Abstract：
:Urinary tract infection (UTI) is arguably the most common infection in the long term care (LTC) setting. Making the diagnosis of UTI and deciding when to initiate treatment with antimicrobial therapy is a challenge to all LTC providers. Widespread prevalence of asymptomatic bacteriuria, lack of an accepted clinical or laboratory gold standard to start antibiotics for UTI, and a high prevalence of cognitive impairment in the LTC population all contribute to this challenge. Several consensus based criteria for diagnosing UTI have been published, though these vary from each other owing to different intended purposes. The McGeer and updated Stone criteria are intended for surveillance and benchmarking purposes. The 2005 Loeb criteria represent minimal criteria for the initiation of antimicrobial therapy. Our review focuses on residents without a urinary catheter. The Loeb criteria should be updated, by inclusion of isolated fever in those with profound cognitive impairment as well as scrotal or prostate swelling tenderness to be consistent with the updated McGeer criteria by Stone et al. Urine testing and antimicrobial therapy should not be ordered in those with isolated nonspecific signs or noninfectious symptoms such as fatigue or delirium. Both cavalier urine testing and unnecessary antimicrobial therapy contribute to direct patient harm as well as the rapidly escalating threat of antimicrobial resistance. Observation and monitoring of residents in whom the diagnosis of UTI is unclear is a best practice that should be implemented. Facilities should consider addressing UTI management as part of their quality assurance and performance improvement process.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Nace DA,Drinka PJ,Crnich CJdoi
10.1016/j.jamda.2013.11.009subject
Has Abstractpub_date
2014-02-01 00:00:00pages
133-9issue
2eissn
1525-8610issn
1538-9375pii
S1525-8610(13)00642-7journal_volume
15pub_type
杂志文章abstract：OBJECTIVE:Medical students often lack training in complex geriatric medical decision making. We therefore developed the serious game, GeriatriX, for training medical decision making with weighing patient preferences, and appropriateness and costs of medical care. We hypothesized that education with GeriatriX would impr...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2014.04.011
更新日期：2014-12-01 00:00:00
abstract：OBJECTIVES:To examine the association of rurality with skilled nursing facility (SNF) all-cause 30-day risk-adjusted rehospitalization rates. DESIGN:Cross-sectional study combining Center for Medicare and Medicaid Services Nursing Home Compare (CMS-NHC) website for 30-day risk-adjusted rehospitalization rates for 2014...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2018.03.001
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND:Although many older adults require skilled nursing facility (SNF) care after acute hospitalization, it is unclear whether internal medicine residents have sufficient knowledge of the care that can be provided at this site. METHODS:We developed a 10-item multiple choice pre-test that assessed knowledge of th...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.08.004
更新日期：2014-01-01 00:00:00
abstract：OBJECTIVES:The objective of this study was to evaluate the impact of a well-developed theory-based function-focused care for cognitively impaired (FFC-CI) intervention on eating performance among long-term care (LTC) residents with moderate-to-severe cognitive impairment. DESIGN:A secondary analysis of longitudinal da...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2015.06.023
更新日期：2015-12-01 00:00:00
abstract：OBJECTIVE:The objective of this study was to examine the association between psychoactive medications and sleep quality in a sample of nursing home patients. DESIGN:We studied a baseline data collection for a clinical trial of a nonpharmacologic sleep intervention program. SETTING:This study was conducted at six comm...
journal_title：Journal of the American Medical Directors Association
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1097/01.JAM.0000131499.71697.9E
更新日期：2004-07-01 00:00:00
abstract：OBJECTIVES:To provide an estimate and level of uncertainty for Medicaid cost savings due to Minnesota's Return to Community Initiative (RTCI). DESIGN:Medicaid cost savings are estimated using a semi-Markov model and simulation approach. SETTING AND PARTICIPANTS:RTCI is a statewide program that assists private paying ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.07.016
更新日期：2020-08-28 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2015.02.014
更新日期：2015-07-01 00:00:00
abstract：OBJECTIVES:To test different adherent strategies aimed at improving hip protector use among nursing care facility residents. DESIGN, SETTING AND PARTICIPANTS:A cluster randomized controlled trial with 234 residents older than 75 years from 9 units of 7 nursing care facilities in the Northern Sydney region, Australia. ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2010.02.010
更新日期：2011-01-01 00:00:00
abstract：OBJECTIVES:Pulmonary infections are common in children with quadriplegic cerebral palsy. High frequency chest wall oscillation with the vest therapy (VT) is used to promote pulmonary clearance and to prevent pneumonias in cystic fibrosis patients. The purpose of this study was to ascertain the effectiveness of VT in pa...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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更新日期：2002-09-01 00:00:00
abstract：OBJECTIVES:Older age is associated with higher risk of death during acute exacerbations of chronic obstructive pulmonary disease (AE-COPD). Older patients hospitalized for AE-COPD often require post-acute care after acute phase. The aim of this study was to evaluate components of a comprehensive geriatric assessment an...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.01.125
更新日期：2019-07-01 00:00:00
abstract：BACKGROUND:Dementia is a syndrome associated with stigma and social isolation. Forty-two percent of people with dementia in the United States and almost 40% in the United Kingdom live in assisted living and residential care facilities. Up to 90% of residents with dementia experience behavioral and psychological symptom...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2015.11.015
更新日期：2016-02-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2012.05.013
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVE:To examine whether established diabetes risk factors and diabetes risk algorithms are associated with future frailty. DESIGN:Prospective cohort study. Risk algorithms at baseline (1997-1999) were the Framingham Offspring, Cambridge, and Finnish diabetes risk scores. SETTING:Civil service departments in Lond...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.08.016
更新日期：2013-11-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.03.009
更新日期：2020-09-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2015.09.006
更新日期：2015-12-01 00:00:00
abstract：BACKGROUND:The purpose of this descriptive, retrospective analysis was to develop a demographic and clinical profile of nursing home residents with a diagnosis of Huntington's disease (HD). METHODS:Queries were made of a large data repository of linked and de-identified Minimum Data Set version 3.0 and prescription cl...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.01.010
更新日期：2014-06-01 00:00:00
abstract：OBJECTIVES:Patients discharged to a skilled nursing facility (SNF) for post-acute care have a high risk of hospital readmission. We aimed to develop and validate a risk-prediction model to prospectively quantify the risk of 30-day hospital readmission at the time of discharge to a SNF. DESIGN:Retrospective cohort stud...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.01.137
更新日期：2019-04-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.04.021
更新日期：2019-10-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2008.04.011
更新日期：2008-10-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.10.012
更新日期：2020-05-01 00:00:00
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pub_type： 杂志文章,随机对照试验
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更新日期：2019-03-01 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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更新日期：2007-07-01 00:00:00
abstract：OBJECTIVES:This study examined the extent to which program site-based and Veteran characteristics were associated with potentially avoidable hospitalizations or other hospitalization of Veterans enrolled in the Veterans Affairs (VA) Home Based Primary Care (HBPC). DESIGN:Retrospective claims-based study. SETTING AND ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
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更新日期：2021-01-29 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.05.028
更新日期：2020-07-19 00:00:00
abstract：OBJECTIVES:The purpose of this study was to examine whether a 12-week combined physical exercise training and nutritional intervention improves physical performance and enhances health-related quality of life (HRQOL) among prefrail elderly women living in the community. DESIGN:This was a randomized controlled trial in...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2014.12.005
更新日期：2015-03-01 00:00:00
abstract：:The phenomenon of elderly sexual offenders is poorly catalogued, and is especially complex. In institutions, elderly people are often unrecognized victims of sexual abuse but are also at great risk for doing abuse toward vulnerable victims like children. The lack of attention to an elder's basic needs can endanger or ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2012.05.012
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVES:The recent emphasis on knowledge translation (KT) in health care is based on the premise that quality of care improves when research findings are translated into practice. This study aimed to identify the extent, nature, and settings of KT research pertaining to the care of older adults. DESIGN AND METHODS:...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2010.12.004
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:Good scientific evidence indicates that calcium and vitamin D supplementation decrease the incidence of osteoporosis-related fractures among institutionalized elderly. OBJECTIVE:The objective was to study the frequency of prescribing calcium and vitamin D supplements in elderly institutionalized individuals...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1097/01.JAM.0000110649.22467.B4
更新日期：2004-03-01 00:00:00
abstract：OBJECTIVE:To evaluate the effects of the modified Hospital Elder Life Program (mHELP) comprising 3 nurse-administered protocols in older patients undergoing gastrointestinal (GI) surgery. DESIGN:Cluster randomized trial. SETTING:Two 36-bed GI wards at a university-affiliated medical center in Taiwan. PARTICIPANTS:Ol...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2018.09.016
更新日期：2019-05-01 00:00:00
abstract：OBJECTIVES:EHealth interventions are increasingly being applied in perioperative care but have not been adequately studied for older surgical patients who could potentially benefit from them. Therefore, we evaluated the feasibility of perioperative eHealth interventions for this population. DESIGN:A systematic review ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2020.05.035
更新日期：2020-12-01 00:00:00
