A Two Year Follow up of Nutrition Status Among Veterans in a Nursing Home Setting: The Impact on Mortality

2012 ◽  
Vol 13 (3) ◽  
pp. B20
Author(s):  
Douglas Faulder ◽  
Anne-Marie Boström ◽  
Deanna Van Soest ◽  
Betty Kolewaski ◽  
Douglas Faulder ◽  
...  
2018 ◽  
Vol 39 (6) ◽  
pp. 683-687 ◽  
Author(s):  
Lisa Pineles ◽  
Chris Petruccelli ◽  
Eli N. Perencevich ◽  
Mary-Claire Roghmann ◽  
Kalpana Gupta ◽  
...  

OBJECTIVETo directly observe healthcare workers in a nursing home setting to measure frequency and duration of resident contact and infection prevention behavior as a factor of isolation practiceDESIGNObservational studySETTING AND PARTICIPANTSHealthcare workers in 8 VA nursing homes in Florida, Maryland, Massachusetts, Michigan, Washington, and TexasMETHODSOver a 15-month period, trained research staff without clinical responsibilities on the units observed nursing home resident room activity for 15–30-minute intervals. Observers recorded time of entry and exit, isolation status, visitor type (staff, visitor, etc), hand hygiene, use of gloves and gowns, and activities performed in the room when visible.RESULTSA total of 999 hours of observation were conducted across 8 VA nursing homes during which 4,325 visits were observed. Residents in isolation received an average of 4.73 visits per hour of observation compared with 4.21 for nonisolation residents (P<.01), a 12.4% increase in visits for residents in isolation. Residents in isolation received an average of 3.53 resident care activities per hour of observation, compared with 2.46 for residents not in isolation (P<.01). For residents in isolation, compliance was 34% for gowns and 58% for gloves. Healthcare worker hand hygiene compliance was 45% versus 44% (P=.79) on entry and 66% versus 55% (P<.01) on exit for isolation and nonisolation rooms, respectively.CONCLUSIONSHealthcare workers visited residents in isolation more frequently, likely because they required greater assistance. Compliance with gowns and gloves for isolation was limited in the nursing home setting. Adherence to hand hygiene also was less than optimal, regardless of isolation status of residents.Infect Control Hosp Epidemiol 2018;39:683–687


2019 ◽  
Vol 5 ◽  
pp. 233372141989745 ◽  
Author(s):  
Oonagh M. Giggins ◽  
Julie Doyle ◽  
Ken Hogan ◽  
Mable George

Purpose: Achieving adequate levels of illumination to stimulate the circadian system can be difficult in a nursing home. The aim of this study was to examine the impact that a 4-week cycled lighting intervention had on activity, sleep, and mood in older adults living in a nursing home. Patients and methods: Ten residents were given an activity monitor to objectively measure activity and sleep, and subjective mood scores were also recorded during the study period. The cycled lighting intervention was designed to mimic normal natural daylight. Results: Some participants responded positively to the lighting intervention showing improvements in activity levels, sleep, and mood, while others showed no change or a continued decline. Conclusion: Although the results are inconclusive, a cycled lighting intervention remains a potentially promising intervention in the nursing home setting. Further studies with more robust measurements and a larger, more homogeneous cohort are required to investigate this further.


1990 ◽  
Vol 11 (1) ◽  
pp. 13-16 ◽  
Author(s):  
Jean E. Cederna ◽  
Margaret S. Terpenning ◽  
Mark Ensberg ◽  
Suzanne F. Bradley ◽  
Carol A. Kauffman

AbstractRecent reports have emphasized an increase in both infection and colonization with methicillin-resistantStaphylococcus aureus(MRSA) in institutionalized older patients. We studied whether or not local treatment with mupirocinointment could eliminate nasal colonization with S aureus. A total of 102 patients in a Veterans Administration nursing home were screened for Saureusnasal colonization. Thirty-nine patients (38.2%) were colonized, 18 with methicillin-sensitive Saureus (MSSA) and 21 with MRSA. Almost half of all colonized patients were in the most dependent functional category and there was a significant association of MRSA colonization, but not MSSA colonization, with poor functional status. Colonized patients were treated with mupirocin ointment applied to the anterior nares twice daily for seven days. After treatment, MSSA persisted in only two patients and MRSA in only one patient; thus, nasal colonization was eliminated in 91.4% of colonized patients. At one month and two months follow-up, 11 patients became transiently recolonized and three became persistently recolonized with Saureus. Mupirocin was well tolerated with no side effects noted. Mupirocin ointment may be useful in controlling nasal colonization with S aureus in the nursing home setting.


2020 ◽  
Author(s):  
Kerstin Hämel ◽  
Gundula Röhnsch

Abstract Background and Objectives In integrated daycare, community-dwelling older people in need of care join existing groups in residential care facilities during the day. This study focuses on how nursing home residents experience the integrative care approach, exploring opportunities for social inclusion and mechanisms of exclusion. Research Design and Methods A purposive sample of residents differing in cognitive capacity and level of (non)conflictual interaction with daycare guests was selected. Episodic interviews with residents (N = 10) and close relatives (N = 2) were conducted in 3 pilot facilities in Germany and analyzed using thematic coding. Results The analysis revealed different orientation patterns towards the presence of daycare guests: respondents (a) demonstrated indifference to the daycare guests, (b) saw bonding with guests as a means to connect to the outside world, and (c) perceived incompatibility between in-group and out-group. Criticisms included disruption of daily routines and loss of privacy. Most interviewees came to terms with the care situation using rational and moral arguments. Discussion and Implications The study reveals the importance of residents’ participation when integrating daycare guests. Institutional procedures are required to prevent exclusion of daycare guests and avoid overtaxing residents.


Author(s):  
Carlota Gonzalvo ◽  
Kim Hurkens ◽  
Hugo de Wit ◽  
Brigit van Oijen ◽  
Rob Janknegt ◽  
...  

2017 ◽  
Author(s):  
Susie Donnelly ◽  
Brenda Reginatto ◽  
Oisin Kearns ◽  
Marie Mc Carthy ◽  
Bill Byrom ◽  
...  

BACKGROUND Despite an aging population, older adults are typically underrecruited in clinical trials, often because of the perceived burden associated with participation, particularly travel associated with clinic visits. Conducting a clinical trial remotely presents an opportunity to leverage mobile and wearable technologies to bring the research to the patient. However, the burden associated with shifting clinical research to a remote site requires exploration. While a remote trial may reduce patient burden, the extent to which this shifts burden on the other stakeholders needs to be investigated. OBJECTIVE The aim of this study was to explore the burden associated with a remote trial in a nursing home setting on both staff and residents. METHODS Using results from a grounded analysis of qualitative data, this study explored and characterized the burden associated with a remote trial conducted in a nursing home in Dublin, Ireland. A total of 11 residents were recruited to participate in this trial (mean age: 80 years; age range: 67-93 years). To support research activities, we also recruited 10 nursing home staff members, including health care assistants, an activities co-ordinator, and senior nurses. This study captured the lived experience of this remote trial among staff and residents and explored the burden associated with participation. At the end of the trial, a total of 6 residents and 8 members of staff participated in semistructured interviews (n=14). They reviewed clinical data generated by mobile and wearable devices and reflected upon their trial-related experiences. RESULTS Staff reported extensive burden in fulfilling their roles and responsibilities to support activities of the trial. Among staff, we found eight key characteristics of burden: (1) comprehension, (2) time, (3) communication, (4) emotional load, (5) cognitive load, (6) research engagement, (7) logistical burden, and (8) product accountability. Residents reported comparatively less burden. Among residents, we found only four key characteristics of burden: (1) comprehension, (2) adherence, (3) emotional load, and (4) personal space. CONCLUSIONS A remote trial in a nursing home setting can minimize the burden on residents and enable inclusive participation. However, it arguably creates additional burden on staff, particularly where they have a role to play in locally supporting and maintaining technology as part of data collection. Future research should examine how to measure and minimize the burden associated with data collection in remote trials.


1988 ◽  
Vol 7 (3) ◽  
pp. 331-349 ◽  
Author(s):  
Nathan L. Linsk ◽  
Baila Miller ◽  
Roberta Pflaum ◽  
Anna Ortigara-Vicik

The Alzheimer's Disease Family Care Center program was established within an intermediate care teaching nursing home as a demonstration program to investigate ways to involve families in care of their relatives. In total, 45 family members participated in a program including an orientation session; a preliminary family involvement interview; contracts with family members, in which they chose specific tasks to engage in during visits; a five-session course on Alzheimer's disease and how families may be partners in care within the facility; and an ongoing family support group. Evaluation data sources include a baseline and 9-month follow-up questionnaire completed by families, preliminary and follow-up family interviews conducted by project codirectors, records of family visits, and family choices on contracts. Findings from the 23 family members who contracted for tasks during their visits and from the follow-up questionnaire completed by 25 family members showed that most sought social and emotional interactions with relatives, some maintained direct personal care activities, and only a few identified interest in extensive involvement with staff and facility. At follow-up, family members involved in the program reported they continued to feel close to their relatives. Many felt that their relatives were generally stable or improved with regard to cognitive function, but over a third noted difficulties in communicating. Participating family members reported that the program of staff supports helped them to feel more integral to the unit. They expressed a need for more education and support for their involvement in the nursing home setting. Project findings confirm previous studies recommending that programming at nursing homes needs to include specific institutional and staff supports to maintain and enhance family contributions to the long-term nursing home care of their relatives.


2018 ◽  
Vol 27 (7-8) ◽  
pp. 1452-1463 ◽  
Author(s):  
Bridget Laging ◽  
Amanda Kenny ◽  
Michael Bauer ◽  
Rhonda Nay

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