The Virginia Long-Term Care Clinician Network (VA LTC-CN)
Growing from the need to problem-solve quickly during the COVID-19 pandemic, the Virginia Long-Term Care Clinician Network (VA LTC-CN) is a peer learning collaborative facilitating communication of vital information and robust discussion on timely topics affecting Virginia LTC clinicians. The VA LTC-CN brings together doctors and advanced practice clinicians working across the commonwealth in nursing homes, assisted living facilities, and other congregate care settings. The network provides a central mode of communication, access to a monthly newsletter and Zoom forum with available continuing education (CE) credit, and fr...
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Kristin M. MacDonald, Laura Finch, Kimberly Ivey, Jenni Mathews, Christian Bergman, Leland Waters Source Type: research
Infection Control Advocate and Resident Education (ICARE)
In 2016, the Centers for Medicare and Medicaid Services (CMS) made major revisions to the regulatory requirements to improve the safety and quality of care that would be implemented in three phases (2016-2019). This included major additions to the infection prevention and control (IPC) requirements for nursing homes (NHs), including the requirement of an enhanced IPC plan, an infection preventionist (IP), and the inclusion of the IP in the quality assessment and assurance committee. While NHs were expected to have these requirements in place by the end of 2019, the COVID-19 pandemic overwhelmed NHs and the healthcare syste...
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Sarah E. Ross, Jennifer J. Severance, Sara Murphy, Diana Cervantes Source Type: research
Providing COVID-19 Therapeutics and Clinical Guidance in Skilled Nursing Facilities
Residents in skilled nursing facilities (SNFs) are at high risk for hospitalization and death from COVID-19 (1,2). Outpatient COVID-19 therapeutics reduce severe illness, and they became more available locally as of April 25, 2022 (3,4). However, evolving guidance and medication administration logistics created barriers to timely use of therapeutics for SNF residents in a large metropolitan city. October 31, 2022, 8.1% reported COVID-19 cases among area SNF residents (n=1,957) were treated with therapeutics and 20 (25%) of 79 unique facilities reported therapeutics use. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Christy Zelinski, Sylwia Jasniuk, Linda Li, Dheeraj Mahajan, Kelly Walblay, Leirah Jordan, Do Young Kim, Stephanie Black Source Type: research
Urinary Tract Infection Guideline Adherence in Dutch Nursing Home Network
To examine guideline adherence three years after the introduction of a national guideline on urinary tract infection (UTI) based on the 2018 International Delphi Consensus Criteria for Suspected UTI in Frail Older Adults. The appropriate use of urine dipsticks, treatment decisions and antibiotic drug choices in nursing home residents with (suspected) UTIs without a catheter were examined. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Gary Y.C. Yeung, Martin Smalbrugge, Laura van Buul, Jeanine J.S. Rutten, Paul Van Houten, Ineke J. Gerridzen, Martine C. De Bruijne, Karlijn J. Joling, Cees M.P.M. Hertogh Source Type: research
Certified Nursing Assistants' Compassion at Work, Well-being and Turnover Intentions
Compassion is innate and fundamental to caregiving, and is associated with many known benefits. It is well-established that compassion experienced by patients and in organizational contexts (e.g., compassionate environments, organizational compassion practices) is beneficial. An opportunity exists to study direct caregivers, a population that is underexplored, and compassion at work the experience of both demonstrating and receiving compassion as a caregiver. This project suggests that experienced compassion at work could help solve healthcare worker burnout. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Kristin M. MacDonald, Jessica Mittler, Christopher Reina, Laura E. McClelland, Adam Atherly Source Type: research
Complex Care Clinical Model
Residents in skilled nursing facilities (SNF) have multiple chronic illnesses which lead to poor prognosis and shortened lifespan. Evidence demonstrates majority of these patients and their families lack insight into the severity of their illness. We know that advance care planning (ACP) is an integral part of every patients ’ care in SNFs. We also know there is lack of effective quality ACP and goals of care conversations causing last-minute crisis decision-making. This results in inappropriate, potentially harmful, and unwanted treatments. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Maria Anna Go, Chikal Patel, Summer Galecki Source Type: research
DRINK: Dehydration Risk Screening to Reduce Urinary Tract Infection Hospitalizations
Proactive prevention of dehydration, and subsequent prevention of Urinary Tract Infections (UTIs), improves patient outcomes. UTIs are a leading cause of hospitalization in long term care setting. We aimed to reduce UTI hospitalizations by implementing a 3-pronged approach focused on a dehydration education campaign: 1) dehydration risk assessment screening, 2) education of nursing home staff on hydration awareness, and 3) hydration campaign to target 7 structured drink rounds for moderate- to high-risk patients daily. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Brenton Buehler, Jessica Iarussi, Todd Sobol Source Type: research
Social Determinants in Discharge Planning from Skilled Nursing Facilities
This study explores the social characteristics of patients discharged from SNFs to the community. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: John Naumovski, Suzanne S. Colilla, Andrea L. Coyle, Jennifer Nebel, Christen Bosh Source Type: research
Rehabilitation Intensity and Successful Discharge in Persons with Dementia
Audiology, speech-language therapy, and occupational therapy (OSLA) can address functional deficits of dementia, but we do not know this set of services ’ effect on successful discharge after heart failure hospitalization in persons living with dementia. We hypothesize that increased OSLA time was associated with successful discharge home from skilled nursing facilities (SNFs) in Veterans with dementia (VwD) after heart failure (HF) hospitalizatio n. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Thomas A. Bayer, Lan Jiang, Mriganka Singh, Thomas Nubong, Zachary Kunicki, Julia Browne, John McGeary, Catherine Kelso, Wen-Chih Wu, James L. Rudolph Source Type: research
Nursing Home Profit Status and Pain Among Residents with Dementia
Pain is highly prevalent among nursing home (NH) residents with dementia. Estimates suggest 35-80% of NH residents with dementia experience pain and 20% of residents in pain do not receive analgesics. Pain has been identified as a quality indicator used to measure and monitor NH performance. There is growing attention focused on the role of NH ownership profit status in the context of quality and delivery of care. However, there is limited research on the role of profit status in the management of pain among residents with dementia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Sorah Levy, Sarah D. Holmes, Barbara Resnick Source Type: research
Length of Stay Among Nursing Home Admissions in a Hospital
A retrospective study from one nursing home in Singapore in 2017-2018 showed length of stay (LOS) of 8.7 days. We aim to quantify length of stay contributed by admissions of nursing home patients in a newly established acute hospital. We also aim to describe patterns of admissions. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Chong Yau Ong, Jean MH Lee Source Type: research
Differences and Similarities in the 2021 Special Focus Facility Program
The Special Focus Facility Program is a resource-intensive quality improvement intervention reserved for the lowest-performing nursing facilities (NFs) in the United States. NFs are eligible for enrollment after three consecutive surveys during which the facility is not substantially compliant with regulations. SFFs are subject to increased oversight and escalating penalties. Due to the intensive nature of the intervention, the number of SFFs is capped at 88 nationally. In addition to enrolled SFFs, there is a list of 435 Special Focus “Candidates” (SFFcs). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Annie Rhodes, Thomas V. Caprio, Sarah Marrs, Tracey Gendron, Leland Waters Source Type: research
Correlated Prescribing Patterns for Antibiotics and Antipsychotics at Veteran Affairs
In nursing homes (NHs), antibiotics and antipsychotics pose risks to resident safety. Previous work in community NHs characterized providers ’ prescribing rates for antibiotics and antipsychotics and assessed associations between the two drug classes. This analysis assesses antibiotic and antipsychotic prescribing patterns at nursing homes located in Veterans Affairs (VA) medical centers known as community living centers (CLCs). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Abigail Beck, Robin L. Jump, Brigid Wilson, Sunah Song, Taissa A. Bej, Taylor Boyer, Katie Suda, Charlesnika Evans Source Type: research
Evaluation of a Training Course for Certified Nursing Assistants
The optimal performance of nursing homes depends significantly on training their personnel, especially certified nursing assistants (CNAs), who provide the bulk of daily care for residents. There are several challenges to delivering effective training in the long-term care (LTC) setting. One of the greatest challenges is high turnover rates, which interfere with the continuity of care and necessitate the constant training of new staff. 2022 Long Term Care Staffing Study, which received information from 1201 nursing facilities in Texas noted direct care CNA turnover at 67.4%, and licensed vocational nurse (LVN) turnover at ...
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Sarah E. Ross, Jennifer J. Severance, Sara Murphy, Solymar Rivera-Torres Source Type: research
Feasibility of Registered Nurse Model to Identify Acute Care Preferences
Acute health care interventions for residents of skilled nursing facilities (SNFs) are often unwarranted, unwanted, and/or harmful. A provider-focused model supporting patient centered and appropriate care among SNF patients, Reducing Avoidable Facility Transfers (RAFT), has previously demonstrated reduced emergency department and hospital utilization by emphasizing appropriate use of Provider Orders for Life Sustaining Treatment (POLST) completion and Do Not Hospitalize (DNH) orders. The RAFT model relied heavily on physicians, nurse practitioners and physician ’s assistants. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Daniel S. Stadler, Annaliese Volckaert, Ellen Flaherty, Sharon O'Connor, Bich Tran Source Type: research
