Abstract：
INTRODUCTION:Antibiotic stewardship programs (ASPs) are coordinated interventions promoting the appropriate use of antibiotics to improve patient outcomes and reduce microbial resistance. These programs are now mandated in nursing homes (NHs) but it is unclear if these programs improve resident outcomes. This systematic review evaluated the current evidence regarding outcomes of ASPs in the NH. METHODS:PubMed, CINAHL, EMBASE, and the Cochrane Library were systematically searched for intervention trials of ASPs performed in NHs that evaluated final health outcomes (mortality and Clostridium difficile infections), healthcare utilization outcomes (emergency department visits and hospital admissions) and intermediate health outcomes (number of antibiotics prescribed, adherence to recommended guidelines). RESULTS:A total of 14 studies rated good or fair quality were included. Eight studies reported a reduction in antibiotic prescriptions. Ten found an increase in adherence to guidelines proposed by the studied ASP. None reported a statistically significant change in NH mortality rates, C. difficile infection rates, or hospitalizations. DISCUSSION:The limited research to date suggests that NH ASPs can affect intermediate health outcomes, but not key health outcomes or health care utilization. CONCLUSION:Larger trials evaluating more intensive interventions over longer durations may be needed to determine whether ASPs in NHs improve health outcomes as they have in hospitals.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Feldstein D,Sloane PD,Feltner Cdoi
10.1016/j.jamda.2017.06.019subject
Has Abstractpub_date
2018-02-01 00:00:00pages
110-116issue
2eissn
1525-8610issn
1538-9375pii
S1525-8610(17)30362-6journal_volume
19pub_type
杂志文章abstract：:Sexuality is an important component of emotional and physical intimacy that men and women experience throughout their lives. Research suggesting that a high proportion of men and women remain sexually active well into later life refutes the prevailing myth that aging and sexual dysfunction are inexorably linked. Age-r...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2013.01.022
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVES:To explore next-of-kin's (NOK's) perceptions of end-of-life (EOL) care in the nursing home setting and to compare these perceptions for residents receiving hospice care plus usual care versus usual care only. DESIGN:Mailed survey. SETTING:Three nursing homes in central Massachusetts. PARTICIPANTS:Nursing ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2010.07.017
更新日期：2011-02-01 00:00:00
abstract：:Nutritional problems are frequent in nursing homes including undernutrition, obesity, and diabetes mellitus, mainly related to disability and behavior troubles. Adequate nutritional care relies both on the quality of menus for regular and modified diet (texture-modified and enriched food) and on the staff knowledge of...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2009.04.003
更新日期：2010-01-01 00:00:00
abstract：OBJECTIVE:To investigate if there is seasonal variation in cardiac deaths in older persons living in a nursing home in New York City. DESIGN:In a prospective study, the major clinical cause of death of all persons aged 60 years and older residing in a nursing home in New York City during a 15-year period was investiga...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2000-11-01 00:00:00
abstract：:Older adults living in nursing homes are the most vulnerable group of the COVID-19 pandemic. There are many difficulties in isolating residents and limiting the spread in this setting. We have developed a simple algorithm with a traffic light format for resident classification and sectorization within nursing homes, b...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.10.023
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVE:To identify predictors of adverse outcomes (nursing home placement and hospital length of stay) in a cohort of older hospitalized patients. DESIGN:Prospective cohort study. SETTING:A suburban medical center in the New York City metropolitan area. PARTICIPANTS:Patients aged 65 years and older admitted from ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2000-09-01 00:00:00
abstract：:Chronic indwelling catheters are used to manage urinary retention, especially in the presence of urethral obstruction, and to facilitate healing of incontinence-related skin breakdown. These indwelling foreign bodies become coated and sometimes obstructed by biofilm laden with bacteria and struvite crystals. Bacteria ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2006.01.020
更新日期：2006-07-01 00:00:00
abstract：OBJECTIVES:The purpose of this study was to examine the beneficial effects on cognitive function by a cognitive intervention program designed for dementia care called Learning Therapy in Japan and SAIDO Learning in the United States (hereinafter "SAIDO Learning," as appropriate). SAIDO Learning is a working memory trai...
journal_title：Journal of the American Medical Directors Association
pub_type： 临床试验,杂志文章
doi：10.1016/j.jamda.2014.10.021
更新日期：2015-01-01 00:00:00
abstract：CONTEXT:Home Hospital is a worldwide phenomenon that provides acute and subacute medical care in the home in an attempt to reduce the need for hospitalization. OBJECTIVE:To evaluate the clinical parameters of a home hospitalization program operating in Jerusalem for 8 years. DESIGN:The Jerusalem Home Hospitalization ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2002-03-01 00:00:00
abstract：OBJECTIVE:Incident reports guide fall prevention efforts in long-term care (LTC) facilities, often based on descriptions of how falls occurred. The validity of these reports is poorly understood. We examined agreement on fall characteristics between fall incident reports and analysis of video footage of real-life falls...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2014.12.003
更新日期：2015-05-01 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：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 identify patient characteristics associated with higher numbers of prescribed drugs or risk of receiving one or more inappropriate medications. DESIGN:A cross-sectional survey using chart reviews. PARTICIPANTS:A total of 414 long-stay residents of 20 nursing homes in three states MEASUREMENTS:Current m...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2000-05-01 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:The relationship between health care expenditures and health care outcomes, such as life expectancy and mortality, is complex. Research outcomes show different and contradictory results on this relationship. How and why health care expenditures affect health outcomes is not clear. A causal link between the t...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.11.027
更新日期：2017-03-01 00:00:00
abstract：BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) can be classified into groups A/C or B/D based on symptom intensity. Different threshold values for symptom questionnaires can result in misclassification and, in turn, different treatment recommendations. The primary aim was to find the best fitting...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2017.09.003
更新日期：2017-12-01 00:00:00
abstract：:Osteoporosis is expected to increase as our population pyramid shifts toward old age. It is associated with increased risk of fractures, leading to complications of limitation of ambulation, loss of independence, and chronic pain. Depression is also a common occurrence in the elderly population. Currently, up to 35% o...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2011.09.003
更新日期：2012-06-01 00:00:00
abstract：OBJECTIVE:Delirium superimposed on dementia (DSD) is common, morbid, and costly, yet frequently undiagnosed. Our study aimed to develop a brief screening test to improve health care worker recognition of DSD. DESIGN/SETTING/PARTICIPANTS:Older hospitalized adults with dementia were prospectively enrolled from medical a...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.05.011
更新日期：2019-11-01 00:00:00
abstract：OBJECTIVE:To characterize Medicare skilled nursing facility (SNF) residents who become acutely ill with heart failure (HF) and assess the association between the outcomes of rehospitalization and mortality, and severity of the acute exacerbation, comorbidity, and processes of care. DESIGN:SNF medical record review of ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1097/01.JAM.0000073964.19754.C0
更新日期：2003-07-01 00:00:00
abstract：OBJECTIVES:To evaluate the effectiveness of (1) dissemination strategies to improve clinical practice behaviors (eg, frequency and documentation of pain assessments, use of pain medication) among health care team members, and (2) the implementation of the pain protocol in reducing pain in long term care (LTC) residents...
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 determine if a facility-wide oral care educational program will improve the quality of routine oral care provided to nursing home residents. DESIGN:Single-blind, pre-post observational study of direct caregivers providing routine oral care to residents in 2 nursing homes. INTERVENTION:A 30-minute oral ca...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2009.09.001
更新日期：2009-11-01 00:00:00
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：OBJECTIVES:Adverse events in nursing homes are leading causes of morbidity and mortality, prompting facilities to investigate their antecedents. This study examined the contribution of safety climate-how frontline staff typically think about safety and act on safety issues-to adverse events in Veterans Affairs (VA) nur...
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：:Vital signs are objective measures of physiological function that are used to monitor acute and chronic disease and thus serve as a basic communication tool about patient status. The purpose of this analysis was to review age-related changes of traditional vital signs (blood pressure, pulse, respiratory rate, and temp...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2010.04.009
更新日期：2011-06-01 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:The objective of this study was to evaluate the benefits of influenza vaccination against hospitalization and mortality on frail elderly people. DESIGN:The design was a population-based retrospective cohort study. SETTING:Taiwan's National Health Insurance claims data. PARTICIPANTS:Participants were 5063 ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.12.003
更新日期：2014-04-01 00:00:00
abstract：OBJECTIVE:To assess the prevalence of permanent atrial fibrillation (AF) in community-dwelling subjects aged 85 and to determine the anticoagulation therapy rate. DESIGN:Community-based survey of inhabitants aged 85 years. PARTICIPANTS:Participants were 328 people born in 1924 and assigned to 7 primary health care te...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2011.04.005
更新日期：2012-01-01 00:00:00
abstract：:Suboptimal vitamin D status is common in sick, elderly patients and is associated with secondary hyperparathyroidism, increased bone turnover, and accelerated bone loss. Nutritional supplementation of elderly patients with vitamin D and calcium has been associated with a reduction in fractures and falls. Recently, the...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2005.12.010
更新日期：2006-03-01 00:00:00
abstract：OBJECTIVES:There is a paucity of data for the assessment of frailty in acutely ill hospitalized older adults. We aim to (1) compare the performance of frailty measures [5-item scale of fatigue, resistance, ambulation, illnesses, and loss of weight) (FRAIL), Tilburg Frailty Indicator (TFI), and Clinical Frailty Scale (C...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.04.011
更新日期：2017-07-01 00:00:00
abstract：OBJECTIVES:Protein supplementation has been proposed as an effective dietary strategy to increase skeletal muscle mass and improve physical performance in frail elderly people. Our objective was to assess the impact of 24 weeks of dietary protein supplementation on muscle mass, strength, and physical performance in fra...
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.2012.07.005
更新日期：2012-10-01 00:00:00
