Appropriate Nursing Home Nurse Hours per Resident Day in Korea: A Secondary Analysis of Longitudinal Data

2019 ◽  
Vol 51 (5) ◽  
pp. 569-579 ◽  
Author(s):  
Juh Hyun Shin
Keyword(s):  
Nursing Home ◽  
Longitudinal Data ◽  
Secondary Analysis ◽  
Home Nurse

scholarly journals Impact of Roommates on MDRO Spread in Nursing Homes

2020 ◽  
Vol 41 (S1) ◽  
pp. s66-s67
Author(s):  
Gabrielle M. Gussin ◽  
Ken Kleinman ◽  
Raveena D. Singh ◽  
Raheeb Saavedra ◽  
Lauren Heim ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Multidrug Resistant ◽  
Healthcare Intervention ◽  
Odds Ratios ◽  
Care Needs ◽  
Environmental Cleaning ◽  
The Impact

Background: Addressing the high burden of multidrug-resistant organisms (MDROs) in nursing homes is a public health priority. High interfacility transmission may be attributed to inadequate infection prevention practices, shared living spaces, and frequent care needs. We assessed the contribution of roommates to the likelihood of MDRO carriage in nursing homes. Methods: We performed a secondary analysis of the SHIELD OC (Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, CA) Project, a CDC-funded regional decolonization intervention to reduce MDROs among 38 regional facilities (18 nursing homes, 3 long-term acute-care hospitals, and 17 hospitals). Decolonization in participating nursing homes involved routine chlorhexidine bathing plus nasal iodophor (Monday through Friday, twice daily every other week) from April 2017 through July 2019. MDRO point-prevalence assessments involving all residents at 16 nursing homes conducted at the end of the intervention period were used to determine whether having a roommate was associated with MDRO carriage. Nares, bilateral axilla/groin, and perirectal swabs were processed for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CRE). Generalized linear mixed models assessed the impact of maximum room occupancy on MDRO prevalence when clustering by room and hallway, and adjusting for the following factors: nursing home facility, age, gender, length-of-stay at time of swabbing, bedbound status, known MDRO history, and presence of urinary or gastrointestinal devices. CRE models were not run due to low counts. Results: During the intervention phase, 1,451 residents were sampled across 16 nursing homes. Overall MDRO prevalence was 49%. In multivariable models, we detected a significant increasing association of maximum room occupants and MDRO carriage for MRSA but not other MDROs. For MRSA, the adjusted odds ratios for quadruple-, triple-, and double-occupancy rooms were 3.5, 3.6, and 2.8, respectively, compared to residents in single rooms (P = .013). For VRE, these adjusted odds ratios were 0.3, 0.3, and 0.4, respectively, compared to residents in single rooms (P = NS). For ESBL, the adjusted odds ratios were 0.9, 1.1, and 1.5, respectively, compared to residents in single rooms (P = nonsignificant). Conclusions: Nursing home residents in shared rooms were more likely to harbor MRSA, suggesting MRSA transmission between roommates. Although decolonization was previously shown to reduce MDRO prevalence by 22% in SHIELD nursing homes, this strategy did not appear to prevent all MRSA transmission between roommates. Additional efforts involving high adherence hand hygiene, environmental cleaning, and judicious use of contact precautions are likely needed to reduce transmission between roommates in nursing homes.Funding: NoneDisclosures: Gabrielle M. Gussin, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

A Secondary Analysis of the Intensity of Hospice Visits Among Medicare Decedents in the Last Seven Days of Life by Place of Residence

2021 ◽  
pp. 104990912110648
Author(s):  
Pauline Karikari-Martin ◽  
Lirong Zhao ◽  
Lynn Miescier
Keyword(s):  
Nursing Home ◽  
Retrospective Analysis ◽  
Social Worker ◽  
Assisted Living ◽  
Secondary Analysis ◽  
Place Of Residence ◽  
Assisted Living Facility ◽  
Payment Policy ◽  
Medicare Data

Background In 2016, Medicare finalized the Service Intensity Add-on (SIA) payment policy to increase the intensity of hospice registered nurse (RN) or social worker (SW) visits in the last 7 days of life. The research objective was to compare the intensity of hospice RN or SW visits in the last 7 days of life among older decedents who received a hospice visit, while residing in a traditional home, an assisted living facility, or long-term nursing home. Methods A retrospective analysis using 2016-2018 Medicare data of decedents 65 years or older (n= 2 067 863) related to the Medicare SIA payment policy. Intensity was defined as the number and duration of hospice RN or SW visits in the last 7 days of life using Medicare claims code G0299 and G0155. Results Regression results suggest that decedents who received a SIA related visit while residing in an assisted living facility, had on average a slightly longer duration of hospice RN visits in the last 7 days of life, compared to decedents residing in a traditional home, after controlling for demographics and other factors (P<.0001). The duration of hospice RN visits remained unchanged among decedents who received a SIA visit in 2017 or 2018, when compared to 2016 (P <.0001). Overall the average number of hospice SW visits did not differ by place of residence among decedents who received a SIA visit. Conclusions Among decedents who received a SIA related visit, the duration of hospice RN visits were slightly different by place of residence.

scholarly journals What nursing home environment can maximise eating independence among residents with cognitive impairment? Findings from a secondary analysis

2020 ◽  
Vol 41 (6) ◽  
pp. 709-716
Author(s):  
Alvisa Palese ◽  
Silvia Gonella ◽  
Luca Grassetti ◽  
Melania Longobardi ◽  
Alessandro De Caro ◽  
...  
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Home Environment ◽  
Secondary Analysis

Effectiveness of laptop-based versus smartphone-based videoconferencing interaction on loneliness, depression and social support in nursing home residents: A secondary data analysis

2020 ◽  
pp. 1357633X2097200
Author(s):  
Hsiu-Hsin Tsai ◽  
Ching-Yu Cheng ◽  
Wann-Yun Shieh
Keyword(s):  
Social Support ◽  
Nursing Home ◽  
Depressive Symptoms ◽  
Data Analysis ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Secondary Data ◽  
Confounding Variables ◽  
Generalised Estimating Equations ◽  
Small Screen

Introduction The worldwide coronavirus disease 2019 pandemic re-emphasises the importance of Internet videoconferencing in supporting interactions between nursing home residents and their family and friends. However, there is a scarcity of comparative studies on how modalities of conferencing programs impact health outcomes. The purpose of this study was to compare laptop-based with smartphone-based videoconferencing programs on nursing home residents’ perceptions of loneliness, depressive symptoms and social support. Methods This retrospective secondary analysis used data from two previous studies on the effectiveness of videoconferencing programs (laptop-based and smartphone-based) to improve outcomes of loneliness, depressive symptoms and social support (type and source) among nursing home residents. Generalised estimating equations compared differences from baseline measures with measures at 1 and 3 months between the two groups with and without adjusting for the effects of confounding variables. Results With the exception of age, there were no differences in demographics between participants in the laptop and smartphone groups. Neither changes from baseline in mean scores for loneliness nor depressive symptoms differed between groups. However, changes in mean scores from baseline between groups were significantly greater in the smartphone-based group compared with the laptop-based group for three types of social support: informational and appraisal at 1 and 3 months; and emotional at 3 months. Changes from baseline in mean scores for social support from friends (at 1 and 3 months) and other sources (at 3 months) were also significantly greater for the smartphone group compared with the laptop group. Discussion The two modalities of videoconferencing did not differ in effects on depressive symptoms or loneliness. However, smartphones had a greater effect on the type and source of social support compared with laptops. Whether the small screen of a smartphone reduces users’ anxiety and allows them to talk more on screen is worth studying.

Psychometric Properties of the Ambulatory Surgery Index of Nausea, Vomiting, and Retching

2016 ◽  
Vol 24 (3) ◽  
pp. 454-464
Author(s):  
Jan Odom-Forren ◽  
Lynne A. Hall ◽  
Susan J. Fetzer
Keyword(s):  
Quality Of Life ◽  
Factor Analysis ◽  
Longitudinal Data ◽  
Psychometric Properties ◽  
Ambulatory Surgery ◽  
Recovery Period ◽  
Secondary Analysis ◽  
Valid Measure ◽  
Future Studies

Background and Purpose: At least one-third of ambulatory surgery patients will experience nausea or vomiting during the recovery period. The purpose of this study was to examine the psychometric properties of the Ambulatory Surgery Index of Nausea, Vomiting, and Retching (AS-INVR). Methods: Secondary analysis of longitudinal data from a study of 203 adult ambulatory surgery patients was conducted. Results: Based on the results of factor analysis, the retching item was eliminated and the 6-item, 2-dimensional AS-INV was formed. Cronbach’s alphas for the AS-INV ranged from .83 to .87 across the 5 days postsurgery. Higher AS-INV scores were associated with self-reported presence of nausea and lower quality of life. Conclusions: The shortened AS-INV provides a reliable and valid measure of the amount and distress because of nausea and vomiting in adult patients after ambulatory surgery and should be considered for use in future studies.

scholarly journals Older Emergency Department Patients: Does Baseline Care Status Matter?

2020 ◽  
Vol 23 (4) ◽  
pp. 289-296
Author(s):  
Fabrice Immanuel Mowbray ◽  
Komal Aryal ◽  
Eric Mercier ◽  
George Heckman ◽  
Andrew P. Costa
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Nursing Home ◽  
Home Care ◽  
Support Services ◽  
Service Use ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Post Discharge ◽  
Formal Support

Background Little is known about the prognostic differences between older emergency department (ED) patients who present with different formal support requirements in the community. We set out to describe and compare the patient profiles and patterns of health service use among three older ED cohorts: home care clients, nursing home residents and those receiving no formal support. Methods We conducted a secondary analysis of the Canadian cohort from the interRAI multinational ED study. Data were collected using interRAI ED contact assessment on patients 75 years of age and older (n = 2,274), in eight ED sites across Canada. A series of descriptive statistics were reported. Adjusted as­sociations were determined using logistic regression. Results Older adults receiving no formal support services were most stable. However, they were most likely to be hospitalized. Older home care clients were most likely to report depressive symptoms and distressed caregivers. They also had the great­est odds of frequent ED visitation post-discharge (OR=1.9; 95% CI=1.39–2.59). Older adults transferred from a nursing home were the frailest but had the lowest odds of hospital admission (OR=0.14; 95% CI=0.09–0.23). Conclusion We demonstrated the importance of inquiring about commu­nity-based formal support services and provide data to support decision-making in the ED.  

scholarly journals A National Assessment of Access to Technology Among Nursing Home Residents: A Secondary Analysis (Preprint)

2018 ◽  
Author(s):  
Kimberly Ryan Powell ◽  
Gregory Lynn Alexander ◽  
Richard Madsen ◽  
Chelsea Deroche
Keyword(s):  
Information Technology ◽  
Nursing Home ◽  
Nursing Homes ◽  
Health Information ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Patient Portals ◽  
Health Records ◽  
Access To Technology ◽  
Electronic Health

BACKGROUND According to the National Center for Health Statistics, there are over 1.7 million nursing home residents in the United States. Nursing home residents and their family members have unique needs and stand to benefit from using technology empowering them to be more informed and engaged health care consumers. Although there is growing evidence for benefits of patient-facing technologies like electronic patient portals on patient engagement in acute and outpatient settings, little is known about use of this technology in nursing homes. OBJECTIVE The purpose of this study was to report findings from a secondary analysis of data from a national nursing home study of information technology (IT) adoption, called IT sophistication. We describe the extent to which nursing homes (n=815) allow residents or their representatives to access technology including electronic health records, patient portals, and health information-exchange systems as well as the ability of the residents or representatives to self-report data directly into the electronic health record. METHODS We used descriptive statistics and regression techniques to explore relationships between information technology adoption (IT sophistication) and residents’ or their representatives’ access to technology. Covariates of location, bed size, and ownership were added to the model to understand their potential influence on the relationship between IT sophistication and resident access to technology. RESULTS Findings revealed that resident access to technology was a significant predictor of the nursing home IT sophistication (P<.001). The inclusion of covariates—nursing home location, bed size, and ownership—with their interactions produced a nonsignificant effect in the model. Residents’ or their representatives’ use of electronic health records and personal health records were both significant predictors of overall IT sophistication (P<.001). CONCLUSIONS As nursing homes continue to progress in technological capabilities, it is important to understand how increasing IT sophistication can be leveraged to create opportunities to engage residents in their care. Understanding the impact of health information technology on outcomes and which technologies make a difference will help nursing home administrators make more informed decisions about adoption and implementation.

Progression of Eye Disorders in a Nursing Home

1997 ◽  
Vol 91 (6) ◽  
pp. 571-578 ◽  
Author(s):  
M.S. Marx ◽  
P. Werner ◽  
R.C. Feldman ◽  
J. Cohen-Mansfield
Keyword(s):  
Visual Acuity ◽  
Nursing Home ◽  
Longitudinal Data ◽  
Macular Degeneration ◽  
Nursing Home Residents ◽  
Corrected Visual Acuity ◽  
Eye Disorders ◽  
Best Corrected Visual Acuity

This study of the progression of eye pathology in 100 nursing home residents found that the amount of eye pathology (cataracts, macular degeneration, and glaucoma) was high and increased from Time 1 to Time 2 (mean interval = 315 days) and that the increases in cataracts and macular degeneration were statistically significant. Also, the residents’ best-corrected visual acuity dropped significantly from Time 1 to Time 2. These longitudinal data indicate the importance of routine assessments to detect changes in the vision of elderly residents.

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