Abstract：
OBJECTIVE:A 2-year cluster randomized trial of Mouth Care Without a Battle (MCWB) was conducted in nursing homes (NHs) to determine if recommended mouth care practices provided by NH staff could improve residents' oral hygiene and denture outcomes. DESIGN:Cluster randomized trial of NHs. SETTING AND PARTICIPANTS:Seven MCWB NHs and 6 control NHs. A total of 219 NH residents completed baseline and 24-month oral examinations and, if applicable, denture assessments (control = 98, intervention = 121). INTERVENTION:The intervention consisted of training NH staff in the MCWB protocol, and providing support in its use for 2 years. MEASURES:Descriptive data from the Minimum Data Set and clinical oral health assessments: the Plaque Index for Long-Term Care (range 0‒3), the Gingival Index for Long-Term Care (range 0‒4), and the Denture Plaque Index (range 0‒4), with lower scores indicating better oral health. RESULTS:There were no significant demographic or health differences between groups at baseline. Residents' mean age (standard deviation) was 77.8 years (13.5), 71% were female, and 49% had cognitive impairment. At 24 months, there were significant improvements in oral and denture hygiene in the intervention group compared with control (all P < .05) with mean changes in indices that were 0.44 (Plaque Index for Long-Term Care), 0.55 (Gingival Index for Long-Term Care), and 0.67 (Denture Plaque Index) points lower in intervention NHs than control NHs. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE:Training NH staff to attend to residents' oral hygiene and denture care had a sustained, favorable impact on residents' oral and denture hygiene after 24 months compared with usual care. The protocol, MCWB, can be used by direct caregivers to improve the oral hygiene and denture care of NH residents.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Weintraub JA,Zimmerman S,Ward K,Wretman CJ,Sloane PD,Stearns SC,Poole P,Preisser JSdoi
10.1016/j.jamda.2018.09.036subject
Has Abstractpub_date
2018-12-01 00:00:00pages
1086-1091issue
12eissn
1525-8610issn
1538-9375pii
S1525-8610(18)30551-6journal_volume
19pub_type
杂志文章,随机对照试验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:To establish the mortality risk and adverse events associated with the use of atypical antipsychotic medications in people with Parkinson disease psychosis (PDP) in a clinically defined trial cohort. DESIGN:Post hoc analysis of data from a multicenter, open-label extension study of pimavanserin comparing pe...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamda.2015.06.021
更新日期：2015-10-01 00:00:00
abstract：OBJECTIVE:To determine if participation in a 12-month longitudinal long-term care (LTC) rotation resulted in improved knowledge and attitudes about geriatrics. DESIGN:Longitudinal study with paired measurements. SETTING:A community LTC facility and a university-affiliated, community-based internal medicine residency ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2006.05.009
更新日期：2007-02-01 00:00:00
abstract：:A consensus among geriatricians, ethicists, and neurologists supports a palliative approach to the care of individuals with late-stage dementia. But ten years after the publication of the first large study demonstrating the lack of efficacy of percutaneous endoscopic gastrostomy (PEG) tubes in prolonging life for pati...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2008.03.011
更新日期：2008-06-01 00:00:00
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 systemati...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.06.019
更新日期：2018-02-01 00:00:00
abstract：:In long-term care facilities, 5 to 15% of residents have chronic urinary catheters in place. Catheters are commonly used for urinary retention, incontinence control, wound management, and patient comfort. The appropriate use and management of these devices continues to be studied and debated. Transurethral catheters a...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2002-05-01 00:00:00
abstract：OBJECTIVES:The primary objective of this study was to identify proton pump inhibitor (PPI) prescribing patterns in a population of older adults admitted to 22 Midwestern skilled long term care facilities (LTCF) with medical coverage provided by the US Medicare Part A program. The relationship between PPI prescribing pa...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.01.021
更新日期：2013-06-01 00:00:00
abstract：:The aging population in China is growing rapidly and by the middle of this century will peak. In addition, in 2000, elderly people aged 80 and older accounted for 18% of the world's population of oldest old. We identify here ways to begin addressing China's unique aging population needs. Through improving geriatric an...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2009.06.007
更新日期：2009-09-01 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：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:Rehabilitation plays a vital role in the mitigation and improvement of functional limitations associated with aging and chronic conditions. Moderating factors such as sex, age, the medical diagnosis, and rehabilitation timing for admission status, as well as the expected change related to inpatient rehabilit...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.05.034
更新日期：2020-12-01 00:00:00
abstract：OBJECTIVES:Although the biological rationale for the association between folate, vitamin B12, and homocysteine with cognitive function seems plausible, conflicting results have been reported. This study aimed to determine the associations between 1-carbon (1-C) metabolism biomarkers (folate, vitamin B12, and homocystei...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.05.008
更新日期：2017-09-01 00:00:00
abstract：OBJECTIVE:To identify nursing home standards related to items brought in from the community for residents through a nationwide survey of directors of nursing. Specifically we examined the policies with regard to food, cigarettes, alcoholic beverages, and over-the-counter medications. METHODS:A national survey was dist...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2009.03.003
更新日期：2009-07-01 00:00:00
abstract：OBJECTIVE:To investigate the ability of nurses to recognize delirium and its symptoms and to investigate the factors associated with undetected delirium. DESIGN:A prospective, observational study with repeated measurements over a 6-month period. SETTING:Seven long term care settings in Montreal and Quebec City, Canad...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2010.11.002
更新日期：2012-03-01 00:00:00
abstract：OBJECTIVE:To examine whether reduced ability to self-administer medication can accurately classify living placement (independent or assisted living) in a continuing care retirement community (CCRC). DESIGN:Convenience sample of consecutive patients seen in a medical clinic. SETTING:An outpatient medical clinic at a C...
journal_title：Journal of the American Medical Directors Association
pub_type： 临床试验,杂志文章
doi：10.1016/j.jamda.2005.04.002
更新日期：2005-07-01 00:00:00
abstract：OBJECTIVE:To determine the effects of dopaminergic medication withdrawal in an elderly, demented and minimally ambulatory nursing home population with parkinsonism in New York City. METHODS:In our double-blind, randomized study, 11 patients (7 males, 4 females) were randomized into 2 groups: one group underwent levodo...
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.2008.07.001
更新日期：2008-11-01 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
abstract：OBJECTIVES:To assess the effectiveness of a wireless network (WiFi-based) localization system (devices mounted on resident wheelchairs) in decreasing caretaker time spent searching for residents and providing alerts of residents going outdoors in a skilled nursing facility. DESIGN:A controlled study over two 2-month p...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2012.04.010
更新日期：2012-07-01 00:00:00
abstract：OBJECTIVES:This study investigates the transitions of community-dwelling patients with a proximal femoral fracture towards recovery of independence using multistate modeling. The prognostic value of factors affecting the short-term rate of recovery of independence in activities of daily living was assessed for the resi...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.08.006
更新日期：2020-09-19 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:To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. METHODS:Qualitative, semistructu...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2015.01.072
更新日期：2015-05-01 00:00:00
abstract：:Vitamin D deficiency is a common finding in institutionalized older persons. Vitamin D-deficient elderly persons are at higher risk of falls and fractures. Long-term care residents should be considered at high risk of vitamin D deficiency and therefore vitamin D supplementation is highly recommended in this population...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2010.09.013
更新日期：2011-03-01 00:00:00
abstract：OBJECTIVES:To assess whether using coronavirus disease 2019 (COVID-19) community activity level can accurately inform strategies for routine testing of facility staff for active severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:In total, 59,...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.10.038
更新日期：2021-01-01 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
abstract：OBJECTIVE:Older adults receiving Medicare home health services who experience undernutrition may be at increased risk of experiencing adverse outcomes. We sought to identify the association between baseline nutritional status and subsequent health service utilization and mortality over a 1-year period in older adults r...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2010.08.017
更新日期：2011-05-01 00:00:00
abstract：OBJECTIVE:The Geriatric Level of Dysfunction Scale (GLDS) was developed to assess the intensity, frequency, and duration of 19 behavioral disturbance categories that can potentially interfere with long-term care. DESIGN:Secondary analysis of data collected from residents in long-term care facilities. PARTICIPANTS:Par...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2005.04.006
更新日期：2005-09-01 00:00:00
abstract：OBJECTIVES:Structured programs for routine pain assessment and treatment are necessary to optimize care for residents of long-term care facilities (LTCFs). A pilot study was designed to develop, implement, and evaluate a system for pain assessment and monitoring in a LTCF. Additional goals were to determine whether a v...
journal_title：Journal of the American Medical Directors Association
pub_type： 临床试验,杂志文章
doi：10.1016/j.jamda.2004.12.024
更新日期：2005-03-01 00:00:00
abstract：OBJECTIVE:To assess whether medical orders within Physician Orders for Life-Sustaining Treatment (POLST) forms reflect patients' preferences for care at the end of life. DESIGN:This cross-sectional study assessed the agreement between medical orders in POLST forms and the free-form text documentation of an advance car...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.10.016
更新日期：2020-11-13 00:00:00
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：: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
