Archivo de la categoría: Scoop.it

Frailty Index and functional level upon admission predict hospital outcomes: an interRAI-based cohort study of older patients in post-acute care hospitals | BMC Geriatrics | Full Text

Geriatric assessment upon admission may reveal factors that contribute to adverse outcomes in hospitalized older patients. The purposes of this study were to derive a Frailty Index (FI-PAC) from the interRAI Post-Acute Care instrument (interRAI-PAC) and to analyse the predictive ability of the FI-PAC and interRAI scales for hospital outcomes. This retrospective cohort study was conducted by combining patient data from interRAI-PAC with discharge records from two post-acute care hospitals. The FI-PAC was derived from 57 variables that fulfilled the Frailty Index criteria. Associations of the FI-PAC and interRAI-PAC scales (ADLH for activities of daily living, CPS for cognition, DRS for mood, and CHESS for stability of health status) with hospital outcomes (prolonged hospital stay ≥90 days, emergency department admission during the stay, and in-hospital mortality) were analysed using logistic regression and ROC curves. The Frailty Index derived from interRAI-PAC predicts adverse hospital outcomes. Its predictive ability was similar to that of the ADLH scale, whereas other interRAI-PAC scales had less predictive value. In clinical practice, assessment of functional ability is a simple way to assess a patient’s prognosis.

Sourced through Scoop.it from: bmcgeriatr.biomedcentral.com

Sigue leyendo

Publicado en Scoop.it | Comentarios desactivados en Frailty Index and functional level upon admission predict hospital outcomes: an interRAI-based cohort study of older patients in post-acute care hospitals | BMC Geriatrics | Full Text

DIVERT | covid toolkit

Download this DIVERT Scale SQL script and share with your IM/IT staff to generate reports to target patients using based on their most recent interRAI-HC.

Sourced through Scoop.it from: divertcovid.ca

Sigue leyendo

Publicado en Scoop.it | Comentarios desactivados en DIVERT | covid toolkit

An Andalusian delegation visits the Basque Country to learn about the political framework and experiences regarding social and healthcare | EUROPEAN INNOVATION PARTNERSHIP

An Andalusian delegation visits the Basque Country to learn about the political framework and experiences regarding social and healthcare…

Sourced through Scoop.it from: ec.europa.eu

Sigue leyendo

Publicado en Scoop.it | Comentarios desactivados en An Andalusian delegation visits the Basque Country to learn about the political framework and experiences regarding social and healthcare | EUROPEAN INNOVATION PARTNERSHIP

Predictors of Functional Decline in Nursing Home Residents: The Shelter Project 

Fedecostante M, Onder G, Eusebi P, Dell’Aquila G, Zengarini E, Carrieri B, et al. Predictors of functional decline in nursing home residents: the Shelter project. J Gerontol A Biol Sci Med Sci. 2019.

 

The aim of our study was to identify independent predictors of functional decline in older nursing home (NH) residents, taking into account both resident and facility characteristics.

 
Methods

Longitudinal observational study involving 1,760 older (≥65 y) residents of NH participating in the SHELTER* study (57 NH in eight countries). All residents underwent a comprehensive geriatric assessment using the interRAI LTCF. Functional decline was defined as an increase of at least one point in the MDS Long Form ADL scale during a 1 year follow-up. Facility and country effects were taken into account.

 
Results

During the study period 891 (50.6%), NH residents experienced ADL decline. Residents experiencing ADL decline were older, had lower disability at baseline, were more frequently affected by severe dementia and by urinary incontinence, and used more antipsychotics. In the mixed-effect logistic regression model, factors independently associated with a higher risk of functional decline were dementia and urinary incontinence, whereas the presence of a geriatrician was a protective factor.

 
Conclusions

Both resident and facility characteristics are associated with the risk of functional decline in NH residents. Increasing the quality of healthcare by involving a geriatrician in residents’ care might be an important strategy to improve the outcome of this vulnerable population.

Sourced through Scoop.it from: academic.oup.com

Sigue leyendo

Publicado en Scoop.it | Comentarios desactivados en Predictors of Functional Decline in Nursing Home Residents: The Shelter Project 

DIVERT-Collaboration Action Research and Evaluation (CARE) Trial Protocol: a multiprovincial pragmatic cluster randomised trial of cardiorespiratory management in home care | BMJ Open

Sourced through Scoop.it from: bmjopen.bmj.com

Sigue leyendo

Publicado en Scoop.it | Comentarios desactivados en DIVERT-Collaboration Action Research and Evaluation (CARE) Trial Protocol: a multiprovincial pragmatic cluster randomised trial of cardiorespiratory management in home care | BMJ Open

Moving Towards Common Data Elements and Core Outcome Measures in Frailty Research

With aging populations around the world, frailty is becoming more prevalent increasing the need for health systems and social systems to deliver optimal evidence based care. However, in spite of the…

Sourced through Scoop.it from: link.springer.com

Sigue leyendo

Publicado en Scoop.it | Comentarios desactivados en Moving Towards Common Data Elements and Core Outcome Measures in Frailty Research

A frailty index derived from a standardized comprehensive geriatric assessment predicts mortality and aged residential care admission

Frailty in older adults is a condition characterised by a loss or reduction in physiological reserve resulting in increased clinical vulnerability. However, evidence suggests that frailty may be modifiable, and identifying frail older people could help better target specific health care interventions and services. Sigue leyendo

Publicado en Scoop.it | Comentarios desactivados en A frailty index derived from a standardized comprehensive geriatric assessment predicts mortality and aged residential care admission

Appropriateness of transferring nursing home residents to emergency departments: a systematic review | BMC Geriatrics | Full Text

Elderly living in a Nursing Home (NH) are frequently transferred to an Emergency Department when they need acute medical care. A proportion of these transfers may be considered inappropriate and may be avoidable. Systematic review. Literature search performed in September 2018 using PubMed, Web of Science, the Cochrane Library and the Cumulative Index to Nursing… Sigue leyendo

Publicado en Scoop.it | Comentarios desactivados en Appropriateness of transferring nursing home residents to emergency departments: a systematic review | BMC Geriatrics | Full Text

Predictors of emergency room visits or acute hospital admissions in Palliative Home Care Clients

Hospitals are considered a setting ill-prepared for end of life issues; therefore, use of such acute care services has to be considered an indicator of poor quality end of life care. This study examines predictors of ERVH prior to death among HPC home care clients. 

Methods: A retrospective cohort study of a sample of 764 HPC home care clients who received services from a community care access centre (CCAC) in southern Ontario, Canada.

All clients were assessed using the Resident Assessment Instrument for Palliative Care (interRAI PC) as part of normal clinical practice between April 2008 and July 2010. The Andersen-Newman framework for health service utilization was used as a conceptual model for the basis of this study.

Logistic regression and Cox regression analyses were carried out to identify predictors of ERVH. 

Results: Half of the HPC clients had at least one or more ERVH (n = 399, 52.2%). Wish to die at home (OR = 0.54) and advanced care directives (OR = 0.39) were protective against ERVH.

Unstable health (OR = 0.70) was also associated with reduced probability, while infections such as prior urinary tract infections (OR = 2.54) increased the likelihood of ERVH. Clients with increased use of formal services had reduced probability of ERVH (OR = 0.55). 

Conclusions: Findings of this study suggest that predisposing characteristics are nearly as important as need variables in determining ERVH among HPC clients, which challenges the assumption that need variables are the most important determinants of ERVH.

Ongoing assessment of HPC clients is essential in reducing ERVH, as reassessments at specified intervals will allow care and service plans to be adjusted with clients’changing health needs and end of life preferences.

Source: 7thspace.com

Author: Lialoma Salam-WhiteJohn P HirdesJeffrey W PossJane Blums
Source: BMC Palliative Care 2014, 13:35

Sigue leyendo

Publicado en Scoop.it | Comentarios desactivados en Predictors of emergency room visits or acute hospital admissions in Palliative Home Care Clients

The interRAI Acute Care instrument incorporated in an eHealth system for standardized and web-based geriatric assessment..

The BelRAI-software allows standardized transmural information transfer and the centralization of medical, allied health professionals and nursing data. It is strictly secured and follows strict privacy regulations, allowing hospitals to optimize (transmural) communication and interaction. Howeve… Sigue leyendo

Publicado en Scoop.it | Comentarios desactivados en The interRAI Acute Care instrument incorporated in an eHealth system for standardized and web-based geriatric assessment..