Journal of geriatric emergency medicine最新文献

{"title":"Geriatric Emergency Medicine Fellowship Journal Club – Community Paramedicine","authors":"Priyank Bhatnagar, Don Melady","doi":"10.17294/2694-4715.1077","DOIUrl":"https://doi.org/10.17294/2694-4715.1077","url":null,"abstract":"","PeriodicalId":73757,"journal":{"name":"Journal of geriatric emergency medicine","volume":"76 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141817847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Older Adult with Transplanted Kidney Failure from Ureteral Obstruction Within a Hernia","authors":"Joel Glotfelty, Hannah Grainger, Christina Shenvi","doi":"10.17294/2694-4715.1082","DOIUrl":"https://doi.org/10.17294/2694-4715.1082","url":null,"abstract":"","PeriodicalId":73757,"journal":{"name":"Journal of geriatric emergency medicine","volume":"102 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141657457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Care of an Older Adult with Complex Care Needs","authors":"Muhammad Adnan Khan, Himika Dalia, Michelle Dietz","doi":"10.17294/2694-4715.1075","DOIUrl":"https://doi.org/10.17294/2694-4715.1075","url":null,"abstract":"","PeriodicalId":73757,"journal":{"name":"Journal of geriatric emergency medicine","volume":"46 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140978993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best Practices in the Care of Older Adults During an Unplanned Acute Observation Stay","authors":"Jonny Macias Tejada, Michael Malone","doi":"10.17294/2694-4715.1079","DOIUrl":"https://doi.org/10.17294/2694-4715.1079","url":null,"abstract":"","PeriodicalId":73757,"journal":{"name":"Journal of geriatric emergency medicine","volume":" 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140996013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"After-hours, Severity, and Distance are Associated with Non-VHA Emergency Department Use for Older Veterans: Insights from a Regional Health Information Exchange.","authors":"Elina Kurkurina, Kimberly M Judon, Ula Hwang, Kenneth S Boockvar, Juan P Wisnivesky, Matthew R Augustine","doi":"10.17294/2694-4715.1100","DOIUrl":"10.17294/2694-4715.1100","url":null,"abstract":"<p><strong>Background: </strong>Older adults treated in emergency departments (EDs) are at higher risk for adverse outcomes. Using multiple facilities can worsen this issue through service duplication and poor care transitions. Veterans with dual insurance coverage can access both Veterans Health Administration (VHA) and non-VHA EDs. This study aimed to identify factors associated with non-VHA ED use among veterans.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of patients aged ≥ 65 who had primary care at the James J Peters VA Medical Center and at least one VHA or non-VHA ED visit between October 2017 and February 2020. Data were collected from the Veterans Affairs Corporate Data Warehouse and the Bronx Regional Health Information Exchange Organization. Generalized linear mixed models were used to examine factors influencing non-VHA ED use.</p><p><strong>Results: </strong>The study sample consisted of 3,897 veterans and a total of 13,312 ED visits. Compared to VHA-exclusive ED users, non-VHA ED users were more likely to live farther away (OR 1.04, CI 1.02 - 1.06) and seek care outside regular hours, including mornings (OR 1.61, CI 1.39 - 1.87), nights (OR 1.49, CI 1.33 - 1.66), weekends (OR 1.28, CI 1.16 - 1.42), and holidays (OR 1.32, CI 1.04 - 1.68). They were also more likely to present with emergency care sensitive conditions (OR 2.13, CI 1.90 - 2.37) and recent inpatient hospitalizations (OR 1.22, CI 1.05 - 1.41).</p><p><strong>Conclusion: </strong>These findings suggested that distance and acuity are important predictors of non-VHA ED use in urban areas such as the Bronx, NY. Identifying veterans with key risk factors could improve care coordination and potentially reduce non-VHA ED use.</p>","PeriodicalId":73757,"journal":{"name":"Journal of geriatric emergency medicine","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultivating a Career in Geriatric Emergency Medicine.","authors":"Shan W Liu, Angel Li, Kei Ouchi, Carolina Diniz Hooper, Esteban Franco Garcia, Wendy C Coates","doi":"10.17294/2694-4715.1096","DOIUrl":"10.17294/2694-4715.1096","url":null,"abstract":"","PeriodicalId":73757,"journal":{"name":"Journal of geriatric emergency medicine","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Describing and Predicting Trajectories of Healthcare Utilization Among Older Adults Presenting to an Emergency Department Using the interRAI Emergency Department Screener","authors":"Matthew B Downer, Kristina Kokorelias, Andrew P Costa, Don Melady, Samir K Sinha","doi":"10.17294/2694-4715.1072","DOIUrl":"https://doi.org/10.17294/2694-4715.1072","url":null,"abstract":"","PeriodicalId":73757,"journal":{"name":"Journal of geriatric emergency medicine","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139000397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Community Based Teaching Hospital’s Geriatric Emergency Medicine Initiative","authors":"Josette Hartnett, Isabel Muronzi-Belfon, Suzanne J. Rose","doi":"10.17294/2694-4715.1065","DOIUrl":"https://doi.org/10.17294/2694-4715.1065","url":null,"abstract":"","PeriodicalId":73757,"journal":{"name":"Journal of geriatric emergency medicine","volume":"85 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138981813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing medication self-management challenges and self-efficacy during emergency department medication reconciliation: An evidence-based quality improvement project","authors":"Mitchel Erickson, Jyu-Lin Chen, Yoonmee Joo, Stephanie Rogers, Thomas Hoffman, Claire Bainbridge","doi":"10.17294/2694-4715.1069","DOIUrl":"https://doi.org/10.17294/2694-4715.1069","url":null,"abstract":"Introduction Older adult patients (≥65) accessing emergency departments (ED) represent a significant demographic. Recidivism secondary to adverse drug events (ADE) ranges between 6-24% and levels of prescribed medication non-adherence is common among older adults. The ED pharmacist medication reconciliation workflow may mitigate self-management challenges in real time and reduce medication-related harm while potentially impacting recidivism, medication adherence, and patient self-efficacy. The purposes of this evidence-based project were to (1) evaluate the impact of a modified Medication Management for Deficiencies in the Elderly (MedMalDE) intervention on Self-Efficacy for Appropriate Medication Use (SEAMS) and 30-day return to care and (2) identify factors associated with medication self-management challenges (MedMalDE) in the participating institution. Methods As part of an evidence-based quality improvement (QI) effort to build an accredited geriatric emergency department (GED) and meet State legislated acute care medication history requirements, a new medication reconciliation workflow was deployed. To assess the intervention’s impact on self -efficacy in a pre/post design, 21 older adult patient’s underwent SEAMS assessment at two time points: the intervention and 7-14 days post-discharge from the emergency department. Baseline data and medication self-management challenges for an ED convenience sample of 167 older adult patients completed the MedMalDE. Descriptive statistics and a logistic regression model were used to evaluate the impact of the intervention and factors associated with medication management deficiencies. Wilcoxon Signed Rank was used for pre/post SEAMS score change. Results The self-efficacy (SEAMS) scores of 21-patients participating in the intervention were significantly improved from 19.88 to 21 (p=0.0077, p10%, included lack of knowledge regarding medication names, ease of opening or manipulating medications, ease of swallowing medications, and affordability. MedMalDE total scores were significantly associated with female gender (OR=","PeriodicalId":73757,"journal":{"name":"Journal of geriatric emergency medicine","volume":"231 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139241652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GeriCarED: Feasibility of a pilot program of a geriatric personal care attendant addressing mentation, mobility and matters most in an Emergency Department Observation Unit","authors":"Ilianna Santangelo, Anne Marie Thompson, Aileen Tubridy, Kendra cull, Bridget Conly, Benjamin A. White, Maura Kennedy","doi":"10.17294/2694-4715.1070","DOIUrl":"https://doi.org/10.17294/2694-4715.1070","url":null,"abstract":"The aging of the population has a significant impact on the health care system, as older adults have higher rates of emergency department (ED) visits and hospitalization, different care needs, and are at higher risk of iatrogenic harm in the hospital setting. In addition, there has recently been a rapid growth in ED observation units (EDOUs), to which older adults are frequently admitted. Recognizing the specific needs of older adults, our EDOU implemented an ‘Up by 10’ program which incorporates key components of delirium prevention programs. We took an iterative approach to the implementation of this program, resulting in a pilot program of a GeriCarED personal care attendant (PCA) focusing on the care needs of older adults. In this manuscript we report on a quality improvement study describing the feasibility of this pilot program, the role of the GeriCarED personal care attendant, and the number and type of interventions delivered to older adults. The GeriCarED PCA focused on the care of patients 75 years of age and older, as well as younger patients with cognitive or physical impairments. She systematically rounded on each patient, opening the blinds in the room to let in natural light, identifying assistance needed with activities of daily living, addressing sensory impairment, promoting mobilization, providing activities for cognitive engagement, and assessing for mental status changes. Over the 6 months of this pilot program, she saw a total of 586 patients with a median of 6 patients per day (interquartile range 3). She provided nutritional assistance to 90% of her patients, including cutting up food for 29% of patients and feeding 6% of patients. She mobilized 88% of patients, assisted 75% with washing, provided emotional support for 69% of patients, and identified an acute change in mentation in 2% of patients. Though not designed as an Age-Friendly intervention, this program aligned with the mentation, mobility and what matters components of the 4M framework.","PeriodicalId":73757,"journal":{"name":"Journal of geriatric emergency medicine","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135919184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}