scholarly journals Sustainability of INFORM: A Complex Team-Based Improvement Intervention in Long-Term Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 374-374
Author(s):  
Matthias Hoben ◽  
Liane Ginsburg ◽  
Whitney Berta ◽  
James Dearing ◽  
Peter Norton ◽  
...  
Keyword(s):  
Nursing Home ◽  
Repeated Measures ◽  
Nursing Home Care ◽  
Control Group ◽  
Feedback Group ◽  
Term Care ◽  
Long Term Follow Up ◽  
Care Aides

Abstract Improving Nursing Home Care Through Feedback On perfoRMance Data (INFORM) was a complex, theory-based, three-arm, parallel cluster-randomized trial. In 2015–2016, we successfully implemented two theory-based feedback strategies (compared to a standard approach to feedback) to increase nursing home (NH) care aides’ involvement in formal communications about resident care (formal interactions [FI], the primary outcome). Here, we report the extent to which FI was sustained 2.5 years following withdrawal of intervention supports. We also report on several determinants of sustainability. We analyzed data from 18 NHs (46 units, 529 care aides) in the control group, 19 NHs (60 units, 731 care aides) in the basic assisted feedback group (BAF), and 14 homes (41 units, 537 care aides) in the enhanced assisted feedback group (EAF). We assessed sustainability of FI, using repeated measures, hierarchical mixed models, adjusted for care aide, care unit and facility variables. In EAF, FI scores increased from T1 (baseline) to T2 (end of intervention) (1.30–1.42, p=0.010), remaining stable at T3 (long-term follow-up) (1.39 p=0.065). FI scores in BAF increased from T1 to T2 (1.33–1.44, p=0.003) and continued to increase at T3 (1.49, p<0.001). In the control group, FI did not change from T1 to T2 (1.25–1.24, p=0.909), but increased at T3 (1.38, p=0.003). Better culture, evaluation and fidelity enactment significantly increased FI at long-term follow-up. Theory-informed feedback provides long lasting benefits in care aides' involvement in FI. Greater intervention intensity neither implies greater effectiveness nor sustainability. Modifiable context elements and fidelity enactment may facilitate sustained improvement.

Poster 37 Long-Term Follow-up of Profoundly Brain-Injured Young Adults Discharged to Specialist Nursing Home Care

PM&R ◽  
2012 ◽  
Vol 4 ◽  
pp. S202-S202
Author(s):  
Kyaw Nyein ◽  
Wendy Stuttle ◽  
Lynne Turner-Stokes ◽  
Heather Williams
Keyword(s):  
Young Adults ◽  
Nursing Home ◽  
Home Care ◽  
Nursing Home Care ◽  
Brain Injured ◽  
Long Term Follow Up

scholarly journals Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS

2021 ◽  
pp. 014556132098603
Author(s):  
Anni Koskinen ◽  
Marie Lundberg ◽  
Markus Lilja ◽  
Jyri Myller ◽  
Matti Penttilä ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Revision Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Control Group ◽  
University Hospitals ◽  
Balloon Sinuplasty ◽  
Long Term Follow Up

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique. Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011. Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation. Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.

The vulnerability of nursing home residents to the Covid-19 pandemic

2020 ◽  
Vol 23 (2-3) ◽  
pp. 57-60 ◽  
Author(s):  
Edward H Wagner
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Nursing Assistants ◽  
Nursing Home Care ◽  
Term Care ◽  
Staff Members ◽  
Care Facilities

Residents in nursing homes and other long-term care facilities comprise a large percentage of the deaths from Covid 19. Is this inevitable or are there problems with NHs and their care that increase the susceptibility of their residents. The first U.S. cluster of cases involved the residents, staff, and visitors of a Seattle-area nursing home. Study of this cluster suggested that infected staff members were transmitting the disease to residents. The quality of nursing home care has long been a concern and attributed to chronic underfunding and resulting understaffing. Most NH care is delivered by minimally trained nursing assistants whose low pay and limited benefits compel them to work in multiple long-term care settings, increasing their risk of infection, and work while ill. More comparative studies of highly infected long-term care facilities with those organizations that were able to better protect their residents are urgently needed. Early evidence suggests that understaffing of registered nurses may increase the risk of larger outbreaks.

scholarly journals Municipalities’ Decision to Care: At Home or in a Nursing Home

2020 ◽  
Vol 26 (4) ◽  
pp. 327-342
Author(s):  
Theis Theisen
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Long Term Care ◽  
Nursing Home Care ◽  
Empirical Literature ◽  
Term Care ◽  
Scant Attention ◽  
Insurance Mechanism ◽  
Using Data

AbstractAn almost ideal demand system for long-term care is estimated using data from Norway, where the split of long-term care between home care and care in nursing homes is determined by municipalities. Previous literature has barely addressed what determines municipalities’ or other organizations’ allocations of resources to the sub-sectors of long-term care. The results show that home care is a luxury, while nursing home care is a necessity with respect to total expenditures on long-term care. Municipalities respond to high unit costs for home care by reducing that type of care. Municipalities are highly responsive to variations in the need for the two types of care and seem to provide a well-functioning insurance mechanism for long-term care. In the previous empirical literature, municipalities’ role as providers of insurance against the consequences of disabilities and frailty has received scant attention.

A Long-Term Follow-Up of Participants in the Trois-Rivières Semi-Longitudinal Study of Growth and Development

1998 ◽  
Vol 10 (4) ◽  
pp. 366-377 ◽  
Author(s):  
François Trudeau ◽  
Louis Laurencelle ◽  
Janie Tremblay ◽  
Mirjana Rajic ◽  
Roy J. Shephard
Keyword(s):  
Growth And Development ◽  
Perceived Barriers ◽  
Control Group ◽  
Attitudes And Beliefs ◽  
Long Term Follow Up ◽  
Experimental Subjects ◽  
Back Problems ◽  
Experimental Group

The purpose of this project was to undertake a long-term follow-up of participants in the Trois-Rivières Growth and Development Study. Some 20 years after their initial involvement in the program, two groups were compared: experimental subjects (n =150) who had received 5 one-hour sessions of specialized physical education per week throughout their 6 years of primary school, and the original control group (n = 103). All subjects completed a questionnaire regarding current patterns of physical activity (PA), attitudes and beliefs about PA, and perceived barriers to PA. Principal results indicate: (a) More experimental than control women exercise 3 times or more per week, (b) experimental subjects more commonly perceived their health to be very good to excellent, (c) control subjects in general felt less psychological dependency on exercise, and (d) women in the experimental group had a lower relative risk of back problems.

scholarly journals Long-Term Management of Patients with Celiac Disease: Current Practices of Gastroenterologists in Canada

2010 ◽  
Vol 24 (8) ◽  
pp. 499-509 ◽  
Author(s):  
Jocelyn Anne Silvester ◽  
Mohsin Rashid
Keyword(s):  
Celiac Disease ◽  
Practice Guideline ◽  
Long Term Care ◽  
Intestinal Biopsy ◽  
Term Care ◽  
Follow Up Care ◽  
Long Term Follow Up ◽  
Current Practices

BACKGROUND: Long-term follow-up of patients with celiac disease is important for monitoring their clinical status, dietary compliance and complications.AIM: To examine the current practices of Canadian gastroenterologists providing long-term care to patients with celiac disease.METHODS: All gastroenterologists in Canada (n=585) were surveyed regarding their practice demographics, familiarity with celiac disease practice guidelines, and follow-up clinical examination and investigations.RESULTS: Of the 585 surveys mailed to gastroenterologists, 567 were expected to be returned. A total of 242 completed surveys (43%) were received. Of these, 237 (184 adult, 51 pediatric and two mixed) had an active practice that included patients with celiac disease. Long-term follow-up care was provided routinely by 76% of respondents. Follow-up consisted of annual clinic visits (67%), dietary review (77%), reinforcement of the need for adherence to a gluten-free diet (90%) and recommending membership in an advocacy group (65%). Physical examination was performed by 78%; most ordered laboratory tests including serology (65%).Adult gastroenterologists performed routine follow-up intestinal biopsy more often than their pediatric counterparts (46% versus 10%), but performed serology less frequently (48% versus 86%). Pediatric patients were more likely to be followed by a multidisciplinary team. All pediatric gastroenterologists were familiar with at least one celiac disease practice guideline, whereas 15% of adult gastroenterologists were not familiar with any practice guideline. The majority of gastroenterologists who did not routinely provide follow-up expected care to be provided by the patient’s primary physician (86%).CONCLUSIONS: Most gastroenterologists in Canada who responded to the survey provided long-term follow-up care to patients with celiac disease. The diverse practices reported underscore the need to develop consensus-based guidelines for long-term care of these patients.

scholarly journals Does High Caregiver Stress Predict Nursing Home Entry?

2009 ◽  
Vol 46 (2) ◽  
pp. 140-161 ◽  
Author(s):  
Brenda C. Spillman ◽  
Sharon K. Long
Keyword(s):  
Nursing Home ◽  
Strong Predictor ◽  
Stress Factors ◽  
Physical Strain ◽  
Term Care ◽  
Care Survey ◽  
Nursing Home Entry ◽  
Home Placement

This study estimates how informal care, paid formal care, and caregiver stress or burden relate to nursing home placement. Data came from the 1999 National Long Term Care Survey and were merged with administrative data. Results show that stress is a strong predictor of entry over follow-up periods of up to two years, and physical strain and financial hardship are important predictors of high levels of caregiver stress. The estimates indicate that reducing these stress factors would significantly reduce caregiver stress and, as a result, nursing home entry. We conclude that initiatives to reduce caregiver stress hold promise as a strategy to avoid or defer nursing home entry.

Informing Patients About Tardive Dyskinesia: Four-Year Follow Up of a Trial of Patient Education

2002 ◽  
Vol 36 (1) ◽  
pp. 99-103 ◽  
Author(s):  
Robert Chaplin ◽  
Clive Timehin
Keyword(s):  
Informed Consent ◽  
Tardive Dyskinesia ◽  
Educational Intervention ◽  
Control Group ◽  
Random Allocation ◽  
Consent To Treatment ◽  
Long Term Follow Up ◽  
Clinical Stability

Objective: This paper evaluates the effects of an educational intervention about tardive dyskinesia on knowledge and clinical stability at long-term follow up. Method: Fifty-six patients receiving antipsychotic maintenance completed a questionnaire assessing their knowledge about tardive dyskinesia. After random allocation to either educational intervention or control group, their knowledge, clinical stability and rates of tardive dyskinesia were reassessed after four years. Results: Seventy per cent of patients completed the study. The patients in the educational group retained significantly more knowledge at follow up than at baseline but this knowledge was not significantly greater than that of the control group. There were no significant differences in the clinical outcomes between the groups. Conclusion: Patients can retain a small but significant amount of information with a low risk of noncompliance. Discussion about tardive dyskinesia is necessary in the process of obtaining informed consent to treatment.

scholarly journals The Short- and Long-Term Outcome of Intratympanic Steroid Therapy as a Salvage Treatment for Acute Low-Tone Sensorineural Hearing Loss without Episodes of Vertigo

2016 ◽  
Vol 21 (3) ◽  
pp. 132-140 ◽  
Author(s):  
Shinya Morita ◽  
Yuji Nakamaru ◽  
Keishi Fujiwara ◽  
Keiji Iizuka ◽  
Masayori Masuya ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Salvage Treatment ◽  
Sensorineural Hearing ◽  
Control Group ◽  
Long Term Follow Up ◽  
Low Tone ◽  
Hearing Outcomes

Objectives: To evaluate the hearing outcomes of intratympanic steroid (ITS) treatment for patients with acute low-tone sensorineural hearing loss (ALHL) after failure of initial therapy and to investigate the recurrence and progression to definite Ménière's disease (MD) during a long-term follow-up. Methods: We retrospectively reviewed the medical records of 90 patients with refractory ALHL who were followed up for at least 1 year between January 2000 and April 2014. Patients who responded poorly to initial medical treatment received intratympanic dexamethasone injections (ITS group) or isosorbide administration for 4 weeks (diuretic group) as salvage treatment options according to their choice of management. The control group did not receive ITS or the diuretic, due to their refusal of both medical treatments. The hearing outcomes were evaluated 1 month, 1 year and 5 years after the completion of the second-line therapy, and the rates of recurrence and progression to MD were measured during a follow-up period of at least 1 year. Results: Twenty-seven patients in the ITS group, 39 patients in the diuretic group and 24 patients in the control group were enrolled. Of these, 12 patients in the ITS group, 15 patients in the diuretic group and 12 patients in the control group were followed up for over 5 years. We found that the recovery rates and the audiometric functional values after 1 month and 1 year in the ITS group were significantly higher than those in the diuretic and control groups. However, there were no significant differences in the recovery rates or the audiometric functional values after 5 years, or in the rates of recurrence and progression to MD between the groups. Conclusions: Salvage ITS therapy can provide a relatively good short-term hearing outcome for ALHL patients who have persistent hearing loss despite conventional treatment. However, both recurrence and progression to MD after treatment were observed in some patients during the long-term follow-up.

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