Falls Lead to ED Visits by Nursing Home Residents

2009 ◽  
Vol 42 (14) ◽  
pp. 34
Author(s):  
Bruce Jancin
Keyword(s):  
Nursing Home ◽  
Nursing Home Residents ◽  
Ed Visits

scholarly journals Paramedics’ Perspectives on the Hospital Transfers of Nursing Home Residents—A Qualitative Focus Group Study

2020 ◽  
Vol 17 (11) ◽  
pp. 3778
Author(s):  
Alexandra Pulst ◽  
Alexander Maximilian Fassmer ◽  
Falk Hoffmann ◽  
Guido Schmiemann
Keyword(s):  
Nursing Home ◽  
Nursing Staff ◽  
Hospital Admissions ◽  
Urinary Catheter ◽  
Nursing Home Residents ◽  
Point Of View ◽  
Focus Group Study ◽  
Professional Groups ◽  
Catheter Complications ◽  
Ed Visits

Emergency department (ED) visits and hospital admissions are common among nursing home residents (NHRs). Little is known about the perspectives of emergency medical services (EMS) which are responsible for hospital transports. The aim of this study was to explore paramedics’ experiences with transfers from nursing homes (NHs) and their ideas for possible interventions that can reduce transfers. We conducted three focus groups following a semi-structured question guide. The data were analyzed by content analysis using the software MAXQDA. In total, 18 paramedics (mean age: 33 years, male n = 14) participated in the study. Paramedics are faced with complex issues when transporting NHRs to hospital. They mainly reported on structural reasons (e.g., understaffing or lacking availability of physicians), which led to the initiation of an emergency call. Handovers were perceived as poorly organized because required transfer information (e.g., medication lists, advance directives (ADs)) were incomplete or nursing staff was insufficiently prepared. Hospital transfers were considered as (potentially) avoidable in case of urinary catheter complications, exsiccosis/infections and falls. Legal uncertainties among all involved professional groups (nurses, physicians, dispatchers, and paramedics) seemed to be a relevant trigger for hospital transfers. In paramedics’ point of view, emergency standards in NHs, trainings for nursing staff, the improvement of working conditions and legal conditions can reduce potentially avoidable hospital transfers from NHs.

scholarly journals Assessment and Diagnosis of Mental Illness in EDs Among Individuals Without a Home: Findings from the National Hospital Ambulatory Care Survey

2021 ◽  
Vol 22 (6) ◽  
pp. 1276-1282
Author(s):  
Hijab Ahmed ◽  
Jeff Dennis
Keyword(s):  
Mental Health ◽  
Nursing Home ◽  
Nursing Home Residents ◽  
Mental Health Symptoms ◽  
Mental Health Diagnosis ◽  
Health Symptoms ◽  
Care Survey ◽  
Ed Visits ◽  
To Receive ◽  
Health Diagnosis

Introduction: Homeless individuals lack resources for primary healthcare and as a result use the emergency department (ED) as a social safety net. Our primary objective in this study was to identify the differences between features of visits to United States (US) EDs made by patients without a home and patients who live in a private residence presenting with mental health symptoms or no mental health symptoms at triage. Methods: Data for this study come from the 2009-2017 National Health and Ambulatory Medical Care Survey, a nationally representative cross-sectional survey of ED visits in the US. We examined differences in waiting time, length of visit, and triage score among homeless patients, and privately housed and nursing home residents. We used logistic regression to determine the odds of receiving a mental health diagnosis. Residence, age, gender, race, urgency, and whether the person was seen in the ED in the previous 72 hours were controlled. Results: Homeless individuals made up less than 1% of all ED visits during this period. Of these visits, 47.2% resulted in a mental health diagnosis compared to those who live in a private residence. Adjusting for age, race, gender, triage score, and whether the person had been seen in the prior 72 hours, homeless individuals were still six times more likely to receive a mental health diagnosis despite reporting no mental health symptoms compared to individuals who lived in a private residence. Homeless individuals reporting mental health symptoms were two times more likely to receive a mental health diagnosis compared to privately housed and nursing home residents. Conclusions: Homeless individuals are more likely to receive a mental health diagnosis in the ED whether or not they present with mental health symptoms at triage. This study suggests that homelessness as a status impacts how these individuals receive care in the ED. Community coordination is needed to expand treatment options for individuals experiencing emergent mental health symptoms.

scholarly journals Sex-Specific Differences in Hospital Transfers of Nursing Home Residents: Results from the HOspitalizations and eMERgency Department Visits of Nursing Home Residents (HOMERN) Project

2020 ◽  
Vol 17 (11) ◽  
pp. 3915 ◽  
Author(s):  
Alexander Maximilian Fassmer ◽  
Alexandra Pulst ◽  
Guido Schmiemann ◽  
Falk Hoffmann
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
Hospital Admissions ◽  
Nursing Home Residents ◽  
Emergency Department Visits ◽  
Sociocultural Factors ◽  
Transfer Policy ◽  
Hospital Transfer ◽  
Ed Visits ◽  
Multicenter Prospective Study

Nursing home (NH) residents are often transferred to hospital (emergency department (ED) visits or hospital admissions) and this occurs more frequently in males. However, respective reasons are rather unclear. We conducted a multicenter prospective study in 14 northwest German NHs with 802 residents in which NH staff recorded anonymized data between March 2018 and July 2019 for each hospital transfer. Measures were analyzed using descriptive statistics and compared between sexes via univariate logistic regression analyses using mixed models with random effects. Eighty-eight planned transfers (53.5% hospital admissions, 46.5% ED visits) occurred as well as 535 unplanned transfers (63.1% hospital admissions, 36.9% ED visits). The two most common causes for unplanned transfers were deteriorations of health status (35.1%) and falls/accidents/injuries (33.5%). Male transferred residents were younger, more often married; their advance directives were more commonly not considered correctly and the NH staff identified more males nearing the end of life than females (52.9% vs. 38.2%). Only 9.2% of transfers were rated avoidable. For advance directive availability and NH staff’s perceptions on transfer conditions, we found marked inter-facility differences. There might be sociocultural factors influencing hospital transfer decisions of male and female nursing home residents and facility characteristics that may affect transfer policy.

scholarly journals Characteristics of outpatient emergency department visits of nursing home residents: an analysis of discharge letters

2021 ◽  
Author(s):  
Stephanie Heinold ◽  
Alexander Maximilian Fassmer ◽  
Guido Schmiemann ◽  
Falk Hoffmann
Keyword(s):  
Emergency Department ◽  
Nursing Home ◽  
Nursing Staff ◽  
Wound Care ◽  
Nursing Home Residents ◽  
Emergency Department Visits ◽  
Therapeutic Interventions ◽  
Ed Visits ◽  
Multi Center Study ◽  
Gp Care

Abstract Background Unplanned emergency department (ED) visits of nursing home residents (NHR) are common, with many transfers not leading to hospitalization. However, there is little research on what diagnostic and therapeutic measures are performed during visits. Aims We analyzed underlying diagnoses, characteristics and performed medical procedures of unplanned outpatient ED visits by NHR. Methods We conducted a multi-center study of 14 nursing homes (NHs) in northwestern Germany in 03/2018–07/2019. Hospital transfers were documented by nursing staff using a standardized questionnaire for 12 months. In addition, discharge letters were used to collect information about the respective transfer, its reasons and the extend of the medical services performed in the ED. Results A total of 161 unplanned ED visits were included (mean age: 84.2 years; 68.3% females). The main transfer reasons were trauma (59.0%), urinary catheter and nutritional probe problems (overall 10.6%; male NHR 25.5%) and altered mental state (9.9%). 32.9% where discharged without imaging or blood test prior. 67.4% of injured NHR (n = 95) required no or only basic wound care. Catheter-related problems (n = 17) were mainly treated by changing an existing suprapubic catheter (35.3%) and by flushing the pre-existing catheter (29.4%). Discussion Our data suggest that the diagnostic and therapeutic interventions performed in ED, often do not exceed general practitioner (GP) care and many ED visits seem to be unnecessary. Conclusion Better coordination and consultation with GPs as well as better training of nursing staff in handling catheter problems could help to reduce the number of ED visits.

Erratum: Hearing Levels among Elderly Nursing Home Residents

1980 ◽  
Vol 45 (2) ◽  
Author(s):  
Ronald L. Schow ◽  
Michael A. Nerbonne
Keyword(s):  
Nursing Home ◽  
Nursing Home Residents ◽  
Male And Female

In the February 1980 issue of this journal, the report by Ronald L. Schow and Michael A. Nerbonne ("Hearing Levels Among Elderly Nursing Home Residents") contains an error. On page 128, the labels "Male" and "Female" in Table 2 should be reversed.

Deficits in Selective Attention Alter Gait in Frail Older Adults

GeroPsych ◽  
2016 ◽  
Vol 29 (1) ◽  
pp. 29-36 ◽  
Author(s):  
Véronique Cornu ◽  
Jean-Paul Steinmetz ◽  
Carine Federspiel
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Selective Attention ◽  
Dual Task ◽  
Nursing Home Residents ◽  
Gait Rehabilitation ◽  
Rehabilitation Programs ◽  
Gait Parameters ◽  
Growing Body ◽  
Task Conditions

Abstract. A growing body of research demonstrates an association between gait disorders, falls, and attentional capacities in older adults. The present work empirically analyzes differences in gait parameters in frail institutionalized older adults as a function of selective attention. Gait analysis under single- and dual-task conditions as well as selective attention measures were collected from a total of 33 nursing-home residents. We found that differences in selective attention performances were related to the investigated gait parameters. Poorer selective attention performances were associated with higher stride-to-stride variabilities and a slowing of gait speed under dual-task conditions. The present findings suggest a contribution of selective attention to a safe gait. Implications for gait rehabilitation programs are discussed.

Autobiographical Memory Among Nursing Home Residents With Dementia

2000 ◽  
Author(s):  
Katinka Dijkstra ◽  
Michelle S. Bourgeois ◽  
Lou Burgio ◽  
Rebecca Allen-Burge
Keyword(s):  
Nursing Home ◽  
Autobiographical Memory ◽  
Nursing Home Residents
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