The journal of nursing home research sciences最新文献

{"title":"LETTER TO THE EDITOR: VITAMIN D INTAKE AND FALLS AMONG OLDER NURSING HOME RESIDENTS","authors":"K. Salminen, U. Aalto, M. Suominen, H. Kautiainen, K. Pitkälä, H. Roitto","doi":"10.14283/jnhrs.2022.3","DOIUrl":"https://doi.org/10.14283/jnhrs.2022.3","url":null,"abstract":"","PeriodicalId":75093,"journal":{"name":"The journal of nursing home research sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72723800","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":"Comorbidity and dependence jointly indicate the need for palliative care in nursing home residents","authors":"V. Guion, P. Riba Bremerch, Y. Rolland","doi":"10.14283/jnhrs.2022.6","DOIUrl":"https://doi.org/10.14283/jnhrs.2022.6","url":null,"abstract":"","PeriodicalId":75093,"journal":{"name":"The journal of nursing home research sciences","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89044351","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":"Antihyperglycemic Drug Use in Long-Stay Nursing Home Residents with Diabetes Mellitus.","authors":"Anne L Hume,&nbsp;Seun Osundolire,&nbsp;Attah K Mbrah,&nbsp;Anthony P Nunes,&nbsp;Kate L Lapane","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>About 29.2% of American adults ≥ 65 years of age have diabetes mellitus, but details regarding diabetes management especially among nursing home residents are dated.</p><p><strong>Objectives: </strong>Evaluate the prevalence of antihyperglycemic agents in residents with diabetes mellitus and describe resident characteristics using major drug classes.</p><p><strong>Design: </strong>cross-sectional study.</p><p><strong>Setting: </strong>virtually all United States nursing homes.</p><p><strong>Participants: </strong>141,636 residents with diabetes mellitus.</p><p><strong>Measurements: </strong>Minimum Data Set (2016) and Medicare Part D claims determined use of metformin, sulfonylureas, meglitinide analogs, alpha-glucosidase inhibitors, TZDs, DPP4 inhibitors, SGLT2 inhibitors, GLP1 agonists, as monotherapy and with basal insulin.</p><p><strong>Results: </strong>Seventy-two percent received antihyperglycemic drugs [most common: basal insulins (53.9% total; 46.9% with other non-insulin agents), metformin (35.5% total; 14.2% monotherapy), sulfonylureas (19.6% total; 6.3% monotherapy), and DPP4 inhibitors (12.2% total; 2.2% monotherapy)]. Sixty-three percent of meglitinide monotherapy versus 34.1% of metformin monotherapy users; and 38.3% meglitinide-basal insulin versus 22.2% metformin-basal insulin users were ≥85 years. Obesity was greater among users of GLP1 agonists compared to those receiving other agents (monotherapy: 60.5% versus 33-42%; with basal insulin: 76.2% versus 50-58%). End-stage renal disease was least prevalent among metformin users (monotherapy: 6.6%; with basal insulin: 8.8%) and most common among meglitinide monotherapy (19.6%) and GLP1 agonists with basal insulin (22%) users.</p><p><strong>Conclusions: </strong>There is heterogeneity of diabetes treatment in nursing homes. Use of antihyperglycemic drugs with a higher risk of hypoglycemia, such as insulin with sulfonylureas or meglitinides, continue in nursing home residents.</p>","PeriodicalId":75093,"journal":{"name":"The journal of nursing home research sciences","volume":"8 ","pages":"10-19"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9706405/pdf/nihms-1852404.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40711539","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":"Editorial: Research in nursing homes in the time of COVID","authors":"Y. Rolland, P. de Souto Barreto","doi":"10.14283/jnhrs.2022.2","DOIUrl":"https://doi.org/10.14283/jnhrs.2022.2","url":null,"abstract":"effort in human history. The drama experienced in longterm care facilities (LTCFs) during the epidemic period must however raise questions about the ability of the scientific community to find specific solutions for the oldest and most vulnerable people living in LTCFs in a timely manner. Many epidemiological works carried out in developed countries such as France, the United States, Spain, Italy, Canada alarmed the medical community on a major number of deaths due to SARS-CoV-2 in LTCFs (1). Schematically, about 30% of all deaths due to SARS-CoV-2 concern residents of LTCFs (2,3). This high percentage of deaths within a very minority subgroup of the population (1% of the French population) contrasts with the low number of scientific studies involving residents of LTCFs. A quick search on the PudMed. gov website proves it. By filtering on the research carried out on “humans”, only 694 references emerge by associating the keywords “nursing home” and “COVID-19” (less with “longterm care facility”). This number is derisory (around 0.49%) compared to the 141,237 results obtained with the keyword “COVID-19” alone. To put it another way, 1 in approximately 200 COVID-related manuscripts to date relate to residents of LTCFs. Of course, this observation can be balanced by the research which, without focusing specially on the population living in LTCFs, has led to advances in the care of people living in LTCFs. Research on vaccination is one example among others. However, should we not again be surprised that before the massive and priority vaccination of the residents of LTCFs, none were included in the original work that led to the implementation of the vaccination against SARS-Cov-19 in all institution worldwide? To date, only 5 Randomized Controlled Trial (RCT) have been published on COVID-19 in “nursing home”. In the initial phase, the preventive measures implemented in the LTCFs relied on common sense and were mainly empirical (4). Yet, the severity of the epidemic in the LTCFs due to (i) the specificities of the population but also (ii) the organizational characteristics of the institutions justify a strong commitment for research work to bring improved geriatric medicine and quality of care in LTC during the pandemic. The very high age of the residents, their multiple morbidities, their undernutrition explain their immunosuppression and the high rate of deaths. The very high prevalence of neuro-degenerative diseases in LTCFs, often at severe stage and complicated with psychobehavioral disorders such as wandering compromise the feasibility in applying protective measures and in particular in wearing the mask. Finally, community life, in closed spaces, sometimes old and poorly ventilated, is conducive to the spread of the virus. The conjunction of these three factors (patients at very high risk of severe COVID-19/impossibility of applying health rules/promiscuity of many individuals in a closed place), made it possible, from the start of the pandemic","PeriodicalId":75093,"journal":{"name":"The journal of nursing home research sciences","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86180303","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":"Antimicrobial Prophylaxis and Stewardship in Nursing Home: A Narrative Review","authors":"M. Tandan","doi":"10.14283/jnhrs.2021.11","DOIUrl":"https://doi.org/10.14283/jnhrs.2021.11","url":null,"abstract":"The rapid increase in antimicrobial resistance is a great concern in safeguarding the nursing home population. Improving inappropriate prescribing is the main agenda of antimicrobial stewardship. It is complicated to articulate the appropriateness of antimicrobial prescribed in nursing home residents, especially the prophylaxis. It is tricky because most of the residents are often on multiple medications, and there are no guidelines available for prescribers to decide on the appropriateness. Except for urinary tract infections, prescribing instructions rarely exists for other infections in nursing homes. Very few studies discuss prophylactic prescribing, and most of them are prevalence studies. These studies showed the urinary tract, respiratory tract, and skin-related problem as the most common cause of antimicrobial prophylaxis. However, this information is presented as total proportion without disaggregated analysis of conditions and types of the urinary and respiratory tract and skin-related infections. Further, the definition used is vague, and significant risk factors of antimicrobial prophylaxis and precision about the use remain unanswered. Lack of appropriate definition and unanswered questions are potentially challenging for stewardship in nursing homes. This review summarizes the current situation of antimicrobial prophylaxis and discusses gaps in the literature and pertinent areas for moving forward for antimicrobial stewardship in nursing home settings.","PeriodicalId":75093,"journal":{"name":"The journal of nursing home research sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90942037","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":"Physicians' perceived barriers and proposed solutions for high-quality palliative care in dementia in the Netherlands: Qualitative analysis of survey data.","authors":"Laura Bavelaar,&nbsp;Hilde T A van der Steen,&nbsp;Hilde de Jong,&nbsp;Gillian Carter,&nbsp;Kevin Brazil,&nbsp;Wilco P Achterberg,&nbsp;Jenny T van der Steen","doi":"10.14283/jnhrs.2021.5","DOIUrl":"https://doi.org/10.14283/jnhrs.2021.5","url":null,"abstract":"<p><strong>Background: </strong>The literature indicates that palliative care for people with dementia needs to be enhanced.</p><p><strong>Objectives: </strong>To assess barriers to providing high-quality palliative dementia care and potential solutions to overcome these barriers, as perceived by physicians responsible for end-of-life care with dementia.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>The Netherlands.</p><p><strong>Participants: </strong>A representative sample of 311 elderly care physicians of whom 67% (<i>n</i>=207) responded.</p><p><strong>Measurements: </strong>A postal survey in 2013 containing open-ended items probing for barriers in the elderly care physicians' practices and possible solutions. Answers were coded and grouped using qualitative content analysis and presented to expert physicians in 2021.</p><p><strong>Results: </strong>Barriers to palliative care in dementia were (1) beliefs held by family, healthcare professionals or the public that are not in line with a palliative care approach, (2) obstacles in recognizing and addressing care needs, (3) poor interdisciplinary team approach and consensus, (4) limited use or availability of resources, and (5) poor family support and involvement. Suggested solutions were improving communication and information transfer, and educating healthcare staff, families and the public about palliative care in dementia. Timely and frequent communication with the family, including advance care planning, and more highly skilled nursing staff were also proposed as solutions.</p><p><strong>Conclusions: </strong>The results suggest a strong need for ongoing education for healthcare professionals about palliative dementia care. Strengthening interprofessional collaboration and shared responsibility for advance care planning is also key. Increasing public awareness of the dementia trajectory and the need for a proactive approach call for a broader societal agenda setting.</p>","PeriodicalId":75093,"journal":{"name":"The journal of nursing home research sciences","volume":"7 ","pages":"23-31"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7613902/pdf/EMS157623.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10325032","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":"ASSOCIATIONS OF INFECTION PREVENTION AND CONTROL MEASURES WITH COVID-19 CASES AND DEATHS IN NURSING HOMES","authors":"V. Guion, Lingxiao He, H. Blain, H. Villars, G. Durel, P. Barreto, Y. Rolland","doi":"10.14283/jnhrs.2021.6","DOIUrl":"https://doi.org/10.14283/jnhrs.2021.6","url":null,"abstract":"Background/Objectives: To identify which infection prevention and control (IPC) precautions in long-term care facilities (LTCF) were associated with reduced COVID-19 incidence and mortality among residents and reduced COVID-19 incidence in health care professionals (HCP). Design: Retrospective data on self-assessment of adherence to 101 IPC measures collected via an online questionnaire sent to 825 nursing homes in France in December 2020. Setting and participants: Medical and administrative staff jointly reported data on IPC measures, characteristics of LTCF, counts of residents’ COVID-19 deaths and cases, and counts of HCP cases. Measurements: Random forest models were used to identify the most important IPC measures associated with reduced number of COVID-19 deaths and cases in residents and cases in HCP. The identified variables were then included in linear regression models to estimate the association between levels of adherence to each selected IPC measure and COVID-19 deaths and cases. No data on time of IPC measures implementation were collected. Results: Data from 307 LTCF (37.2%) were collected, accounting for 22,214 residents. A higher number of COVID-19 deaths in residents was associated with a better adherence to physical distancing in group activity rooms. A better adherence by HCP to physical distancing during their mealtimes and break times was associated with fewer COVID-19 cases among residents and HCP. Other IPC measures were not significantly associated with COVID-19 cases or deaths. Conclusion: Physical distancing between residents was more implemented when LTCF had been confronted with COVID-19 deaths. Physical distancing between HCP was associated with fewer COVID-19 cases in residents and HCP, suggesting it may prevent significantly COVID-19 spreading in LTCF. HCP should particularly adhere to physical distancing measures during their mealtimes and break times. A higher adherence to such preventive measures does not require extra material or human resources and may be easily achievable.","PeriodicalId":75093,"journal":{"name":"The journal of nursing home research sciences","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83991727","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":"Group Activity Participation in Relation to Contextual Isolation of United States Nursing Home Residents Living with Alzheimer’s Disease and Related Dementias","authors":"B. Jesdale, C. Bova, A. Mbrah, K. Lapane","doi":"10.14283/jnhrs.2021.7","DOIUrl":"https://doi.org/10.14283/jnhrs.2021.7","url":null,"abstract":"Background: Residents of nursing homes frequently report loneliness and isolation, despite being in an environment shared with other residents and staff. Objective: To describe, among long-stay US nursing home residents living with Alzheimer’s disease and/or related dementias (ADRD), group activity participation in relation to contextual isolation: living in a nursing home where fewer than 20% of residents share socially salient characteristic(s). Design: A cross-sectional evaluation of group activity participation in relation to contextual isolation across 20 characteristics based on demographic characteristics, habits and interests, and clinical and care dimensions. Setting: US nursing homes. Participants: We included 335,421 residents with ADRD aged ≥50 years with a Minimum Data Set 3.0 annual assessment in 2016 reporting their preference for group activity participation, and 94,735 with participation observed by staff. Measurements: We identified 827,823 annual (any anniversary) assessments performed on nursing home residents in 2016, selecting one at random for each resident, after prioritizing the assessment with the least missing data (n=795,038). MDS 3.0 item F0500e assesses resident interest in group activities. Results: When considering all potential sources of contextual isolation considered, 30.7% were contextually isolated on the basis of a single characteristic and 13.7% were contextually isolated on the basis of two or more characteristics. Among residents reporting importance of group activity, 81% of those not contextually isolated reported that group activity participation was important, as did 78% of those isolated on one characteristic, and 75% of those isolated on multiple characteristics. Among residents with staff-observed group activity participation, 64% of those not contextually isolated reported were observed participating in group activities, as were 59% of those isolated on one characteristic, and 52% of those isolated on multiple characteristics. Conclusion: Residents with ADRD facing contextual isolation placed less importance on group activity than residents who were not contextually isolated.","PeriodicalId":75093,"journal":{"name":"The journal of nursing home research sciences","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90138921","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":"Nursing Home Vulnerabilities amid COVID-19 Pandemic: A Study of Midwestern States","authors":"P. Nambisan, M. Abahussain, E. Duthie, C. Galambos, B. Zhang, E. Bukowy","doi":"10.14283/jnhrs.2021.9","DOIUrl":"https://doi.org/10.14283/jnhrs.2021.9","url":null,"abstract":"Background: The COVID-19 pandemic disproportionately affected the older adult population, especially those in nursing homes (NHs). However, there is also evidence that some NHs fared better than others. Objectives: This study examines a set of nursing home related factors to understand whether these factors are associated with the number of COVID-19 cases. Design: We combined three datasets from the Centers for Medicare & Medicaid Services (CMS) – the Star Rating Dataset, the Provider Information Dataset, and the COVID-19 Nursing Home Dataset. Setting and Participants: 4390 NHs that responded to the CMS survey. Methods: Data used is from the period of Jan 1–Dec 27, 2020 for all 12 Midwestern states. The measures used were self-reported information on ratings, staff shortages, PPE shortage, number of beds, Registered Nurse (RN), Licensed Practical Nurses (LPN), Certified Nursing Assistants (CNA) hours per resident, star rating and ownership. Results: Of the 4390 NHs in 12 Midwestern states, high performing NHs were less likely to have more than 30 COVID-19 cases versus low-performing facilities for two of the CMS domains (health inspections, 520 NHs [27.6%] vs 1363 NHs [72.4%]; and staffing 773 NHs [41.1%] vs 1110 NHs [58.9%]). There was also a statistically significant association COVID-19 cases and star rating, NH ownership, NH size, RN, LPN, and CNA staffing in NHs (all p ≤ 0.01). NH ownership status persisted as a predictor of COVID 19 cases when controlled for NH size. Conclusions: Our study highlights two interesting findings. A) a statistically significant association between NH ownership structure and COVID-19 cases among residents - for-profit NHs had higher number of COVID-19 cases B) a statistically significant negative association between RN and CNA staffing and COVID-19 cases (i.e., more staffing hours of RNs and CNA correlated with a smaller number of COVID-19 cases) and a statistically significant positive association between LPN staffing and COVID-19 cases. We discuss ensuing policy implications for NHs.","PeriodicalId":75093,"journal":{"name":"The journal of nursing home research sciences","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88751707","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":"Very poor prognosis after a conservatively treated hip fracture in the most frail nursing home residents","authors":"M. Broekman, J. D. Vos, L. D. Vijlder, M. Brundel","doi":"10.14283/jnhrs.2021.10","DOIUrl":"https://doi.org/10.14283/jnhrs.2021.10","url":null,"abstract":"Purpose: In very frail nursing home residents transport to the hospital for diagnostics in case of a suspected hip fracture might be considered too burdensome or not desirable. We aimed to elucidate the prognosis and disease course for this group. Methods: We performed a retrospective cohort study between 2017 and 2020 in a nursing home in the Netherlands. All patients with a suspected hip fracture were eligible. The main exclusion criteria was transport to the hospital for diagnostics. Our primary outcome is survival after one month. Results: 23 patients fulfilled the inclusion criteria. Median age was 84 years. Almost all patients had severe dementia. After one month 20 patients (87%) had died. Median survival was 5 days (interquartile range 3-8). Conclusion: In the most frail nursing home residents with a suspected hip fracture the prognosis is very poor with a median survival of only 5 days.","PeriodicalId":75093,"journal":{"name":"The journal of nursing home research sciences","volume":"104 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79920019","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}