Swallowing Evaluation and Ventilator Dependency—Considerations and Contemporary Approaches

2011 ◽  
Vol 20 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Lori M. Burkhead
Keyword(s):  
Intensive Care Unit ◽  
Best Practices ◽  
Long Term Care ◽  
Term Care ◽  
The Past ◽  
Life Saving ◽  
Number Of Patients ◽  
Care Facilities ◽  
Swallowing Evaluation

With the advent of advanced life-saving practices, speech-language pathologists will continue to see a surge in the number of patients dependent on ventilators in both the acute and chronic phases of the health care continuum. Today, there are more individuals requiring ventilators, whether in the intensive care unit (ICU), in long-term care facilities, or in the community. In the past, it has been common to delay rehabilitation efforts in the ICU patient who requires a ventilator, based on the rationale that patients are too sick. This excuse no longer fits with contemporary knowledge regarding best practices in the ICU. Additionally, this argument is moot with regard to patients with diagnoses that will mandate long-term ventilator use. Our profession must understand and be able to address the unique concerns and needs regarding swallowing in those with either transient or chronic ventilator dependency.

Sexual harassment from older residents at long-term care facilities: is it really part of the job?

2019 ◽  
Vol 32 (3) ◽  
pp. 325-333
Author(s):  
Feliciano Villar ◽  
Josep Fabà ◽  
Rodrigo Serrat ◽  
Montserrat Celdrán ◽  
Teresa Martínez
Keyword(s):  
Sexual Harassment ◽  
Best Practices ◽  
Long Term Care ◽  
Study Data ◽  
Nursing Assistant ◽  
Cross Sectional ◽  
Term Care ◽  
Staff Members ◽  
Care Facilities

ABSTRACTObjectives:To explore the extent to which staff members in long-term care facilities (LTCF) have experienced situations of sexual harassment, how they commonly and ideally manage the situation, and how their work position influences their responses.Design:Cross-sectional quantitative study, using the vignette technique.Method:A total of 2,196 staff-members who were currently working in Spanish LTCF participated in the study. Data were collected using a self-administered questionnaire. Questions regarding sexual harassment were analysed by a vignette that described a case of sexual harassment. Participants had to choose common and best practices for dealing with the case, and report the frequency with which they had experienced similar situations.Results:The results indicate that 29.9% of participants had experienced an episode of sexual harassment in a LTCF similar to the one presented in the vignette. Responses to the situation were diverse and there were significant differences between common and perceived best practices. Differences were also found depending on the work position of the participant (manager, technical staff or nursing assistant).Conclusions:There is a need for a fuller recognition of the sexual needs of older people. However, the presence of inappropriate sexual behavior must also be acknowledged. The right of staff to work in an environment free of harassment must be respected. The need for explicit institutional guidelines and training opportunities is discussed.

scholarly journals Using Telementoring to Share Best Practices on COVID ‐19 in Post‐Acute and Long‐Term Care Facilities

2020 ◽  
Vol 68 (11) ◽  
Author(s):  
Lauren J. Gleason ◽  
Kimberly J. Beiting ◽  
Jacob Walker ◽  
Saira Shervani ◽  
Jeffrey Graupner ◽  
...  
Keyword(s):  
Best Practices ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities

The Presence of Legionellae in Respiratory Devices

2020 ◽  
Author(s):  
Andrew Nutting
Keyword(s):  
Long Term Care ◽  
Positive Airway Pressure ◽  
Term Care ◽  
The Past ◽  
Care Facilities ◽  
Different Types ◽  
Jet Nebulizers ◽  
Respiratory Devices ◽  
Made In

Legionella is a bacterium found naturally in moist environments. Persons can become infected when they inhale airborne droplets of water containing such bacteria. Legionellosis cases associated with the use of respiratory devices such as Continuous Positive Airway Pressure (CPAP) units, jet nebulizers, portable room humidifiers, and respiratory ventilation equipment have been identified in context of a Legionellosis outbreak. However, a systematic search for the presence of Legionella bacteria in respiratory devices outside of a Legionellosis outbreak has not been reported. The goal of this study was to carry out such a survey on different types of respiratory devices in long term care facilities. Twenty-four respiratory devices including 9 CPAP, 4 BIPAPs, 5 oxygen humidifiers, and 6 ventilators were included in this study. A total of 72 sampling swabs were obtained for the testing of Legionella bacteria inside the respiratory devices. Culture and PCR tests for Legionella pneumophelia were made in tandem. No legionella pneumophelia bacteria were found in any of the respiratory devices sampled. Although there have been reports in the past of potential legionellosis cases associated with the use of respiratory devices, our data suggest that there are probably no legionella bacteria present inside respiratory devices separate of a Legionellosis outbreak.

scholarly journals Evidence-based Recommendations to Inform Best Practices for LGBTQ Older Adults in Long-term Care Settings

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 851-851
Author(s):  
Katherine Fasullo ◽  
Erik McIntosh ◽  
Todd Ruppar ◽  
Sarah Ailey ◽  
Susan Buchholz
Keyword(s):  
Older Adults ◽  
Best Practices ◽  
Best Practice ◽  
Long Term Care ◽  
Guideline Development ◽  
Care Staff ◽  
Evidence Based ◽  
Term Care ◽  
Care Facilities

Abstract Lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults are more likely to live alone and have less familial support, which disproportionately contributes to a reliance on long-term care facilities as they age. Best-practice guidelines supported by scholarly literature to care for LGBTQ older adults in long-term care settings do not exist. This review synthesizes literature about LGBTQ older adults in long-term care facilities and provides recommendations for best practice guideline development. Four electronic databases were searched in June 2019 for studies conducted between 2000 – 2019 related to caring for LGBTQ older adults in long-term care settings. An integrative literature review was completed on the twenty eligible studies. Findings showed that LGBTQ participants fear discrimination in long-term care leading to the invisibility of their identities. They recognize a need for increased staff training and the importance of community networks and facility preferences. Long-term care staff have mixed experiences with inclusive practices and complex views of LGBTQ older adults. They experience training deficits and have a need for more expansive training modalities. The recommendations offered by both LGBTQ participants and long-term care staff are to revise policies and forms as well as provide widespread training and education. LGBTQ participants recommend that their unique identities be recognized within long-term care while long-term care staff recommend leadership involvement to change culture and practice. This review provides evidence-based recommendations to promote equitable healthcare to the LGBTQ older adult population and calls to attention the need for long-term care settings to uniformly follow best-practices.

scholarly journals Relationship-Based Care and Behaviours of Residents in Long-Term Care Facilities

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Johanne Desrosiers ◽  
Anabelle Viau-Guay ◽  
Marie Bellemare ◽  
Louis Trudel ◽  
Isabelle Feillou ◽  
...  
Keyword(s):  
Research Design ◽  
Long Term Care ◽  
Cognitive Impairments ◽  
Term Care ◽  
The Past ◽  
Rigorous Research ◽  
Care Facilities ◽  
Relationship Based Care ◽  
The Impact

Introduction. In long-term care (LTC), person-centred approaches are encouraged. One such approach, relationship-based care (RBC), aims among other things to reduce residents’ agitated behaviours. RBC has been used in numerous Quebec LTC facilities over the past decade but it has never been studied.Objective. Explore correlations between use of RBC by trained caregivers and the frequency of agitated and positive behaviours of residents with cognitive impairments.Methods. Two independent raters observed fourteen caregiver/resident dyads in two LTC facilities during assistance with hygiene and dressing. Checklists were used to quantify caregivers’ RBC use and residents’ agitated and positive behaviours.Results. Scores for RBC use were high, suggesting good application of the approach by caregivers. Correlation analyses showed that offering residents realistic choices and talking to them during care were associated with both positive and agitated behaviours (Pfrom 0.03 to 0.003). However, many other components of RBC were not associated with residents’ behaviours during care.Conclusions. There were only a few quantitative links between the RBC checklist items and the frequency of agitated or positive behaviours. Other studies with a more rigorous research design are needed to better understand the impact of relationship-based care on residents’ behaviours.

An oxymoron of long-term care—Sheltering-in-place during an evacuation: A literature review of the best practices of evacuation and sheltering-in-place for long-term care facilities

2017 ◽  
Vol 15 (3) ◽  
pp. 195
Author(s):  
Megan Baxter, MDEM
Keyword(s):  
Literature Review ◽  
Best Practices ◽  
Long Term Care ◽  
Grey Literature ◽  
Term Care ◽  
Medical Supplies ◽  
Best Response ◽  
Key Points ◽  
Care Facilities

Background: Long-term care facilities (LTCFs) are defined as residential facilities that are home to elderly patrons who are no longer able to live independently. These facilities require comprehensive emergency planning to provide the best response to the threat of a disaster for their residents. However, LTCFs are often overlooked in disaster planning, leaving them to work independently to create suitable arrangements in the event of a disaster. This article examines the literature on evacuating and compares it to the literature on sheltering-in-place for LTCFs. Conclusions regarding best practices are also provided.Methods: A literature review and Internet search were completed in July 2016. Information was entered onto a spreadsheet listing the key points of each article, which was reviewed for emerging themes.Results: Out of the 399 acquired articles and grey literature found during the research portion of this article, 30 were deemed pertinent, 22 of which appear in this article. All included articles were peer reviewed. Themes emerging from these articles include the persistent absence of research into the best practices for LTCFs during emergencies and the difficulties of evacuating and sheltering-in-place with frail populations.Conclusion: While there is no one right answer for all scenarios, sheltering-in-place appears to be the default safe option for those in LTCFs—with the assumption that the facility has taken steps toward preparation, such as purchasing generators and securing enough food, water, and medical supplies to sustain the residents, staff, and families of both for 7 days. Additionally, a LTCF needs to devise contingency plans for evacuation if necessary, to be fully prepared for a catastrophic event.

scholarly journals Group Vaccination Five Days before a COVID-19 Outbreak in a Long-Term Care Facility

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1450
Author(s):  
Mathias W. Pletz ◽  
Sabine Trommer ◽  
Steffi Kolanos ◽  
Norman Rose ◽  
Veit Kinne ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Published Data ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Number Of Patients ◽  
Care Facilities

Rapid vaccination may be of benefit in long-term care facilities (LTCF) that are affected by an ongoing COVID-19 outbreak. However, there are concerns regarding the safety and effectiveness of such an approach, particularly regarding the vaccination of pre-symptomatic patients. Here, we report the effectiveness of vaccination in a German LTCF hit by an outbreak that was detected 5 days after the first vaccine doses were administered. In detail, 66.7% of the unvaccinated patients experienced an unfavorable course; this proportion was much lower (33.3%) among the vaccinated patients. Even though this study is limited by a small number of patients, the observation and the comparison with related published data shows that vaccination (i) is safe and (ii) may still be of benefit when given shortly before an infection or even in pre-symptomatic LTCF-patients.

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