A Primary Care Nursing Model in Long-Term Care Facilities: Evaluation of Impact on Affect, Behavior, and Socialization

Abstract Background Palliative care (PC) development cannot only be assessed from a specialized provision perspective. Recently, PC integration into other health systems has been identified as a component of specialized development. Yet, there is a lack of indicators to assess PC integration for pediatrics, long-term care facilities, primary care, volunteering and cardiology. Aim To identify and design indicators capable of exploring national-level integration of PC into the areas mentioned above. Methods A process composed of a desk literature review, consultation and semi-structured interviews with EAPC task force members and a rating process was performed to create a list of indicators for the assessment of PC integration into pediatrics, long-term care facilities, primary care, cardiology, and volunteering. The new indicators were mapped onto the four domains of the WHO Public Health Strategy. Results The literature review identified experts with whom 11 semi-structured interviews were conducted. A total of 34 new indicators were identified for national-level monitoring of palliative care integration. Ten were for pediatrics, five for primary care, six for long-term care facilities, seven for volunteering, and six for cardiology. All indicators mapped onto the WHO domains of policy and education while only pediatrics had an indicator that mapped onto the domain of services. No indicators mapped onto the domain of use of medicines. Conclusion Meaningful contributions are being made in Europe towards the integration of PC into the explored fields. These efforts should be assessed in future regional mapping studies using indicators to deliver a more complete picture of PC development.

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0421 Noise-Induced Stress among Primary Care Workers in Long Term Care Facilities in British Columbia, Canada

Occupational and Environmental Medicine ◽

10.1136/oemed-2014-102362.167 ◽

2014 ◽

Vol 71 (Suppl 1) ◽

pp. A54.2-A54 ◽

Cited By ~ 1

Author(s):

George Astrakianakis ◽

Yat Chow ◽

Murray Hodgson ◽

Maureen Haddock ◽

Pamela Ratner

Keyword(s):

Primary Care ◽

British Columbia ◽

Long Term Care ◽

Term Care ◽

Induced Stress ◽

Care Workers ◽

Care Facilities

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Polypharmacy and use of potentially inappropriate medications in long-term care facilities: does coordinated primary care make a difference?

International Journal of Pharmacy Practice ◽

10.1111/ijpp.12397 ◽

2017 ◽

Vol 26 (4) ◽

pp. 318-324 ◽

Cited By ~ 8

Author(s):

Melissa K. Andrew ◽

Chad A. Purcell ◽

Emily G. Marshall ◽

Nirupa Varatharasan ◽

Barry Clarke ◽

...

Keyword(s):

Primary Care ◽

Long Term Care ◽

Potentially Inappropriate Medications ◽

Term Care ◽

Care Facilities ◽

Inappropriate Medications

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COVID's Impact on Health and Healthcare Workers

10.1093/med/9780197575390.001.0001 ◽

2021 ◽

Author(s):

Don Goldenberg

Keyword(s):

Public Health ◽

Primary Care ◽

Healthcare Workers ◽

Long Term Care ◽

Mental Healthcare ◽

Well Being ◽

Term Care ◽

Persistent Symptoms ◽

Care Facilities

The symptoms, risk factors and typical course of mild, moderate and severe COVID-19 infections are detailed, focusing on correlations with hospitalization and death. The physical and emotional toll on healthcare workers is described, as well as the innovations and sacrifices made by physicians, nurses, and hospitals during the pandemic. Present and enduring changes in primary care and mental healthcare, including increased utilization of telemedicine, are explained. The misinformation and disinformation raging during the pandemic and their adverse effect on public health and patient recovery are uncovered. There is a focus on persistent symptoms, long after the initial COVID infection, including long-COVID syndrome. The book concludes with recommendations to best move forward, addressing public health, healthcare inequities, long-term care facilities, primary care, healthcare worker well-being, and following science and truth.

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Stewardship in the primary care and long-term care settings

10.1093/med/9780198758792.003.0015 ◽

2016 ◽

Author(s):

Naomi Fleming

Keyword(s):

Primary Care ◽

Antimicrobial Stewardship ◽

Long Term Care ◽

Diagnostic Tools ◽

Antibiotic Prescribing ◽

Prescribing Practices ◽

Term Care ◽

Care Facilities ◽

Tract Infections

This chapter focuses on stewardship in the primary care and long-term care settings. Antibiotic prescribing in the community accounts for 80% total antibiotic prescribing and approximately 75% of this is for acute respiratory tract infections, many of which are viral. There is also significant variation in prescribing practices that is not explained by differences in presenting patients. These factors suggest that antimicrobial stewardship programmes are necessary. This chapter identifies the components of stewardship that have been successful in influencing antibiotic prescribing in primary care and shares local experiences with practical examples. The lack of UK evidence about antimicrobial stewardship in long-term care facilities is discussed, along with successful interventions from overseas. Challenges within these settings are highlighted, including patient demand, lack of access to microbiological and diagnostic tools, competing targets, time pressures, and clinical uncertainty.

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Who Should Deliver Primary Care in Long-term Care Facilities to Optimize Resident Outcomes? A Systematic Review

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2018.07.006 ◽

2018 ◽

Vol 19 (12) ◽

pp. 1069-1079 ◽

Cited By ~ 4

Author(s):

Robert Oliver Barker ◽

Dawn Craig ◽

Gemma Spiers ◽

Patience Kunonga ◽

Barbara Hanratty

Keyword(s):

Systematic Review ◽

Primary Care ◽

Long Term Care ◽

Term Care ◽

Care Facilities

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Palliative care integration indicators: an European regional analysis

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2021-003181 ◽

2021 ◽

pp. bmjspcare-2021-003181

Author(s):

Miguel Antonio Sánchez-Cárdenas ◽

Eduardo Garralda ◽

Natalia Sofia Arias-Casais ◽

Edgar Ricardo Benitez Sastoque ◽

Danny Van Steijn ◽

...

Keyword(s):

Primary Care ◽

Palliative Care ◽

Health Systems ◽

Long Term Care ◽

European Countries ◽

Term Care ◽

Care Level ◽

Primary Care Level ◽

Care Facilities

ObjectiveTo estimate the capacity of European countries to integrate palliative care (PC) into their health systems through PC service provision for patients of all ages, with different care needs and diseases, in various settings and by a range of providers.MethodsSecondary analysis of survey data from 51 countries with 22 indicators explored the integration of available PC resources for children, for patients of all ages, at the primary care level, for oncology and cardiac patients, and in long-term care facilities. We also measured volunteer participation. Results were quantified, converted into weighted subscores by area and combined into a single ‘Integration Capacity Score (ICS)’ for each country.ResultsThirty-eight countries reported 543 specialised paediatric PC services. One-third of all surveyed countries reported 20% or more of patients with PC needs at the primary care level. Twenty-four countries have a total of 155 designated centres that integrate oncology and PC. Eight countries were pioneering cardiology services that integrate PC. Eight reported a volunteer workforce of over 1000 and 12 had policies regulating PC provision and interventions in long-term care facilities. Across all indicators, 39 countries (76%) score from low to very low integration capacity, 8 (16%) score at an intermediate level, and 4 (8%; the Netherlands, UK, Germany and Switzerland) report a high-level integration of PC into their health systems.ConclusionVariable progress according to these indicators shows that most European countries are still in the process of integrating PC into their health systems.

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ORGANIZING PRIMARY CARE FOR RESIDENTS IN LONG-TERM CARE FACILITIES: A MULTI-METHOD APPROACH

Innovation in Aging ◽

10.1093/geroni/igz038.905 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S241-S242

Author(s):

Barbara Hanratty ◽

Katie Brittain ◽

Rachel Stocker ◽

Karen Spilsbury

Keyword(s):

Primary Care ◽

Long Term Care ◽

Organisational Change ◽

Term Care ◽

Delivery Of Care ◽

Family Practitioners ◽

Care Facilities ◽

Multi Method Approach ◽

Method Approach

Abstract This multi-method research explores the challenges family practitioners and long-term care facilities face when they work together. It seeks to understand how different responses to these challenges may influence the delivery of care. Whilst different services have their own values, aims, structures and processes, all are contending with constrained resources and frequent organisational change. Our findings from a large qualitative study and analysis of routine health data are organised around the micro (individual), meso (organisational) and macro (system) factors that influence the organisation and delivery of resident care. In this presentation, we draw out the interplay between these levels, and how each shapes and is shaped by the changing demands and nature of care. This presentation will bring new insights into primary care for long-term care facilities, through the perspectives of those who experience and provide care in that setting.

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