scholarly journals Exploring Dementia Care in an Acute Care Setting: Perspectives of Social Workers and Nurses

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 839-839
Author(s):  
Ruth Dunkle ◽  
Katherine Cavagnini ◽  
Joonyoung Cho ◽  
Laura Sutherland ◽  
Helen Kales ◽  
...  
Keyword(s):  
Social Workers ◽  
Acute Care ◽  
Medical Management ◽  
Tertiary Care ◽  
Care Facility ◽  
Well Being ◽  
Dementia Care ◽  
Tertiary Care Facility ◽  
And Training

Abstract Nurses and social workers in acute care settings have unique perspectives about providing care to persons living with dementia (PLwD) who experience behavioral and psychological symptoms of dementia (BPSD). Their distinctive roles and training have important implications for the recovery and well-being of PLwDs during hospital stays. This study utilized the "rigorous and accelerated data reduction" (RADaR) technique to compare perspectives of social workers (n=12) and nurses (n=5) in a Midwestern tertiary care facility about their caring for PLwds with BPSD. Three major themes were identified: 1) patient engagement and coordination with family and professionals, 2) treatment and medical management, and 3) barriers to care. Similarities between social workers and nurses emerged within the themes, including the importance of family involvement and providing person centered care. Differences emerged particularly within the treatment and medical management theme, as nurses utilize medications to treat BPSD and social workers were more likely to use redirection. While there is distinctive training for nurses and social workers, both identified similar barriers to providing care to PLwDs with BPSD, including time constraints, competing demands, and lack of training on BPSD management. Results demonstrate how an understanding of the critical and complementary roles that nurses and social workers play in dementia care and work together to build a care team can inform best practices to support symptom management and quality of life in PLwDs. Continuing education and training could be beneficial for both professionals to improve the quality of care for PlwDs.

Transoral Laser Excision of Base of Tongue Cancer

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P47-P47
Author(s):  
April A. Camp ◽  
Guy J Petruzzelli ◽  
Christopher Fundakowski
Keyword(s):  
Quality Of Life ◽  
Overall Survival ◽  
Survival Data ◽  
Tertiary Care ◽  
Care Facility ◽  
Base Of Tongue ◽  
Tertiary Care Facility ◽  
Laser Excision ◽  
Disease Specific

Objective Recently, the use of laser in head and neck surgery has increased, consequent to technical advances in laser technology and visualization techniques. The objective of this study was to determine survival and qualitative results in patients who have undergone transoral laser excision of base of tongue (BOT) squamous cell carcinoma (SCCA). Methods A retrospective chart review was performed of patients with previously untreated, biopsy proven SCCA of the BOT treated with transoral laser excision at a tertiary care facility. All patients had follow-up for at least 24 months. Disease specific and overall survival data was determined using Kaplan-Meier approximations. Quality of life (QOL) data was obtained via interview using a well established questionnaire. Results Between 1995 and 2005, 71 patients, ages 38–85, were treated with transoral laser excision for BOT SCCA; 1.4, 12.7, 9.9, and 75% were stage I, II, III, and IV, respectively, at diagnosis. At 24 months, overall survival was 90%, while disease-specific survival was 94%. No correlation was found between survival and gender, overall stage, tumor size, nodal status, or adjuvant therapy. Local-regional recurrence occurred in 10% of patients. QOL data was obtained for 46 patients and yielded acceptable results, with 52% of patients reporting mild or no pain, 98% reporting minimal impairment to normal swallowing, and 70% reporting normal speech. Conclusions Transoral laser excision is an innovative method for excision of BOT SCCA and offers an improved approach in terms of survival and quality of life for treatment of these lesions.

scholarly journals S0548 Assessment of the Quality of Upper Endoscopy Procedures Performed for Gastric Ulcers in a Tertiary Care Facility

2020 ◽  
Vol 115 (1) ◽  
pp. S259-S259
Author(s):  
Ahmed Elkheshen ◽  
Mahmoud Hashim ◽  
Reza A. Haider ◽  
Mohamed Hussein ◽  
Courtney Perry ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Care Facility ◽  
Gastric Ulcers ◽  
Upper Endoscopy ◽  
Tertiary Care Facility

Assessing Acute St-Elevation Myocardial Infarction With Prognostic Significance Of The Hyponatramia

2020 ◽  
Vol 11 (3) ◽  
pp. 3251-3260
Author(s):  
Makrand B Mane
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Care Facility ◽  
Early Death ◽  
Public Health Issue ◽  
Care Hospital ◽  
Tertiary Care Facility ◽  
Significant Public Health

Acute Myocardial Infarction (AMI) has become a significant public health issue in developed and developing nations, following extensive diagnostic and management research over recent decades. The study intended to research the prognostic values of inexplicable Hyponatremia in patients with severe STelevation of myocardial infarction, in 100 consecutive patients admitted to Tertiary care hospital. In the analysis, identified patients on admission were diagnosed with or produced Hyponatremia within 72 hours—a lower ejection fraction than those with usual amounts of sodium. The research aimed to evaluate the prognosis significance of Hyponatremia for the estimation of early death in acute ST-elevated myocardial infarction. One hundred straight patients admitted in the Coronary Centre Tertiary Care Facility with severe STelevated myocardial infarction were studied. The data of the study on various risk factors in association with the development of Hyponatremia like as age, sex, use of tobacco, diabetes, hypertension, ejection fraction etc. were analyzed. Thus, the researchers reported that in patients diagnosed with severe ST section escalation, Hyponatremia showed the initial emergence of hyponatremia myocardial infarctions. This condition correlates with the severity of LV dysfunction (in term of LVEF) and can be considered as an individual early death indicator as well as a prediction exacerbates with hyponatremia frequency.

scholarly journals Clinical features and outcomes of infective endocarditis in Egypt: an 11-year experience at a tertiary care facility

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Hussein Hassan Rizk ◽  
Ahmed Adel Elamragy ◽  
Ghada Sayed Youssef ◽  
Marwa Sayed Meshaal ◽  
Ahmad Samir ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Hospital Mortality ◽  
Tertiary Care ◽  
Care Facility ◽  
Period 2 ◽  
Peripheral Embolization ◽  
Tertiary Care Facility ◽  
Few Data ◽  
Healthcare Associated ◽  
Complications And Mortality

Abstract Background Few data are available on the characteristics of infective endocarditis (IE) cases in Egypt. The aim of this work is to describe the characteristics and outcomes of IE patients and evaluate the temporal changes in IE diagnostic and therapeutic aspects over 11 years. Results The IE registry included 398 patients referred to the Endocarditis Unit of a tertiary care facility with the diagnosis of possible or definite IE. Patients were recruited over two periods; period 1 (n = 237, 59.5%) from February 2005 to December 2011 and period 2 (n = 161, 40.5%) from January 2012 to September 2016. An electronic database was constructed to include information on patients’ clinical and microbiological characteristics as well as complications and mortality. The median age was 30 years and rheumatic valvular heart disease was the commonest underlying cardiac disease (34.7%). Healthcare-associated IE affected 185 patients (46.5%) and 275 patients (69.1%) had negative blood cultures. The most common complications were heart failure (n = 148, 37.2%), peripheral embolization (n = 133, 33.4%), and severe sepsis (n = 100, 25.1%). In-hospital mortality occurred in 108 patients (27.1%). Period 2 was characterized by a higher prevalence of injection drug use-associated IE (15.5% vs. 7.2%, p = 0.008), a higher staphylococcal IE (50.0% vs. 35.7%, p = 0.038), lower complications (31.1% vs. 45.1%, p = 0.005), and a lower in-hospital mortality (19.9% vs. 32.1%, p = 0.007). Conclusion This Egyptian registry showed high rates of culture-negative IE, complications, and in-hospital mortality in a largely young population of patients. Improvements were noted in the rates of complications and mortality in the second half of the reporting period.

scholarly journals Characteristics of Critically Ill Patients with COVID-19 Compared to Patients with Influenza—A Single Center Experience

2021 ◽  
Vol 10 (10) ◽  
pp. 2056
Author(s):  
Frank Herbstreit ◽  
Marvin Overbeck ◽  
Marc Moritz Berger ◽  
Annabell Skarabis ◽  
Thorsten Brenner ◽  
...  
Keyword(s):  
Influenza A ◽  
Health Care Systems ◽  
Severe Disease ◽  
Tertiary Care ◽  
Care Facility ◽  
High Volume ◽  
Single Center Experience ◽  
Severe Influenza ◽  
Tertiary Care Facility ◽  
Care Systems

Infections with SARS-CoV-2 spread worldwide early in 2020. In previous winters, we had been treating patients with seasonal influenza. While creating a larger impact on the health care systems, comparisons regarding the intensive care unit (ICU) courses of both diseases are lacking. We compared patients with influenza and SARS-CoV-2 infections treated at a tertiary care facility offering treatment for acute respiratory distress syndrome (ARDS) and being a high-volume facility for extracorporeal membrane oxygenation (ECMO). Patients with COVID-19 during the first wave of the pandemic (n = 64) were compared to 64 patients with severe influenza from 2016 to 2020 at our ICU. All patients were treated using a standardized protocol. ECMO was used in cases of severe ARDS. Both groups had similar comorbidities. Time in ICU and mortality were not significantly different, yet mortality with ECMO was high amongst COVID-19 patients with approximately two-thirds not surviving. This is in contrast to a mortality of less than 40% in influenza patients with ECMO. Mortality was higher than estimated by SAPSII score on admission in both groups. Patients with COVID-19 were more likely to be male and non-smokers than those with influenza. The outcomes for patients with severe disease were similar. The study helps to understand similarities and differences between patients treated for severe influenza infections and COVID-19.

scholarly journals FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
Rebecca L Mauldin ◽  
Kathy Lee ◽  
Antwan Williams
Keyword(s):  
Long Term Care ◽  
Federal Policy ◽  
Care Facility ◽  
Well Being ◽  
The United States ◽  
Term Care ◽  
Long Term Care Facility ◽  
Care Facilities

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

scholarly journals Assessment of diabetes among tuberculosis patients presenting at a tertiary care facility in Pakistan

2016 ◽  
Vol 5 ◽  
pp. S248 ◽  
Author(s):  
Muhammad Irfan ◽  
Naseem Salahuddin ◽  
Qamar Masood ◽  
Owais Ahmed ◽  
Umme Salama Moosajee ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Care Facility ◽  
Tuberculosis Patients ◽  
Tertiary Care Facility

Radionecrosis after Treating Oral Cavity & Oropharyngeal SCC

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P43-P44
Author(s):  
Sundip H Patel ◽  
Mike Yao ◽  
Tara Brennan
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Tertiary Care ◽  
Care Facility ◽  
Tertiary Care Facility ◽  
Pertinent Data ◽  
Associated Risk Factors ◽  
Oropharynx Squamous Cell Carcinoma

Objective 1) The primary goal of this study was to evaluate the incidence of radionecrosis among patients treated with radiation therapy for oral cavity & oropharynx squamous cell carcinoma at our institution. Many patients with oral cavity & oropharyngeal cancers receive radiation to preserve the tongue, knowing the risks of post-treatment radionecrosis. However, recent protocols have intensified chemo-radiotherapy in an effort to improve local control while possibly increasing risk. 2) Among those patients with radionecrosis, we also analyzed their cancer treatment regimen, associated risk factors, the severity of the radionecrosis and the resulting treatment they recieved. Methods We performed a retrospective review of all adult patients at our tertiary care facility with biopsy proven squamous cell carcinoma of the oral cavity & oropharynx from 1999 to 2007 who completed a full course of radiotherapy at our facility with at least 6 months follow-up. Medical charts were reviewed for the presence of radionecrosis as well as for other corresponding, pertinent data. Results After reviewing 241 patients, a total of 107 patients were included. 5 of 65 with oropharynx disease had radionecrosis, revealing an incidence of 7.7%. Among the oral cavity group there were 8 out of 42 patients with radionecrosis, revealing an incidence of 19%. The overall incidence among our treatment group was 12.1%. Conclusions Radiation-induced necrosis of the oral cavity & oropharynx is still a significant complication in the treatment of head and neck cancer and poses a higher risk in the oral cavity than the oropharynx.

scholarly journals MORTALITY AND COVID-19: A SNAPSHOT OF A TERTIARY CARE FACILITY IN PAKISTAN

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
MA Rana ◽  
A Qayyum ◽  
M Hashmi ◽  
MMU Saif ◽  
MF Munir ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cause Of Death ◽  
Tertiary Care ◽  
Sudden Cardiac Arrest ◽  
Care Facility ◽  
Multiple Organ ◽  
Coronary Syndrome ◽  
Tertiary Care Facility ◽  
Biochemical Profiles ◽  
Novel Coronavirus

Background: Since SARS CoV-2 infection began in China and has evolved into a pandemic, mortality associated with this illness has been under discussion and hypercoagubility, severe acute respiratory syndrome and septicemia with multiple organ insufficiency have been cursed as potential causes of death in cases infected with the novel coronavirus. We did a retrospective analysis of cases admitted to our highly dependent and intensive care unit, and we tried to identify the leading cause of death in our cases. Methods: This is a single center retrospective study carried out at Bahria International Hospital Lahore over a 3-month period (May 10th to July 10th 2020) in which we analyzed the clinical and biochemical profiles of the COVID-19 patients who died during this period. Results: A total of 108 patients were admitted during this period out of which 11 patients died. 7 of them were men and 4 women. Majority of them had sudden cardiac arrest due to acute coronary syndrome followed by multiorgan dysfunction syndrome and acute respiratory distress syndrome. Conclusion: Acute coronary syndrome due to hypercoagubility was the leading cause of death in our patients.

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