participated in the study. Results., Eighteen percent of the residents were under-nourished (body mass index <18·5). There was a trend toward decreasing body mass index over the 3-month study period. Residents with low body mass index tended to need assistance at mealtimes. Nineteen residents, many receiving naso-gastric tube-feeding, experienced adverse health events during the study period. Dependency in eating was the major factor differentiating residents with normal or low body mass index values, and also in distinguishing those who experienced adverse health outcomes. Conclusion., Assessment of eating ability, mode of feeding and measurement of body weight can be used by nurses in long-term care settings for early identification of the nutritional status of older people with dementia. [source] Measuring Physical and Social Environments in Nursing Homes for People with Middle- to Late-Stage DementiaJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2006MSc(A), Susan Slaughter RN OBJECTIVES: To evaluate measures of dementia care environments by comparing a special care facility (SCF) with traditional institutional facilities (TIFs). DESIGN: A cross-sectional comparative study of nursing home environments conducted as part of a longitudinal study on quality of life for residents with dementia. SETTING: Twenty-four traditional nursing homes and one special care facility. PARTICIPANTS: One SCF with six distinct environments, 24 TIFs with 45 distinct environments, and 88 family members. MEASUREMENTS: Therapeutic Environment Screening Scale,2+ (TESS-2+); Special Care Unit Environmental Quality Scale (SCUEQS), a subset of the TESS-2+ items; Composite Above Average Quality Score (CAAQS), a composite score of all items on the TESS-2+; and Models of Care Instrument (MOCI). RESULTS: The SCUEQS did not detect a significant difference between the SCF and the TIFs (30.0 vs 27.2, P=.28). The CAAQS detected a significant difference between the SCF and the TIFs, whereby the SCF environments were rated as having above-average quality in 71.4% of the domains, compared with 57.3% for the TIF environments (95% confidence interval (CI) for difference=2.6,25.6%, P=.02). Using the MOCI, SCF families were 1.8 times as likely to rate the SCF as a home or resort versus a hospital as TIF families rating TIFs (95% CI for odds ratio=1.5,2.1, P<.001). CONCLUSION: The TESS-2+ CAAQS differentiated between physical environments better than the more established SCUQES. The MOCI distinguished between environments using a more holistic approach to measurement. The availability of environmental measures that are able to discriminate between specialized and traditional long-term care settings will facilitate future outcome-based research. [source] Commentary on Sung H-C, Chang S-M & Tsai C-S (2005) Working in long-term care settings for older people with dementia: nurses' aides.JOURNAL OF CLINICAL NURSING, Issue 11 2006Journal of Clinical Nursing 1 [source] Nurses' Perceptions of Safety Culture in Long-Term Care SettingsJOURNAL OF NURSING SCHOLARSHIP, Issue 2 2009Laura M. Wagner RN Abstract Purpose: To describe perceptions of workplace safety culture among nurses employed in long-term care (LTC) settings. Design: A cross-sectional survey. Respondents were licensed nurses (N=550) with membership in gerontological nursing professional organizations in the United States (n=296), Canada (n=251), and other (n=3). Methods: An anonymous, self-administered, mail-in questionnaire, which included the Hospital Survey on Patient Safety Culture as well as questions about individual and institutional characteristics. The survey included key aspects of safety culture, such as work setting, supervisor support, communication about errors, and frequency of events reported. Findings: Nurse-managers reported significantly more positive safety culture perceptions compared with licensed staff nurses. Additionally, licensed nurses employed in government-run facilities had significantly less positive safety culture perceptions compared with those working in nonprofit organizations. Conclusions: Interventions designed to improve safety culture in LTC settings should be focused on the concerns of licensed staff nurses and the improvement of communication between these nurses and their managers. Clinical Relevance: Enhancing safety culture in long-term care settings may facilitate improvements in resident safety. Assessment of workplace safety culture is the first step in identifying barriers that nurses face to provide safe resident care. [source] Occupational injuries among aides and nurses in acute care,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2009R.L. Rodríguez-Acosta PhD Abstract Background Occupational injuries are common among nursing personnel. Most epidemiologic research on nursing aides comes from long-term care settings. Reports from acute care settings often combine data on nurses and aides even though their job requirements and personal characteristics are quite different. Our objective was to assess risk of work-related injuries in an acute care setting while contrasting injuries of aides and nurses. Methods A retrospective cohort of aides (n,=,1,689) and nurses (n,=,5,082) working in acute care at a large healthcare system between 1997 and 2004 were identified via personnel records. Workers' compensation filings were used to ascertain occupational injuries. Poisson regression was used to estimate rate ratios (RR) and 95% confidence intervals (95% CI). Results Aides had higher overall injury rates than nurses for no-lost work time (RR,=,1.2, 95% CI: 1.1,1.3) and lost work time (RR,=,2.8, 95% CI: 2.1,3.8) injuries. The risk of an injury due to lifting was greater among aides compared to nurses for both non-lost work time and lost work time injuries. Injury rates among aides were particularly high in rehabilitation and orthopedics units. Most of the injuries requiring time away from work for both groups were related to the process of delivering direct patient care. Conclusions Our findings illustrate the importance of evaluating work-related injuries separately for aides and nurses, given differences in injury risk profiles and injury outcomes. It is particularly important that occupational safety needs of aides be addressed as this occupation experiences significant job growth. Am. J. Ind. Med. 52:953,964, 2009. © 2009 Wiley-Liss, Inc. 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