scholarly journals Examining Caregiver-Resident Communication and Apathy in Dementia in Nursing Homes During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 310-310
Author(s):  
Diane Berish ◽  
Yo-Jen Liao ◽  
Marie Boltz ◽  
Ying-Ling Jao
Keyword(s):  
Nursing Homes ◽  
Data Collection ◽  
Facial Expressions ◽  
Nursing Home Residents ◽  
Lessons Learned ◽  
Daily Routines ◽  
Video Recordings ◽  
Vital Component ◽  
Communication Approach ◽  
The Impact

Abstract This presentation shares lessons learned from conducting a study examining the impact of staff caregivers’ communication approach on apathy in residents with dementia in nursing homes. Due to COVID-19 restrictions, this study had to be paused and required major revisions to continue, which resulted in significant delays and increased expenses. Additionally, this study required in-person data collection and video recordings to capture staff caregivers’ communication with residents with dementia during caregiving activities. However, due to the pandemic, nursing home residents’ daily routines have been significantly changed, making it challenging to capture the nature of caregiver-resident interactions. Furthermore, using masks created unforeseen barriers for capturing communication between staff caregivers and residents including difficulties in identifying residents’ facial expressions, which are a vital component of assessing apathy. The presentation describes approaches to communication with founders, collaborators, and clinical sites and discusses strategies to recruit participants and conduct data collection.

The effect of the implementation of a good medical practice booklet on nursing home residents’ drug prescriptions: a difference-in-differences analysis based on data from electronic pill dispensers (Preprint)

2019 ◽  
Author(s):  
Stéphane Sanchez ◽  
Cécile Payet ◽  
Marie Herr ◽  
Anne Dazinieras ◽  
Caroline Blochet ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Medical Practice ◽  
Intervention Group ◽  
Medication Use ◽  
Nursing Home Residents ◽  
Control Group ◽  
Multilevel Regression ◽  
Difference In Differences ◽  
Good Medical Practice ◽  
The Impact

BACKGROUND The elderly are particularly exposed to adverse events from medication. Among the various strategies to reduce polypharmacy, educational approaches have shown promising results. OBJECTIVE We aimed to evaluate the impact of the implementation of a good medical practice booklet on polypharmacy in nursing homes. METHODS We identified nursing homes belonging to a geriatric care provider that had launched a policy of proper medication use using a good medical practice booklet delivered to prescribers and pharmacists. Data were derived from electronic pill dispensers. The effect of the intervention on polypharmacy was assessed with multilevel regression models, with a control group to account for natural trends over time. The main outcomes were the average daily number of times when medication was administered and the number of drugs with different presentation identifier codes per resident per month. RESULTS 96,216 residents from 519 nursing homes were included between 1 January 2011 and 31 December 2014. The intervention group and the control group both decreased their average daily use of medication (-0.05 and -0.06). The good medical practice booklet did not have a statistically significant effect (exponentiated difference-in-differences coefficient 1.00, 95% confidence interval 0.99-1.02, P=.45). CONCLUSIONS Although the good medical practice booklet itself did not seem effective in decreasing medication use, our data show the effectiveness of a higher-level policy to decrease polypharmacy.

scholarly journals Impact of Roommates on MDRO Spread in Nursing Homes

2020 ◽  
Vol 41 (S1) ◽  
pp. s66-s67
Author(s):  
Gabrielle M. Gussin ◽  
Ken Kleinman ◽  
Raveena D. Singh ◽  
Raheeb Saavedra ◽  
Lauren Heim ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Multidrug Resistant ◽  
Healthcare Intervention ◽  
Odds Ratios ◽  
Care Needs ◽  
Environmental Cleaning ◽  
The Impact

Background: Addressing the high burden of multidrug-resistant organisms (MDROs) in nursing homes is a public health priority. High interfacility transmission may be attributed to inadequate infection prevention practices, shared living spaces, and frequent care needs. We assessed the contribution of roommates to the likelihood of MDRO carriage in nursing homes. Methods: We performed a secondary analysis of the SHIELD OC (Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, CA) Project, a CDC-funded regional decolonization intervention to reduce MDROs among 38 regional facilities (18 nursing homes, 3 long-term acute-care hospitals, and 17 hospitals). Decolonization in participating nursing homes involved routine chlorhexidine bathing plus nasal iodophor (Monday through Friday, twice daily every other week) from April 2017 through July 2019. MDRO point-prevalence assessments involving all residents at 16 nursing homes conducted at the end of the intervention period were used to determine whether having a roommate was associated with MDRO carriage. Nares, bilateral axilla/groin, and perirectal swabs were processed for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CRE). Generalized linear mixed models assessed the impact of maximum room occupancy on MDRO prevalence when clustering by room and hallway, and adjusting for the following factors: nursing home facility, age, gender, length-of-stay at time of swabbing, bedbound status, known MDRO history, and presence of urinary or gastrointestinal devices. CRE models were not run due to low counts. Results: During the intervention phase, 1,451 residents were sampled across 16 nursing homes. Overall MDRO prevalence was 49%. In multivariable models, we detected a significant increasing association of maximum room occupants and MDRO carriage for MRSA but not other MDROs. For MRSA, the adjusted odds ratios for quadruple-, triple-, and double-occupancy rooms were 3.5, 3.6, and 2.8, respectively, compared to residents in single rooms (P = .013). For VRE, these adjusted odds ratios were 0.3, 0.3, and 0.4, respectively, compared to residents in single rooms (P = NS). For ESBL, the adjusted odds ratios were 0.9, 1.1, and 1.5, respectively, compared to residents in single rooms (P = nonsignificant). Conclusions: Nursing home residents in shared rooms were more likely to harbor MRSA, suggesting MRSA transmission between roommates. Although decolonization was previously shown to reduce MDRO prevalence by 22% in SHIELD nursing homes, this strategy did not appear to prevent all MRSA transmission between roommates. Additional efforts involving high adherence hand hygiene, environmental cleaning, and judicious use of contact precautions are likely needed to reduce transmission between roommates in nursing homes.Funding: NoneDisclosures: Gabrielle M. Gussin, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

scholarly journals Evaluation of a 1 MW, 250 kW-hr Battery Energy Storage System for Grid Services for the Island of Hawaii

Energies ◽  
2018 ◽  
Vol 11 (12) ◽  
pp. 3367 ◽  
Author(s):  
Karl Stein ◽  
Moe Tun ◽  
Keith Musser ◽  
Richard Rocheleau
Keyword(s):  
Energy Storage ◽  
Data Collection ◽  
Storage System ◽  
Energy Storage System ◽  
Fast Response ◽  
Lessons Learned ◽  
Battery Energy Storage ◽  
Utility Company ◽  
Battery Energy ◽  
The Impact

Battery energy storage systems (BESSs) are being deployed on electrical grids in significant numbers to provide fast-response services. These systems are normally procured by the end user, such as a utility grid owner or independent power producer. This paper introduces a novel research project in which a research institution has purchased a 1 MW BESS and turned ownership over to a utility company under an agreement that allowed the institution to perform experimentation and data collection on the grid for a multi-year period. This arrangement, along with protocols governing experimentation, has created a unique research opportunity to actively and systematically test the impact of a BESS on a live island grid. The 2012 installation and commissioning of the BESS was facilitated by a partnership between the Hawaii Natural Energy Institute (HNEI) and the utility owner, the Hawaiian Electric and Light Company (HELCO). After the test period ended, HELCO continued to allow data collection (including health testing). In 2018, after 8500 equivalent cycles, the BESS continues to operate within specifications. HNEI continues to provide HELCO with expertise to aid with diagnostics as needed. Details about the BESS design, installation, experimental protocols, initial results, and lessons learned are presented in this paper.

Comparison of Data Collection for Healthcare-Associated Infection Surveillance in Nursing Homes

2016 ◽  
Vol 37 (12) ◽  
pp. 1440-1445 ◽  
Author(s):  
Lauren Epstein ◽  
Nimalie D. Stone ◽  
Lisa LaPlace ◽  
Jane Harper ◽  
Ruth Lynfield ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nursing Homes ◽  
Data Collection ◽  
Clinical Risk Factors ◽  
Healthcare Associated Infection ◽  
Screening Criteria ◽  
Clinical Risk ◽  
Level Data ◽  
Healthcare Associated ◽  
The Impact

OBJECTIVETo facilitate surveillance and describe the burden of healthcare-associated infection (HAI) in nursing homes (NHs), we compared the quality of resident-level data collected by NH personnel and external staff.DESIGNA 1-day point-prevalence surveySETTING AND PARTICIPANTSOverall, 9 nursing homes among 4 Centers for Disease Control and Prevention (CDC) Emerging Infection Program (EIP) sites were included in this study.METHODSNH personnel collected data on resident characteristics, clinical risk factors for HAIs, and the presence of 3 HAI screening criteria on the day of the survey. Trained EIP surveillance officers collected the same data elements via retrospective medical chart review for comparison; surveillance officers also collected available data to identify HAIs (using revised McGeer definitions). Overall agreement was calculated among residents identified by both teams with selected risk factors and HAI screening criteria. The impact of using NH personnel to collect screening criteria on HAI prevalence was assessed.RESULTSThe overall prevalence of clinical risk factors among the 1,272 residents was similar between NH personnel and surveillance officers, but the level of positive agreement (residents with factors identified by both teams) varied between 39% and 87%. Surveillance officers identified 253 residents (20%) with ≥1 HAI screening criterion, resulting in 67 residents with an HAI (5.3 per 100 residents). The NH personnel identified 152 (12%) residents with ≥1 HAI screening criterion; 42 residents had an HAI (3.5 per 100 residents).CONCLUSIONWe identified discrepancies in resident-level data collection between surveillance officers and NH personnel, resulting in varied estimates of the HAI prevalence. These findings have important implications for the design and implementation of future HAI prevalence surveys.Infect Control Hosp Epidemiol 2016;1440–1445

scholarly journals The role of midwives in improving breastfeeding practices in protracted crises: The Gaza Strip example

2020 ◽  
Author(s):  
Alessandro Iellamo ◽  
Emily Monaghan ◽  
Samar AL Moghany ◽  
Jonathan Latham ◽  
Nihal Nassereddin
Keyword(s):  
Breast Milk ◽  
Data Collection ◽  
Gaza Strip ◽  
Healthcare Services ◽  
Lessons Learned ◽  
Security Officers ◽  
Breastfeeding Practices ◽  
Service Training ◽  
The Gaza Strip ◽  
The Impact

Abstract Background: The protection, promotion and support of breastfeeding is the most effective intervention to prevent child morbidity and mortality in all contexts. During the Palestine-Israel conflict that started in the middle of the 20th century, healthcare services are understaffed and lack basic resources, with frequent power cuts and stock-outs of essential drugs and equipment. This case study seeks to answer the questions: (1) How does the protracted crisis in Gaza affect the breastfeeding practices of the most vulnerable population; and (2) What is the role that midwives can play in improving breastfeeding practices?A mixed method (qualitative and quantitative) study was used to collect data. A total of 1044 respondents had a child less than 24 months at the time of the study. A total of 62.75 percent practice early initiation of breastfeeding and 42 percent confirmed that their new-borns were given liquids other than breast milk during the first three days of life. Fifty percent of mothers addressed breast milk insufficiency by drinking additional fluids and 40 percent by using infant formula. Discussion:This study confirms the need to a) implement the IYCF-E operational guidance in the Gaza strip and b) review the pre-service and in-service training for midwives. For vulnerable populations in humanitarian contexts, the impact of this cannot be underestimated. Conducting research in humanitarian settings is particularly challenging. Our experience included integration and linkage with international organizations security officers on the ground, co-ordination of activities with authorities and communities, regular supportive supervision during data collection, allocation of buffer days and geographical areas and in-country and remote assistance to data collection teams Conclusions:This research focuses on a protracted emergency in insecure populated areas. The unpredictable security situation meant that the team adopted a flexible approach during data collection. Lessons learned throughout this process include the importance of a) allocating additional research time, to account for potential interruption b) daily coordination with security officers to ensure safe access to localities c) identification of extra sites, in case escalation of conflict d) training of additional enumerators in case conflict escalation e) negotiation with authorities to ensure compliance with requirements.

scholarly journals Association of care workers’ job satisfaction and global happiness with change of functional performance of severely disabled elderly residents in nursing homes: a cohort and questionnaire study in Japan

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e033937
Author(s):  
Shino Ikeda-Sonoda ◽  
Nao Ichihara ◽  
Jiro Okochi ◽  
Arata Takahashi ◽  
Hiroaki Miyata
Keyword(s):  
Job Satisfaction ◽  
Nursing Home ◽  
Nursing Homes ◽  
Functional Performance ◽  
Nursing Home Residents ◽  
Care Staff ◽  
Lower Probability ◽  
Disabled Elderly ◽  
The Impact

ObjectivesThere is growing concern regarding quality of work life (QWL) among care staff in nursing homes. However, little is known about the impact of QWL on nursing home residents’ functional performance. Recent literature suggests that job satisfaction and happiness of healthcare workers reflect their perceived QWL and impact the quality of their care. This study examined the association between job satisfaction and global happiness with change in functional performance of severely disabled elderly residents in nursing homes.DesignA retrospective cohort study of nursing home residents combined with a questionnaire survey of their care staff.SettingEighteen nursing homes in Japan.ParticipantsData were collected from 1000 residents with a required care level of 3–5 and from 412 care staff in nursing homes between October 2017 and March 2018.Outcomes and explanatory variablesFunctional performance was structurally assessed with ICF (International Classification of Functioning, Disability and Health) staging, composed of 52 items concerning activities of daily life, cognitive function and social participation, at baseline and 6 months later. Deterioration and improvement of functional performance were dichotomously defined as such change in any of the items. QWL of care staff was evaluated with a questionnaire including questions about job satisfaction and global happiness.ResultsFunctional performance deteriorated and improved in 23.0% and 12.7% of residents, respectively. Global happiness of care staff was associated with lower probability of residents’ deterioration (adjusted OR, 0.61; CI 0.44 to 0.84). There was no significant correlation between job satisfaction or happiness of care staff and improvement of residents’ functional performance.ConclusionThese results suggest that QWL of care staff is associated with changes in functional performance of elderly people with severe disabilities in nursing homes.

scholarly journals Public reporting of antipsychotic prescribing in nursing homes: population-based interrupted time series analyses

2018 ◽  
Vol 28 (2) ◽  
pp. 121-131 ◽  
Author(s):  
Noah M Ivers ◽  
Monica Taljaard ◽  
Vasily Giannakeas ◽  
Catherine Reis ◽  
Evelyn Williams ◽  
...  
Keyword(s):  
Time Series ◽  
Nursing Home ◽  
Nursing Homes ◽  
Mass Media ◽  
Nursing Home Residents ◽  
Public Reporting ◽  
Increased Risk ◽  
Antipsychotic Prescribing ◽  
The Impact ◽  
Newspaper Articles

BackgroundAlthough sometimes appropriate, antipsychotic medications are associated with increased risk of significant adverse events. In 2014, a series of newspaper articles describing high prescribing rates in nursing homes in Ontario, Canada, garnered substantial interest. Subsequently, an online public reporting initiative with home-level data was launched. We examined the impact of these public reporting interventions on antipsychotic prescribing in nursing homes.MethodsTime series analysis of all nursing home residents in Ontario, Canada, between 1 October 2013 and 31 March 2016. The primary outcome was the proportion of residents prescribed antipsychotics each month. Balance measures were prescriptions for common alternative sedating agents (benzodiazepines and/or trazodone). We used segmented regression to assess the effects on prescription trends of the newspaper articles and the online home-level public reporting initiative.ResultsWe included 120 009 nursing home resident admissions across 636 nursing homes. Following the newspaper articles, the proportion of residents prescribed an antipsychotic decreased by 1.28% (95% CI 1.08% to 1.48%) and continued to decrease at a rate of 0.2% per month (95% CI 0.16% to 0.24%). The online public reporting initiative did not alter this trend. Over 3 years, there was a net absolute reduction in antipsychotic prescribing of 6.0% (95% CI 5.1% to 6.9%). Trends for benzodiazepine prescribing did not change as substantially during the period of observation. Trazodone use has been gradually increasing, but its use did not change abruptly at the time of the mass media report or the public reporting initiative.InterpretationThe rapid impact of mass media on prescribing suggests both an opportunity to use this approach to invoke change and a warning to ensure that such reporting occurs responsibly.

Accuracy of influenza vaccination rate estimates in United States nursing home residents

2014 ◽  
Vol 143 (12) ◽  
pp. 2588-2595 ◽  
Author(s):  
J. M. GROSHOLZ ◽  
S. BLAKE ◽  
J. D. DAUGHERTY ◽  
E. AYERS ◽  
S. B. OMER ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Influenza Vaccination ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Term Care ◽  
Vaccination Rates ◽  
Vaccination Recommendations ◽  
The Impact

SUMMARYThe US Center for Medicare and Medicaid Services (CMS) requires nursing homes and long-term-care facilities to document residents' vaccination status on the Resident Assessment Instrument (RAI). Vaccinating residents can prevent costly hospital admissions and deaths. CMS and public health officials use RAI data to measure vaccination rates in long-term-care residents and assess the quality of care in nursing homes. We assessed the accuracy of RAI data against medical records in 39 nursing homes in Florida, Georgia, and Wisconsin. We randomly sampled residents in each home during the 2010–2011 and 2011–2012 influenza seasons. We collected data on receipt of influenza vaccination from charts and RAI data. Our final sample included 840 medical charts with matched RAI records. The agreement rate was 0·86. Using the chart as a gold standard, the sensitivity of the RAI with respect to influenza vaccination was 85% and the specificity was 77%. Agreement rates varied within facilities from 55% to 100%. Monitoring vaccination rates in the population is important for gauging the impact of programmes and policies to promote adherence to vaccination recommendations. Use of data from RAIs is a reasonable approach for gauging influenza vaccination rates in nursing-home residents.

scholarly journals Design and Field Methods of the ARISE Network COVID-19 Rapid Monitoring Survey

2021 ◽  
Author(s):  
Elena C. Hemler ◽  
Michelle L. Korte ◽  
Bruno Lankoande ◽  
Ourohiré Millogo ◽  
Nega Assefa ◽  
...  
Keyword(s):  
Data Collection ◽  
Urban Areas ◽  
Response Rates ◽  
Lessons Learned ◽  
Mobile Telephone ◽  
Sub Saharan Africa ◽  
Baseline Survey ◽  
Computer Assisted ◽  
Attitudes And Practices ◽  
The Impact

The coronavirus disease 2019 (COVID-19) pandemic has significant health and economic ramifications across sub-Saharan Africa (SSA). Data regarding its far-reaching impacts are severely lacking, thereby hindering the development of evidence-based strategies to mitigate its direct and indirect health consequences. To address this need, the Africa Research, Implementation Science, and Education (ARISE) Network established a mobile survey platform in SSA to generate longitudinal data regarding knowledge, attitudes, and practices (KAP) related to COVID-19 prevention and management and to evaluate the impact of COVID-19 on health and socioeconomic domains. We conducted a baseline survey of 900 healthcare workers, 1,795 adolescents 10 to 19 years of age, and 1,797 adults 20 years or older at six urban and rural sites in Burkina Faso, Ethiopia, and Nigeria. Households were selected using sampling frames of existing Health and Demographic Surveillance Systems or national surveys when possible. Healthcare providers in urban areas were sampled using lists from professional associations. Data were collected through computer-assisted telephone interviews from July to November 2020. Consenting participants responded to surveys assessing KAP and the impact of the pandemic on nutrition, food security, healthcare access and utilization, lifestyle, and mental health. We found that mobile telephone surveys can be a rapid and reliable strategy for data collection during emergencies, but challenges exist with response rates. Maintaining accurate databases of telephone numbers and conducting brief baseline in-person visits can improve response rates. The challenges and lessons learned from this effort can inform future survey efforts during COVID-19 and other emergencies, as well as remote data collection in SSA in general.

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