The relationship between financial performance and quality of care in nursing homes is not well defined and prior work has been mixed. The recent focus on improving the quality of nursing homes through market-based incentives such as public reporting may have changed this relationship, as public reporting provides nursing homes ...

To test the effectiveness of an integrative psychotherapeutic nursing home program (integrative reactivation and rehabilitation [IRR]) to reduce multiple neuropsychiatry symptoms (MNPS) of cognitively impaired patients and caregiver burden (CB). Randomized controlled trial. Psychiatric-skilled nursing home (IRR) and usual care (UC), consisting of different types of nursing home care at ...

We investigated the frequency with which home care/hospice nurses are provided with and use personal protective equipment (PPE) and factors associated with use. We conducted a mail survey among home care/hospice nurses in North Carolina in 2006. The adjusted response rate was 69% (n = 833). Between 68% and 86% ...

Scand J Caring Sci; 2011; 25; 117-125 General practitioners' reasoning about using mobile distance-spanning technology in home care and in nursing home care The trend for health care and nursing care turns from hospital to health care and nursing care at home. Studies have shown that health care professionals have ...

It appears that the implementation and use of a bedside electronic medical record in nursing homes can be a strategy to improve quality of care. Staff like using the bedside electronic medical record and believe it is beneficial. Information gleaned from this qualitative evaluation of four nursing homes that implemented ...

To explore the nature of relationships between nurses and older people within the home and to illuminate the nature and quality of caring boundaries within this setting. Older people are increasingly receiving nursing care in the home. There has been little exploration of the nature of the nurse-older patient relationship ...

In the course of reformation of the health-care system the impact of measuring the quality of life steadily rises. The current study reports the disease-comprehensive quality of life of the elderly who live in nursing homes and compares these results with the reference value of the German population. Furthermore, the ...

the H1N1 (subtype hemagglutinin 1 neuraminidase 1) influenza pandemic of 2009 was associated with a large increase in demand for primary care office visits. However, many patients with H1N1 symptoms or exposure could be assessed and treated with telephone protocols. specific H1N1 influenza telephone protocols were developed by Mayo Clinic ...

For hospitals, standards for the required number of infection control personnel are outdated and disputed. Such standards are not even available for long-term care and geriatric rehabilitation facilities (ie, nursing homes). This study addressed the question of how much time nursing homes should spend on infection control. Through group discussions ...

To review the risk factors, etiologic profile, treatment approaches, and guidelines for the management of nursing home-acquired pneumonia (NHAP). A search of the current literature was conducted using the MEDLINE and Embase databases. This search, limited to studies performed in humans and published in English between January 1, 1990 and ...

This concurrent mixed-method study examines the nurse work environment of high-quality Medicare-certified home health agencies. High-quality (n = 6) and low-quality (n = 6) home health agencies were recruited using agency-level publicly reported patient outcomes. Direct care registered nurses (RNs) from each agency participated in a focus group and completed ...

This study investigates efficiency and quality of care in nursing homes. By means of Data Envelopment Analysis (DEA), the efficiency of 40 nursing homes that deliver their services in the north-western area of the Lombardy Region was assessed over a 3-year period (2005-2007). Lombardy is a very peculiar setting, since ...

To explore the use of disproportionality analysis of medication error data as a novel method to identify relationships that might not be obvious through traditional analyses. This approach can supplement descriptive data and target quality improvement efforts. Data came from the Medication Error Quality Initiative (MEQI) individual event reporting system. ...

A commentary of the article discussing the possible reimagining of long-term care (LTC) is provided. The reimagining article examines how to diminish the role of nursing homes in the LTC system. The text is provocative. It is also thought-provoking. In this commentary I provide a further opinion that we could ...

BACKGROUND: Nursing Home Compare first published clinical quality measures at the end of 2002. It is a quality report card that for the first time offers consumers easily accessible information about the clinical quality of nursing homes. It led to changes in consumers' demand, increasing the relative importance of clinical ...

Long-term care (LTC) needs to be reconceptualized. The current efforts to reinvent the nursing home perpetuate a flawed model of care. The heritage of the nursing home as the dominant model for LTC needs to be reexamined. The basic LTC building blocks--housing, services, and medical care--can be combined in various ...

Previous research has demonstrated that employment-based benefits are important for the recruitment and retention of nursing assistants (NAs). The objectives of this study were to describe the availability of benefits offered to NAs and to explore the association between nursing home organizational characteristics and NA benefits using the political economy ...

Registered nurses' (RNs') role in Norwegian home care services exists in a state of flux owing to the early discharge of patients from hospitals, more time-consuming and complex care for young patients, and a growing number of older care recipients. The aim of this study was to investigate the RN ...

The aim of the study was to describe nurses' and physicians' experiences of prioritization factors in nursing homes. What are the experiences of health care personnel when prioritizing treatment and care for elderly residents in nursing homes? Little research has been done in this area, yet with the growing elderly ...

Public reporting of the quality of care delivered in hospitals and nursing homes is thought to foster improvements in care. When information is available, consumers may choose high-quality providers. That choice, in turn, may stimulate providers to improve quality as a way to attract a larger share of the market. ...

There is growing political pressure for nursing homes to implement the electronic medical record (EMR) but there is little evidence of its impact on resident care. The purpose of this study was to test the unique and combined contributions of EMR at the bedside and on-site clinical consultation by gerontological ...

To provide pooled data on the prevalence of malnutrition in elderly people as evaluated using the Mini Nutritional Assessment (MNA). Retrospective pooled analysis of previously published datasets. Hospital, rehabilitation, nursing home, community. Four thousand five hundred seven people (75.2% female) with a mean age of 82.3. The prevalence of malnutrition ...

The American Association of Colleges of Nursing in collaboration with leaders in the health care arena has developed a new role in nursing, the clinical nurse leader (CNL). The CNL is a master's-prepared advanced nurse generalist, accountable for providing high-quality, cost-effective care for a cohort of patients in a specific ...

Nursing homes certified by the Medicare and/or Medicaid program are subject to federally mandated and state-enforced quality and safety standards. We examined the relationship between state quality enforcement and nursing home terminations from the two programs. Using data from a survey of state licensure and certification agencies and other secondary ...

CONTEXT: Efforts to improve care for nursing home residents stand to be enhanced by measures to assess the degree to which staff provide palliative care. As the incidence of death in nursing homes increases with the aging population, the gap in measurement must be addressed. To that end, we report ...

To describe lengths of stay of nursing home decedents. Retrospective cohort study. The Health and Retirement Study (HRS), a nationally representative survey of U.S. adults aged 50 and older. One thousand eight hundred seventeen nursing home residents who died between 1992 and 2006. The primary outcome was length of stay, ...

OBJECTIVES: To study the practice of continuous palliative sedation (CPS) by Dutch nursing home physicians in 2007. DESIGN: A structured retrospective questionnaire. SETTING: Nationwide nursing home physician study in the Netherlands. PARTICIPANTS: One thousand two hundred fifty-four nursing home physicians received a questionnaire concerning their last case of CPS in ...

The purpose of this study was to extend earlier research on the dining assistant (DA) federal regulation allowing trained non-nursing staff to provide feeding assistance care in nursing homes. Observations were conducted pre- and post-implementation, with periodic observations during implementation. To assess sustainability, data were analyzed at 12 months post-implementation. ...

Coronary artery disease (CAD) is highly prevalent in nursing home residents and is associated with a substantial clinical and economic burden. Statins reduce mortality and hospitalization rates in older patients with CAD. To assess rates and predictors of statin use among high-risk patients with symptomatic coronary artery disease (CAD) admitted ...

With the aging of the world's population there has become a major need for the development of nursing homes throughout the world. While some countries provide high quality care for the disabled elderly, in others this is not the case. Education of a medical director has been shown to improve ...

The grief that nurses experience when patients and residents die can be complex and has been linked to both problematic (e.g., depression) and beneficial (e.g., gains in coping) outcomes. In this study, 380 nursing assistants working in the nursing home setting were surveyed to gain an understanding of the relationship ...

In this commentary, we examine nursing home quality and indicators that have been used to measure nursing home quality. A brief review of the history of nursing home quality is presented that provides some context and insight into currently used quality indicators. Donabedian's structure, process, and outcome (SPO) model is ...

To assess how functional independence and sociodemographic factors influence discharge destination of patients recovering from stroke in urban Japan. Patients recovering from first-ever stroke (supratentorial lesions) discharged from a long-term rehabilitation hospital. Scores for individual patients were collected at both admission and discharge for the motor components of the Functional ...

The aim of this study was to register the use of long-term indwelling catheters in nursing homes in a defined geographical region, and present the indications for and duration of catheterization, catheter material and size, the time between the regular catheter changes and the number of patients with regular catheter ...

The Centers for Medicare and Medicaid Services provides a report card on nursing homes at a Web site called Nursing Home Compare (NHC) that includes information on 19 clinical quality measures (QMs). The information is intended to inform consumer choice, to provide a focus for state regulatory initiatives, and to ...

Seizures are a common neurologic disorder of childhood, and many pediatric nurses will care for children with epilepsy during their careers. The term "seizure precautions" is used frequently in nursing practice; however, its definition varies among institutions. Childhood epilepsy has many phenotypes, and while some children require airway clearance and ...

Although the importance of nurse leadership stability and participation in decision making in nursing homes is well established, scarce literature exists on determinants of intent to leave among directors of nursing (DONs) in nursing homes. : The purpose of this study was to examine factors associated with DON intent to ...

Rationale, aims and objectives  Annual national prevalence surveys have been conducted in the Netherlands over the past 10 years and have revealed high prevalence rates in Dutch nursing homes. Pressure ulcer guideline implementation is one of the factors that can influence prevalence rates. Previous research has shown that these guidelines ...

PURPOSE: To clarify the ability of nurses and nursing assistants working in primary care, secondary care and nursing homes to identify depressed individuals using their clinical skills using meta-analysis of published studies. METHODS: Literature search, appraisal and meta-analysis. We located 22 studies reporting on the detection of depression, 4 involving ...

To identify risk factors for early nursing home placement (NHP) in Alzheimer's disease (AD), focusing on the impact of longitudinal change in cognition, activities of daily living (ADL), service utilization, and cholinesterase inhibitor treatment (ChEI). In an open, 3-year, prospective, multicenter study in a routine clinical setting, 880 AD patients ...

BACKGROUND: Drug-resistant Acinetobacter species are problematic in tertiary-care hospitals. We describe the epidemiology, resistance patterns, and outcomes of older adults with Acinetobacter infection in community hospitals. METHODS: We queried the microbiology databases of the Oakwood Healthcare System (4 hospitals with 632, 259, 199, and 168 beds) for clinical Acinetobacter cultures ...

Pressure ulcers (PU) remain a major health care problem throughout the world. Although malnutrition is considered to be one of the intrinsic risk factors for PU, more evidence is needed to identify the exact relation between PU and malnutrition. This study aims to identify whether there exists a relationship between ...

A telephone survey of Medicare beneficiaries with diabetes living in rural underserved areas and enrolled in the Informatics for Diabetes Education and Telemedicine project identified 109 subjects who requested further training in functions of the home telemedicine unit after initial in-home training by regional nurse installers. The initial training provided ...

BACKGROUND: While benefits of hospice care in nursing homes have been documented, interorganizational challenges such as staff conflicts regarding planned care or their respective roles have also been documented. Through case studies, this research aimed to characterize the partnerships of successful nursing home-hospice collaborators. METHODS: Six nursing homes and hospices ...

To test the effect of prenatal and infancy home visits by nurses on 12-year-old, firstborn children's use of substances, behavioral adjustment, and academic achievement. Randomized controlled trial. Public system of obstetric and pediatric care in Memphis, Tennessee. We studied 12-year-old, firstborn children (n = 613) of primarily African American, economically ...

Nurses who provide care in the home are at risk of blood exposure from needlesticks. Using safety-engineered medical devices reduces the risk of needlestick. The objectives of this study were to assess provision of safety devices by home care and hospice agencies as well as the use of these devices ...

Strategies to access a stratified random sample of New England home health care agencies and nurses are described. The combined strategies resulted in a sample of 123 home health care agencies and 2,459 home healthcare nurses from the six New England states. The results will inform researchers aiming to achieve ...

OBJECTIVE: To assess the impact of state Medicaid wage pass-through policy on direct-care staffing levels in U.S. nursing homes. DATA SOURCES: Online Survey Certification and Reporting (OSCAR) data, and state Medicaid nursing home reimbursement policies over the period 1996-2004. STUDY DESIGN: A fixed-effects panel model with two-step feasible-generalized least squares ...

OBJECTIVES. Informed by a life course perspective, this study investigates the effects of spousal loss and availability of adult children on elderly husbands' and wives' risk of nursing home entry. METHODS: Based on longitudinal data from the Health and Retirement Study, we studied 2,116 couples who were community residents in ...

AIMS: To explore the activities of daily living and psychological well-being of older people living in nursing homes and also to examine the effectiveness of a gardening programme in enhancing socilaisation and life satisfaction, reducing loneliness and promoting activities of daily living for older people living in nursing homes. BACKGROUND: ...