An Innovative Approach for Decreasing Fall Trauma Admissions from Geriatric Living Facilities: Preliminary Investigation

2015 ◽  
Vol 81 (12) ◽  
pp. 1279-1283
Author(s):  
Tracy Evans ◽  
Brian Gross ◽  
Katelyn Rittenhouse ◽  
Carissa Harnish ◽  
Ashley Vellucci ◽  
...  

Geriatric living facilities have been associated with a high rate of falls. We sought to develop an innovative intervention approach targeting geriatric living facilities that would reduce geriatric fall admissions to our Level II trauma center. In 2011, a Trauma Prevention Taskforce visited 5 of 28 local geriatric living facilities to present a fall prevention protocol composed of three sections: fall education, risk factor identification, and fall prevention strategies. To determine the impact of the intervention, the trauma registry was queried for all geriatric fall admissions attributed to patients living at local geriatric living facilities. The fall admission rate (total fall admissions/total beds) of the pre-intervention period (2010–2011) was compared with that of the postintervention period (2012–2013) at the 5 intervention and 23 control facilities. A P value < 0.05 was considered statistically significant. From 2010 to 2013, there were 487 fall admissions attributed to local geriatric living facilities (intervention: 179 fall admissions; control: 308 fall admissions). The unadjusted fall rate decreased at intervention facilities from 8.9 fall admissions/bed pre-intervention to 8.1 fall admissions/bed postintervention, whereas fall admission rates increased at control sites from 5.9 to 7.7 fall admissions/bed during the same period [control/intervention odds ratio (OR), 95% confidence interval (CI) = 1.32, 1.05–1.67; period OR, 95%CI = 1.55,1.18–2.04, P = 0.002; interaction of control/intervention group and period OR 95% CI = 0.68, 0.46–1.00, P = 0.047]. An aggressive intervention program targeting high-risk geriatric living facilities resulted in a statistically significant decrease in geriatric fall admissions to our Level II trauma center.

Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 86
Author(s):  
Fauna Herawati ◽  
Yuni Megawati ◽  
Aslichah ◽  
Retnosari Andrajati ◽  
Rika Yulia

The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective.


2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Masta Hutasoit

Background: Bantul is one of the areas in Yogyakarta that is at risk of disaster. The results of interviews with the head of SD N 2 Padokan found that the school had never had any training on disaster and not yet implemented the curriculum on disaster mitigation. Children are age groups that are very vulnerable to the impact of both physical and psychological disasters. Knowledge of disaster preparedness is important for disaster preventionThe purpose of the study: to determine the effect of health education on knowledge of student preparedness to earthquake disaster events in SD N 2 Padokan, Bantul.Method: This research is quantitative research with quasi experiment design. The design used was pre test and post test nonequivalent control group. The number of samples in the intervention group and the control group were 27 students of class V. The sampling were collected by purposive sampling according to the criteria. Methods of data collection using questionnaires and using nonparametric statistical analysis Wilcoxon with the help of SPSS v.17 for Windows program.Results: The results showed no effect of health education on earthquake disaster preparedness knowledge in SD N 2 Padokan obtained p value 0.480 with α 0.05. In the intervention group the difference of knowledge before and after is indicated by p value 0.180, while for the control group 1,000.Conclusion: there is no effect of health education on disaster preparedness knowledge in SD N 2 Padokan.  


2020 ◽  
Vol 35 (6) ◽  
pp. 273-282
Author(s):  
Scott M. Pearson ◽  
Anushka Tandon ◽  
Danielle R. Fixen ◽  
Sunny A. Linnebur ◽  
Gretchen M. Orosz ◽  
...  

OBJECTIVE: To evaluate the impact of a pharmacist-led transitional care intervention targeting high-risk older people after an emergency department (ED) visit.<br/> DESIGN: Retrospective cohort study of older people with ED visits prior to and during a pharmacist-led intervention.<br/> SETTING: Patients receiving primary care from the University of Colorado Health Seniors Clinic.<br/> PARTICIPANTS: The intervention cohort comprised 170 patients with an ED visit between August 18, 2018, and February 19, 2019, and the historical cohort included 166 patients with an ED visit between August 18, 2017, and February 19, 2018. All included patients either had a historical diagnosis of heart failure or chronic obstructive pulmonary disease, or they had an additional ED visit in the previous six months.<br/> INTERVENTIONS: The pilot intervention involved postED discharge telephonic outreach and assessment by a clinical pharmacist, with triaging to other staff if necessary.<br/> MAIN OUTCOME MEASURE: The primary outcome was the proportion of patients with at least one repeat ED visit, hospitalization, or death within 30 days of ED discharge. Outcome rates were also assessed at 90 days postdischarge.<br/> RESULTS: The primary outcome occurred in 21% of the historical cohort and 25% of the intervention cohort (adjusted P-value = 0.48). The incidence of the composite outcome within 90 days of ED discharge was 43% in the historical group compared with 38% in the intervention group (adjusted P-value = 0.29).<br/> CONCLUSION: A pharmacist-led telephonic intervention pilot targeting older people did not appear to have a significant effect on the composite of repeat ED visit, hospitalization, or death within 30 or 90 days of ED discharge. A limited sample size may hinder the ability to make definitive conclusions based on these findings.


2009 ◽  
Vol 29 (1) ◽  
pp. 81-112 ◽  
Author(s):  
Dorit Ravid ◽  
Vital Geiger

Research indicates that morphological awareness contributes to success in literacy acquisition and consolidation, since morphology links together phonological and semantic facets of language. The role of morphology is especially important in Hebrew, a highly synthetic Semitic language. The current study aimed to investigate the impact of an intervention program on knowledge and awareness of morphology in Hebrew-speaking grade-schoolers. Two three-month intervention programs were conducted in two groups of 4th-grade children: a metalinguistic morphological intervention program using linguistic humor, and a parallel intervention program using nonverbal humor. A morphological awareness test was administered to the two groups prior to and following the intervention period. The results demonstrate consistent advantages to the morphological intervention group, including tasks related both directly and indirectly to content taught.


Author(s):  
Fernanda Faria ◽  
Cheryl Howe ◽  
Ricardo Faria ◽  
Alynne Andaki ◽  
João Carlos Marins ◽  
...  

We investigated the impact of a sports activities program on metabolic syndrome (MetS) components and pre-MetS among adolescents. Blood samples, blood pressure, weight, height, body mass index, waist circumference, body fat percentage, frequency of food consumption, daily time in moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB) of 92 male adolescents aged 14–18 years (16.07 ± 0.93) were evaluated. From this initial sample, 36 participants (39.1%) were diagnosed with pre-MetS or MetS and were invited to participate in the intervention program. Twelve individuals diagnosed with pre-MetS or MetS agreed to participate in a recreational sports activities program lasting 14 weeks. The pre- and post-sport program comparison showed a reduction in total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL), and an increase in HDL and MVPA time in the intervention group. Sports activities accounted for 42% of the MVPA daily recommendation, and at the end of the intervention period, only seven subjects maintained a positive diagnosis for pre-MetS or MetS. This study showed that recreational sports activities had a significant impact on the lipid profile.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
T. Ronen

The lecture describes a school-based aggression reduction learning intervention. The intervention program aimed to impart children with learned resourcefulness repertoire for reducing aggressive behavior. Based on the self-control intervention model developed by Ronen and Rosenbaum (2001), and in light of positive psychology theory the intervention focused on increasing children's coping, teach them to work toward positive goals such as increasing social relationships, and help themselves change.447 ninth grade students participated in this study. 167 students participated in the intervention groups and 280 students from the same schools who received no intervention and served as a control group.The outcomes point to the efficacy of the model in reducing aggression. The rate of aggression in the intervention group decreased significantly in compare with their base-line grade and in compare with the control group. Also hostile thought and negative emotion did not change - the child could control those and not behave in an aggressive way. Analysis showed that the changed in reducing aggression results from the increase in self-control skills.


2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 159-159 ◽  
Author(s):  
J. C. Yao ◽  
J. D. Hainsworth ◽  
E. Baudin ◽  
M. Peeters ◽  
D. Hoersch ◽  
...  

159 Background: Octreotide LAR has been the foundation of NET therapy; however, additional treatment options are needed. Everolimus, an oral inhibitor of mTOR, demonstrated promising antitumor activity in patients with NET as a single agent and in combination with octreotide LAR in two phase II studies. Methods: Patients (n = 429) with well or moderately differentiated advanced NET and history of carcinoid symptoms received oral everolimus 10 mg/d + octreotide LAR 30 mg IM q 28 days (n = 216) or placebo + octreotide LAR (n = 213). Common primary sites included the small intestine, lung, and colon. The primary endpoint was progression-free survival (PFS) per central review by RECIST. Crossover from P+O to open-label E+O was allowed at disease progression. Results: Median PFS (95% CI) with E+O was 16.4 months (13.67-21.19) vs. 11.3 months (8.44-14.59) for P+O. E+O was associated with a 23% reduction in risk of progression: HR = 0.77; 95% CI: 0.59-1.00; one-sided p-value = .026 (pre-specified significance boundary is p ≤ .0246). A high rate of informative censoring resulted in loss of power in central review results. Correcting for the informative censoring bias, the pre-specified marginal Cox model using inverse probability of censoring weights (IPCW) analysis showed a significant 5.5-month improvement in median PFS with E+O; HR = 0.60; 95% CI: 0.44-0.84, with one-sided p-value = .0014. The benefit of E+O was seen across all patient subgroups. Updated analyses of the impact of pre-study and post-progression octreotide LAR therapy will be reported. Most frequent drug-related adverse events (AEs) with E+O were stomatitis, rash, fatigue, and diarrhea; mostly grade 1-2. Grade 3-4 AEs reported in >5% were stomatitis, fatigue, diarrhea, infections, and hyperglycemia. Conclusions: In this large phase III trial, E+O provided a 5.1-month clinically meaningful increase in median PFS compared with P+O in the central adjudicated review. Correcting for the informative censoring bias, a significant PFS improvement of 5.5 months was seen, with a p value = .0014. The safety profile of E+O was acceptable. [Table: see text]


2020 ◽  
Vol 8 (1) ◽  
pp. 9
Author(s):  
Susanti Niman ◽  
Achir Yani S Hamid ◽  
Ice Yulia W

The prevalence of CHF is increasing every year. The impact of a psychosocial condition requiring comprehensive treatment for CHF in all aspects. One contributing factor to success is the involvement of the family. Purpose: This study aimed to determine the differences of social support towards clients with CHF who were receiving family psychoeducation.  Method: This study used a Quasi -experimental pre-post test without a control group”.  A sample of  25 respondents and sample retrieval techniques with a purposive sampling procedure. The instrument used was an ISSB questionnaire for measuring social support. The intervention group was provided with family psychoeducation that performed 5 sessions. Result and conclusion: The finding this study showed was a significant change before and after the family support family psychoeducation (p-value 0.00<α).  Characteristics of the family and the client is not associated with social support. Family psychoeducation research way recommended developed in a public hospital.


2021 ◽  
Vol 27 (3) ◽  
pp. 146045822110429
Author(s):  
Mohammad K Al-Nawayseh ◽  
Montaha AL-Iede ◽  
Eman Elayeh ◽  
Rima Hijazeen ◽  
Khaled Al Oweidat ◽  
...  

The main aim of this study is to assess the effectiveness of using a developed asthma mobile application to enhance medication adherence in Jordan. Asthma patients visiting outpatient respiratory clinics and using inhalers were recruited. Patients were assigned into two groups: intervention and control. The intervention group was instructed to download and use the application. Asthma control was assessed using Asthma Control Test (ACT) at baseline and at follow-up of 3 months for both groups. A total of 171 patients (control, n = 83, and intervention, n = 88) participated in the study. After 3 months of usage, patients in the intervention group achieved a significant improvement in ACT score compared to control ( p-value <0.05), and reported a significant satisfaction of the application use. Therefore, the asthma mobile application is found as an effective tool to enhance medication adherence in asthma patients.


CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S53-S54
Author(s):  
N. Barclay

Background: Most admissions to hospitals occur through the emergency department (ED). The impact of emergency physicians’ decisions to admit a patient to hospital can have wide ranging effects on health care spending, hospital congestion and patient outcomes. A growing body of evidence shows that outpatient management of conditions such as diverticulitis, heart failure and pulmonary embolism is both safe, effective and can reduce costs. Aim Statement: To support emergency staff in making safe, informed decisions to appropriately reduce admission rates without increasing the rate of patients returning and being admitted. Measures &amp; Design: Significant variability in admission rates between emergency physicians exists and no correlation between actual and self-reported admission rates is observed. One means to change behavior is through audit and feedback, however a Cochrane review on this topic concluded that it was only effective if specific conditions were met; findings which were incorporated into this project. An audit tool was created comparing individual physicians’ admission and “bounce back” rates to their peers. The tools contained averages for the individual and site for admission and bounce back rates and were shared with physicians every 2 months. Physicians were divided into three equal groups, low, medium and high admitters and targets established. Department heads met with high admitters. Evaluation/Results: The project was started in September 2016. Admission rates in the three physician groups were compared in the ten months before September 2016 (prior) and after January 2017 (post). September to December 2016 was considered the “rollout” period and not included in the analysis. Significance was tested using a Permutation test and a p-value cut off level of 5%. Nine emergency departments took part. Seven sites experienced a significant decrease in the admission rate of top admitters, three showed a significant increase in the rate of low admitters and two showed a significant increase in the rate of medium admitters. Pooled results showed a decrease in the admission rates of the top admitters and no significant change to the medium or low admitters. Discussion/Impact: Comparing the pre- and post-periods yielded a decrease in admissions of 773 patients on an annualized basis. The impact of the change in the top five highest admitters at the biggest three hospitals estimated an annualized beds savings of 25.3 beds.


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