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 the definition of a SNF, SNF staffing requirements, and SNF services provided on-site. The test was administered to trainees on the first day of a mandatory SNF rotation that occurred during their first, second or third year of training. RESULTS:Sixty-seven internal medicine residents [41 postgraduate year (PGY)-1, 11 PGY-2, and 15 PGY-3] were assessed with the test. The mean number of questions answered correctly was 4.9, with a standard deviation of 1.6. Regardless of their level of training, residents had a poor baseline knowledge of SNF care (mean scores 4.2 for PGY-1, 5.3 for PGY-2, and 6.3 for PGY-3) (P < .0001). Performance on some questions improved with increased level of training but others did not. CONCLUSIONS:Medical residents have insufficient knowledge about the type of care that can be provided at a SNF and efforts to improve this knowledge are needed to assure proper triage of patients and safe transitions to the SNF.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Ward KT,Eslami MS,Garcia MB,McCreath HEdoi
10.1016/j.jamda.2014.08.004subject
Has Abstractpub_date
2014-01-01 00:00:00pages
841-3issue
11eissn
1525-8610issn
1538-9375pii
S1525-8610(14)00537-4journal_volume
15pub_type
杂志文章abstract:OBJECTIVES:To compare survival rates of hip fracture patients treated within a comprehensive geriatric hip fracture unit (CGHFU) with those undergoing a standard of care treatment (SOCT) in general orthopedic wards. DESIGN:Retrospective chart review. SETTING:A geriatric hip fracture unit of a division of geriatric me...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.09.003
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:The association between frailty and malnutrition is widely noted, but the common and distinct aspects of this relationship are not well understood. We investigated the prevalence of prefrailty/frailty and malnutrition/nutritional risk; their overlapping prevalence; compared their sociodemographic, physical, a...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.06.017
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to measure the level of lighting in nursing homes in a variety of areas to determine its adequacy in meeting the visual needs of elderly residents. DESIGN:Observational study PARTICIPANTS:Eight nursing homes cooperating in an intervention study designed to prevent accidental...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2007.01.003
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Studies show that in nursing homes (NHs), the prevalence of moderate-to-severe obesity has doubled in the last decade and continues to increase. Obese residents are often complex and costly, and this increase in prevalence has come at a time when NHs struggle to decrease hospitalizations, particul...
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
abstract:BACKGROUND:Nursing home residents' repeated transfers to hospital are costly and can lead to in-hospital complications and high mortality for frail residents. However, no research has examined the trajectory of residents' symptoms over their nursing home residency and its relationship to hospital transfer. AIM:The pur...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.06.019
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVES:To determine the prevalence, rate of underdiagnosis and undertreatment, and association with activities of daily living dependency of spasticity in a nursing home setting. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:This study is an analysis of a deidentified data set generated by a prior qualit...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.01.005
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:Nursing facilities have lagged behind in the adoption of interoperable health information technology (ie technologies that allow the sharing and use of electronic patient information between different information systems). The objective of this study was to estimate the nationwide prevalence of electronic he...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.11.002
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:From 2013 to 2016, the Centers for Medicare and Medicaid Services Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents ("the Initiative") tested a series of clinical interventions and care models, through organizations called Enhanced Care and Coordination Providers (ECCPs), with ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.01.002
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Individuals with heart failure (HF) who are hospitalized and admitted to skilled nursing facilities (SNFs) are at high risk for rehospitalization and death. The care preferences of this high-risk population have not been studied. OBJECTIVES:To describe care preferences of patients with HF admitted to SNFs f...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.05.021
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:To evaluate whether STOPP/START v2 potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) are associated with 6-month mortality and unplanned hospitalization in hospital-discharged older patients. DESIGN:Multicenter prospective cohort observational study. SETTING AND PARTIC...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.03.023
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:To define the prevalence of dysphagia and its associated factors and to investigate the influence of dysphagia and nutritional therapies performed in dysphagic subjects on clinical outcomes, including nutritional status, pressure ulcers, hospitalization, and mortality. DESIGN:A prospective observational stu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.07.023
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To evaluate whether botulinum toxin can decrease the burden for caregivers of long term care patients with severe upper limb spasticity. METHOD:This was a double-blind placebo-controlled trial with a 24-week follow-up period. SETTING:A 250-bed long term care hospital, the infirmary units of 3 regional hospi...
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.2012.03.005
更新日期:2012-06-01 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:Older people who are admitted to inpatient rehabilitation settings often experience sleep disturbance or disorders. Both intrinsic and environmental factors may contribute to reduced sleep quality. Poor sleep quality has been reported to be associated with poorer rehabilitation outcomes. The aim of this revi...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2020.03.002
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:The aim of this systematic review was to summarize the validity of nutritional screening tools to detect the risk of malnutrition in community-dwelling older adults. DESIGN:A systematic review and meta-analysis. The protocol for this systematic review was registered in the PROSPERO database (CRD42017072703)...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.06.024
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To analyze the burden of institutionalizations after femoral fracture and compare it with other "catastrophic" disease entities like stroke, myocardial infarction, or pneumonia. DESIGN/SETTING/PARTICIPANTS:Routine data of 414,000 hospitalized German patients aged 66 years and older were used to calculate ins...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.05.013
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVES:Because they are potentially modifiable and may coexist, we evaluated the combined occurrence of a reduced forced expiratory volume in 1 second (FEV1) and peripheral artery disease (PAD), including its association with exertional symptoms, physical inactivity, and impaired mobility, in sedentary elders with ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.05.008
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:To determine the effect of a Social Health Maintenance Organization (S/HMO) on diverting older adults admitted into a nursing facility from converting to long-stay placement. DESIGN:Members of the SCAN S/HMO and those in Medicare Fee-For-Service were compared on successful discharge to the community after b...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.10.009
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Inappropriate antipsychotic prescribing is a key quality indicator by which clinical outcomes might be monitored and improved in long-term care (LTC), but limited evidence exists on the most effective strategies for reducing inappropriate antipsychotic use. OBJECTIVES:The objective of the study was to evalu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.07.025
更新日期:2020-03-01 00:00:00
abstract::Internists and family physicians are trained in evidence-based medicine (EBM). The philosophy of incorporating clinical research "evidence" into medical practice is taught at the undergraduate and graduate levels of medical training. Practicing physicians incorporate EBM into their practices in variable degrees depend...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:
更新日期:2004-09-01 00:00:00
abstract:IMPORTANCE:Currently there is no risk factor scale that identifies older persons at risk of frailty. OBJECTIVES:In this study, we identified significant multisystem risk factors of frailty, developed a simple frailty risk index, and evaluated it for use in primary care on an external validation cohort of community-liv...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.03.008
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the effects of humor therapy assessed using observational methods on agitation, engagement, positive behaviors, affect, and contentment. DESIGN:Single-blind cluster randomized controlled trial. SETTING:A total of 35 Sydney nursing homes. PARTICIPANTS:All eligible residents within geographicall...
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.2014.03.017
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Most studies assessing the effect of central nervous system (CNS)-acting medicines on cognitive disturbances have focused on the use of individual medicines. The impact on cognitive function when another CNS-acting medicine is added to a patient's treatment regimen is not well known. OBJECTIVE:To determine ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.02.008
更新日期:2016-06-01 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
doi:10.1097/01.JAM.0000028225.84012.3B
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVES:To examine individual items of the SARC-F in predicting adverse outcomes. DESIGN:Prospective cohort study. SETTING:Community-dwelling older people in Hong Kong SAR China. PARTICIPANTS:A total of 4000 men and women aged 65 years and over, stratified in 3 age groups (65-69, 70-74, 75+ years of age). MEASUR...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.09.006
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:Our study examined the proportion of skilled nursing facility (SNF) post-acute care residents who did not receive timely primary care provider (PCP) services following discharge, factors associated with lack of timely PCP services, and factors associated with perfect 30-day home time among those who did not ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.09.016
更新日期:2020-10-26 00:00:00
abstract:OBJECTIVES:Green House and other small nursing home (NH) models are considered "nontraditional" due to their size (10-12 beds), universal caregivers, and other home-like features. They have garnered great interest regarding their potential benefit to limit Coronavirus Disease 2019 (COVID-19) infections due to fewer peo...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2021.01.069
更新日期:2021-01-26 00:00:00
abstract::Loneliness is a common problem in long-term care facilities (LTCF) and previous work has shown that animal-assisted therapy (AAT) can to some degree reverse loneliness. Here, we compared the ability of a living dog (Dog) and a robotic dog (AIBO) to treat loneliness in elderly patients living in LTCF. In comparison wit...
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.2007.11.007
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Informal caregivers of patients with a cognitive impairment may face exhaustion while taking care of their relatives, and are themselves at higher risk of disease. The objective was to assess the relationship between patients' comorbidities evaluated with the Charlson index, and the caregiver burd...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.10.011
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:For persons with dementia, the appropriate duration of cholinesterase inhibitor (ChEI) use remains unclear. We examined patterns of ChEI use during nursing home (NH) transition and the factors associated with discontinuation following admission. DESIGN:Population-based retrospective cohort study using linke...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.07.020
更新日期:2018-11-01 00:00:00