Electronic Health Record Implementation in Community Nursing Homes

2007 ◽  
Vol 8 (1) ◽  
pp. 31-34 ◽  
Author(s):  
G BRANDEIS ◽  
M HOGAN ◽  
M MURPHY ◽  
S MURRAY
Keyword(s):  
Nursing Homes ◽  
Electronic Health Record ◽  
Health Record ◽  
Community Nursing ◽  
Electronic Health

scholarly journals Description of antibiotic use variability among US nursing homes using electronic health record data

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Sarah Kabbani ◽  
Stanley W. Wang ◽  
Laura L. Ditz ◽  
Katryna A. Gouin ◽  
Danielle Palms ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Electronic Health Record ◽  
Antibiotic Use ◽  
Health Record ◽  
Short Stay ◽  
Prescribing Practices ◽  
Electronic Health ◽  
Facility Level ◽  
Tract Infections

Abstract Background: Antibiotics are frequently prescribed in nursing homes; national data describing facility-level antibiotic use are lacking. The objective of this analysis was to describe variability in antibiotic use in nursing homes across the United States using electronic health record orders. Methods: A retrospective cohort study of antibiotic orders for 309,884 residents in 1,664 US nursing homes in 2016 were included in the analysis. Antibiotic use rates were calculated as antibiotic days of therapy (DOT) per 1,000 resident days and were compared by type of stay (short stay ≤100 days vs long stay >100 days). Prescribing indications and the duration of nursing home-initiated antibiotic orders were described. Facility-level correlations of antibiotic use, adjusting for resident health and facility characteristics, were assessed using multivariate linear regression models. Results: In 2016, 54% of residents received at least 1 systemic antibiotic. The overall rate of antibiotic use was 88 DOT per 1,000 resident days. The 3 most common antibiotic classes prescribed were fluoroquinolones (18%), cephalosporins (18%), and urinary anti-infectives (9%). Antibiotics were most frequently prescribed for urinary tract infections, and the median duration of an antibiotic course was 7 days (interquartile range, 5–10). Higher facility antibiotic use rates correlated positively with higher proportions of short-stay residents, for-profit ownership, residents with low cognitive performance, and having at least 1 resident on a ventilator. Available facility-level characteristics only predicted a small proportion of variability observed (Model R2 version 0.24 software). Conclusions: Using electronic health record orders, variability was found among US nursing-home antibiotic prescribing practices, highlighting potential opportunities for targeted improvement of prescribing practices.

scholarly journals Experiences with the Liverpool care pathway for the dying patient in nursing home residents: a mixed-method study to assess physicians’ and nurse practitioners’ perceptions

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Maartje S. Klapwijk ◽  
Natashe Lemos Dekker ◽  
Monique A. A. Caljouw ◽  
Wilco P. Achterberg ◽  
Jenny T. van der Steen
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
Electronic Health Record ◽  
Nurse Practitioners ◽  
Care Pathway ◽  
Nursing Home Residents ◽  
Health Record ◽  
Electronic Health ◽  
Dying Patient

Abstract Background The Liverpool care pathway for the dying patient (LCP) is a multidisciplinary tool developed for the dying phase for use in palliative care settings. The literature reports divergent experiences with its application in a nursing home setting related to its implementation and staff competencies. The aim of this study is to understand how the LCP is being used in the context of the nursing home, including for residents with dementia, and experienced from the perspectives of those responsible for medical treatment in nursing homes. Methods A mixed-methods approach was used, consisting of a survey followed by interviews. A link to a 9-item online survey with closed and open-ended questions was emailed to all physicians and nurse practitioners of 33 care organisations with nursing homes in three regions of the Netherlands (North, West and South). In addition, 10 respondents with particularly positive or negative experiences were selected for semi-structured interviews. Results The survey was completed by 159 physicians and nurse practitioners. The respondents were very positive on the content and less positive on the use of the LCP, although they reported difficulties identifying the right time to start the LCP, especially in case of dementia. Also using the LCP was more complicated after the implementation of the electronic health record. The LCP was judged to be a marker of quality for the assessment of symptoms in the dying phase and communication with relatives. Conclusion An instrument that prompts regular assessment of a dying person was perceived by those responsible for (medical) care to contribute to good care. As such, the LCP was valued, but there was a clear need to start it earlier than in the last days or hours of life, a need for a shorter version, and for integration of the LCP in the electronic health record. Regular assessments with an instrument that focusses on quality of care and good symptom control can improve palliative care for nursing home residents with and without dementia.

Business: The Electronic Health Record: Front Line Experience

2011 ◽  
Vol 21 (1) ◽  
pp. 18-22
Author(s):  
Rosemary Griffin
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Electronic Health Record ◽  
Financial Incentives ◽  
Best Practice ◽  
Health Care Systems ◽  
The United States ◽  
Health Record ◽  
Health Trends ◽  
Electronic Health

National legislation is in place to facilitate reform of the United States health care industry. The Health Care Information Technology and Clinical Health Act (HITECH) offers financial incentives to hospitals, physicians, and individual providers to establish an electronic health record that ultimately will link with the health information technology of other health care systems and providers. The information collected will facilitate patient safety, promote best practice, and track health trends such as smoking and childhood obesity.

What Can Human Factors Contribute to Improve Electronic Health Record Usability and Patient Safety?

2012 ◽  
Author(s):  
Robert Schumacher ◽  
Robert North ◽  
Matthew Quinn ◽  
Emily S. Patterson ◽  
Laura G. Militello ◽  
...  
Keyword(s):  
Patient Safety ◽  
Human Factors ◽  
Electronic Health Record ◽  
Health Record ◽  
Electronic Health
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