scholarly journals Health Care Providers' Opinions on Communication Between Nursing Homes and Emergency Departments

2010 ◽  
Vol 11 (3) ◽  
pp. 204-210 ◽  
Author(s):  
Suzanne M. Gillespie ◽  
Lauren J. Gleason ◽  
Jurgis Karuza ◽  
Manish N. Shah
Keyword(s):  
Health Care ◽  
Nursing Homes ◽  
Health Care Providers ◽  
Emergency Departments ◽  
Care Providers

scholarly journals Benefits of Musculoskeletal Physical Therapy in Emergency Departments: A Systematic Review

2019 ◽  
Vol 99 (9) ◽  
pp. 1150-1166 ◽  
Author(s):  
Eveline Matifat ◽  
Marianne Méquignon ◽  
Caitriona Cunningham ◽  
Catherine Blake ◽  
Oma Fennelly ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Usual Care ◽  
Health Care Providers ◽  
Emergency Departments ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Current Evidence ◽  
Care Providers ◽  
High Quality

Abstract Background Over the past few decades, physical therapists have emerged as key health care providers in emergency departments (EDs), especially for patients with musculoskeletal disorders (MSKD). Purpose The purpose of this review was to update the current evidence regarding physical therapist care for patients with MSKD in EDs and to update current recommendations for these models of care. Data Sources Systematic searches were conducted in 5 bibliographic databases. Study Selection The studies selected presented quantitative data related to the care of patients with MSKD by physical therapists in an ED setting. Data Extraction Raters reviewed studies and used the Effective Public Health Practice Project Quality Assessment Tool to assess their methodological quality. Data Synthesis Fifteen studies were included. Two studies, 1 of weak and 1 of strong quality, demonstrated that physical therapist care in EDs was as effective as or more effective than usual medical care for pain reduction, and 6 studies of varying quality reported that physical therapist care in EDs was as effective as usual care in EDs in reducing disability. Eight studies of varying quality reported that physical therapist care could significantly reduce waiting time in EDs. Four studies of varying quality reported that physical therapists ordered no more, or even fewer, medical images than physicians. In terms of health care costs, 2 studies of moderate to high quality found no significant differences in costs between physical therapist care and usual care in EDs. Finally, 6 studies of varying quality reported that patients were as satisfied or more satisfied with physical therapist care as with usual medical care in EDs. Limitations The roles of physical therapists in EDs vary depending on the setting, legislation, and training of providers. Only a limited number of high-quality studies were identified. Conclusions Although the quality of the evidence is heterogeneous, physical therapist care for patients with MSKD in EDs may be beneficial.

Provisional Educational Needs of Health Care Providers in Palliative Care in Three Nursing Homes in Ontario

1997 ◽  
Vol 13 (3) ◽  
pp. 13-17 ◽  
Author(s):  
Chris Patterson ◽  
William Molloy ◽  
Rosalie Jubelius ◽  
G.H. Guyatt ◽  
M. Bédard
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Nursing Homes ◽  
Health Care Providers ◽  
Educational Needs ◽  
Physical Symptoms ◽  
Spiritual Needs ◽  
Care Providers ◽  
Pharmacological Management ◽  
Traditional Lectures

Health care providers in three nursing homes in Ontario were surveyed to determine educational needs, barriers to meeting these needs, and the preferred format for education. Of the 415 health care providers asked to participate, 225 completed the questionnaire. Need was expressed for the majority of the 35 educational topics identified, including the role of the palliative care team, management of physical symptoms, pharmacological and non-pharmacological management of pain, stress management, spiritual needs, culture and death, and counseling. Group discussions and seminars were favored over traditional lectures. The primary factors influencing attendance at a palliative care workshop were loss of pay and time and location of the workshop.

Current Controversies in Prehospital Resuscitation of the Terminally Ill Patient

1990 ◽  
Vol 5 (1) ◽  
pp. 49-57 ◽  
Author(s):  
R. Jack Ayres
Keyword(s):  
Health Care ◽  
Nursing Homes ◽  
Health Care Providers ◽  
Care Provider ◽  
Life Support ◽  
Terminally Ill ◽  
Advanced Life Support ◽  
Care Providers ◽  
Emergency Health Care ◽  
Prehospital Emergency

Prehospital health-care providers regularly are called upon to assist terminally ill patients in residential or institutional, non-hospital settings such as nursing homes or hospices. Among the most crucial issues regarding such patients is whether they should be resuscitated. With alarming frequency, EMS providers are encountering vigorous and sometimes violent refusals of examination, treatment, and/or transportation from the terminally ill patient, members of the patient's family, or third persons ostensibly acting on the patient's behalf. Today, the prehospital emergency health-care provider repeatedly is faced with the legal and ethical questions that surround the issue of resuscitation and advanced life support.

scholarly journals Older Patients in Emergency Departments. Challenges from the health care providers’ perspective

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Deutschbein ◽  
M Möckel ◽  
L Schenk
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Health Care Providers ◽  
Demographic Change ◽  
Health Care Professionals ◽  
Emergency Departments ◽  
Older Patients ◽  
Care Providers ◽  
Complex Needs ◽  
Prolonged Length

Abstract Background Patients aged 65 and above are the fastest growing patient population in Europe. This is one of greatest challenges for almost all health services providers, including acute hospitals and their Emergency Departments (ED). As of today, older patients represent up to 30% of all ED patients, it is estimated. However, it is largely unclear to what degree EDs are currently prepared for older patients and how they need to adjust. This study analyses the present situation from the perspective of health care professionals caring for older ED patients. Methods The study was embedded in a mixed methods design using qualitative expert interviews. N = 25 semi-structured, guided interviews were conducted with professional health care providers from 7 Berlin EDs (physicians, nurses), and adjacent health care sectors such as nursing homes, rehabilitation clinics, and medical practices. Interviewees were asked about their daily experiences with older ED patients and their ideas of health care deficits and potentials. Data was analyzed using content analysis and hermeneutics. Results Health care providers assess the ED care situation for older patients and the necessity of adjustments in different ways but mostly as deficient. EDs are described as not elderly-friendly and partly as hazardous: older patients are at risk of adverse events such as developing a delirium. Risk factors are prolonged length of stay, the busy and noisy ED setting, and falls hazards. In general, ED staffing is not adequate to care for older patients with complex needs. Conclusions Considering demographic change, German Eds need to concentrate on the growing number of oder patients and their specific needs. Further research and development of specific care concepts for older ED patients is strongly needed. Potential adjustments of ED structures and care concepts also need to involve patients’ experiences and subjective needs. However, data on the patient perspective is still missing. Key messages Older patients and demographic change represent great challenges for EDs. Care concepts need to be developed to meet older patients needs and to avoid risks of adverse events.

scholarly journals Planning for the Future

2017 ◽  
Vol 12 (1) ◽  
Author(s):  
Mitch Levine
Keyword(s):  
Health Care ◽  
Nursing Homes ◽  
Health Care Providers ◽  
Long Term Care ◽  
Care Providers ◽  
Advanced Dementia ◽  
Term Care ◽  
Advanced Directive ◽  
Advanced Directives

In this issue of CJGIM Quinn et al discuss the merits of physicians taking the time to focus on the overall goals of care in patients with advanced dementia who present for the treatment of an acute problem. Rather than immediately managing the presenting new illness they suggest that the clinical management plan be put into the context of what are the specific overarching goals and expectations of the individual patient with an advanced dementia. The problem of course is that unless it is clearly spelled out in advance, it is a challenge to know what these consist of for a patient who is in an advanced state of cognitive decline. In this situation health care providers frequently have to rely on the patient’s family for some direction, but the latter are not always fully informed. In Ontario, a document issued by the Ontario Ministry of Health and Long-Term Care called a “Do Not Resuscitate Confirmation Form” gives clear direction regarding the use of CPR.1 When completed for an individual in a long-term care facility, this information provides excellent guidance for first responders and health care providers regarding resuscitation. But these forms do not discuss the various degrees of medical care that can be provided beyond cardio-pulmonary resuscitation. Interventions such as IV fluids, antibiotics and feeding options, still need to be addressed. These are treatments that patients may or may not want. Clearly what is needed is a more comprehensive document that is widely proffered by provincial ministries of health, to be completed or updated annually by the patients in long-term care institutions (or by their power of attorneys).When a patient deteriorates in a long-term care institution the nursing staff often feel uncomfortable making pivotal decisions and as a result patients are inevitably transferred to acute care facilities for assessment and possible treatment. But if the patients are accompanied by a clear and standardized detailed advanced directive this will assist the physicians to do what Quinn et al are suggesting in their article. As such, it should be apparent that the completion of an advanced directive is the vital step to ensuring that patient care is reflective of what patients want. Yet advance directives do not accompany all patient transfers from nursing homes to hospital emergency rooms despite that it is now more than one and a half decades since a clinical trial showed the benefits of employing advanced directives in nursing homes.2 Perhaps what is needed is for the completion of a detailed advanced directive to become a designated Quality Indicator (QI) in the long-term care setting. In a health care environment that is linking budgets to QIs, nothing catches a health care administrator’s attention faster than a QI with implications. The universal completion of a detailed health care advanced directive would provide sufficient guidance for all physicians treating patients with advanced dementia who they are meeting for the first time. As a consequence, making clinical decisions that reflect the patient’s values will become the standard of care.

scholarly journals Media framing of emergency departments: a call to action for nurses and other health care providers

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kimberley Thomas ◽  
Annette J. Browne ◽  
Sunny Jiao ◽  
Caryn Dooner ◽  
Patrice Wright ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care Providers ◽  
Emergency Departments ◽  
Nursing Practice ◽  
Health Care Needs ◽  
Care Providers ◽  
Care Needs ◽  
Public Media ◽  
Social Inequities

Abstract Background As part of a larger study focused on interventions to enhance the capacity of nurses and other health care workers to provide equity-oriented care in emergency departments (EDs), we conducted an analysis of news media related to three EDs. The purpose of the analysis was to examine how media writers frame issues pertaining to nursing, as well as the health and social inequities that drive emergency department contexts, while considering what implications these portrayals hold for nursing practice. Methods We conducted a search of media articles specific to three EDs in Canada, published between January 1, 2018 and May 1, 2019. Media items (N = 368) were coded by story and theme attributes. A thematic analysis was completed to understand how writers in public media present issues pertaining to nursing practice within the ED context. Results Two overarching themes were found. First, in ED-related media that portrays health care needs of people experiencing health and social inequities, messaging frequently perpetuates stigmatizing discourses. Second, media writers portray pressures experienced by nurses working in the ED in a way that evades structural determinants of quality of care. Underlying both themes is an absence of perspectives and authorship from practicing nurses themselves. Conclusions We recommend that frontline nurses be prioritized as experts in public media communications. Nurses must be supported to gain critical media skills to contribute to media, to destigmatize the health care needs of people experiencing inequity who attend their practice, and to shed light on the structural causes of pressures experienced by nurses working within emergency department settings.

Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
Health Care Providers ◽  
Elder Abuse ◽  
Skilled Nursing Facility ◽  
Pressure Sores ◽  
Care Providers ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

Interdisciplinary Therapy Assessments for the Older Adult

2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Standardized Testing ◽  
Health Care Providers ◽  
Outcome Measurement ◽  
Care Providers ◽  
Patient Centered ◽  
Screening Process ◽  
Evidenced Based ◽  
Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

Sign in / Sign up

Export Citation Format

Share Document