scholarly journals Comparison of 3 Different Perioperative Care Models for Patients With Hip Fractures Within 1 Health Service

2017 ◽  
Vol 8 (2) ◽  
pp. 87-93 ◽  
Author(s):  
Lillian Sarah Coventry ◽  
Austin Nguyen ◽  
Amalia Karahalios ◽  
Sasha Roshan-Zamir ◽  
Phong Tran
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Perioperative Care ◽  
Health Care Facilities ◽  
Discharge Destination ◽  
Medical Problems ◽  
Care Facilities ◽  
Care Models ◽  
To Receive

Introduction: Orthogeriatric care models have been introduced within many health-care facilities to improve outcomes for hip fracture patients. This study aims to evaluate differences in care between 3 models, an orthopedic model, a geriatric model, and a comanaged model. Materials and Methods: A retrospective analysis was conducted for hip fracture patients treated at Western Health between November 2012 and March 2014. All patients aged 65 years or older were included in the analysis. Results: There were 183 patients in the orthopedic model, 137 in the geriatric model, and 126 in the comanaged model. Demographics and clinical characteristics were similar across the 3 models. Length of stay, mortality, and discharge destination were also consistent across the 3 groups. However, groups involving geriatricians were more likely to receive preoperative medical assessments, have greater recognition of postoperative medical problems, and have implementation of long-term osteoporosis management. Conclusion: The involvement of geriatricians in perioperative care models resulted in more comprehensive medical care without impacting length of stay, mortality, or discharge destination.

scholarly journals Determinants of Hospital Length of Stay among Patients with Pneumonia Admitted to a Large Canadian Hospital from 1991 to 2001

2005 ◽  
Vol 12 (7) ◽  
pp. 365-370 ◽  
Author(s):  
Margaret J McGregor ◽  
J Mark FitzGerald ◽  
Robert J Reid ◽  
Adrian R Levy ◽  
Michael Schulzer ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Long Term Care ◽  
Care Facility ◽  
Community Acquired Pneumonia ◽  
Hospital Length Of Stay ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Care Facilities

BACKGROUND: Pneumonia is a common reason for hospital admission, and the cost of treatment is primarily determined by length of stay (LOS).OBJECTIVES: To explore the changes to and determinants of hospital LOS for patients admitted for the treatment of community-acquired pneumonia over a decade of acute hospital downsizing.METHODS: Data were extracted from the database of Vancouver General Hospital, Vancouver, British Columbia, on patients admitted with community-acquired pneumonia (International Classification of Diseases, Ninth Revision, Clinical Modification codes 481.xx, 482.xx, 483.xx, 485.xx and 486.xx) from January 1, 1991 to March 31, 2001. The effects of sociodemographic factors, the specialty of the admitting physician (family practice versus specialist), admission from and/or discharge to a long-term care facility (nursing home) and year of admission, adjusted for comorbidity, illness severity measures and other potential confounders were examined. Longitudinal changes in these factors over the 10-year period were also investigated.RESULTS: The study population (n=2495) had a median age of 73 years, 53% were male and the median LOS was six days. Adjusted LOS was longer for women (10% increase, 95% CI 3 to 16), increasing age group (7% increase, 95% CI 4 to 10), admission under a family physician versus specialist (42% increase, 95% CI 32 to 52) and admission from home with subsequent discharge to a long-term care facility (75% increase, 95% CI 47 to 108). Adjusted hospital LOS decreased by an estimated 2% (95% CI 1 to 3) per annum. The mean age at admission and the proportion admitted from long-term care facilities both increased significantly over the decade (P<0.05).CONCLUSIONS: Results suggest that the management of hospitalized patients with pneumonia changed substantially between 1991 and 2001. The interface of long-term care facilities with acute care would be an important future area to explore potential efficiencies in caring for patients with pneumonia.

Siting efficiency of long-term health care facilities

1998 ◽  
Vol 32 (1) ◽  
pp. 25-43 ◽  
Author(s):  
HomeéF.E. Shroff ◽  
Th.R. Gulledge ◽  
Kingsley E. Haynes ◽  
Molly K. O'Neill
Keyword(s):  
Health Care ◽  
Health Care Facilities ◽  
Care Facilities

scholarly journals The Ability of the Nottingham Hip Fracture Score to Predict Mobility, Length of Stay and Mortality in Hospital, and Discharge Destination in Patients Admitted with a Hip Fracture

2020 ◽  
Vol 107 (4) ◽  
pp. 319-326 ◽  
Author(s):  
Radcliffe Lisk ◽  
Keefai Yeong ◽  
David Fluck ◽  
Christopher H. Fry ◽  
Thang S. Han
Keyword(s):  
Hip Fracture ◽  
Length Of Stay ◽  
Adverse Events ◽  
Nursing Care ◽  
Risk Group ◽  
Area Under The Curve ◽  
High Risk Group ◽  
Discharge Destination ◽  
Increased Risk ◽  
Surgery Rates

Abstract The Nottingham Hip Fracture Score (NHFS) has been developed for predicting 30-day and 1-year mortality after hip fracture. We hypothesise that NHFS may also predict other adverse events. Data from 666 patients (190 men, 476 women), aged 60.2–103.4 years, admitted with a hip fracture to a single centre from 1/10/2015 and 7/12/2017 were analysed. The ability of NHFS to predict mobility within 1 day after surgery, length of stay (LOS) find mortality, and discharge destination was evaluated by receiver operating characteristic curves and two-graph plots. The area under the curve (95% confidence interval [CI]) for predicting mortality was 67.4% (58.4–76.4%), prolonged LOS was 59.0% (54.0–64.0%), discharge to residential/nursing care was 62.3% (54.0–71.5%), and any two of failure to mobilise, prolonged LOS or discharge to residential/nursing care was 64.8% (59.0–70.6%). NHFS thresholds at 4 and 7 corresponding to the lower and upper limits of intermediate range where sensitivity and specificity equal 90% were identified for mortality and prolonged LOS, and 4 and 6 for discharge to residential/nursing care, which were used to create three risk categories. Compared with the low risk group (NHFS = 0–4), the high risk group (NHFS = 7–10 or 6–10) had increased risk of in-patient mortality: rates = 2.0% versus 7.1%, OR (95% CI) = 3.8 (1.5–9.9), failure to mobilise within 1 day of surgery: rates = 18.9% versus 28.3%, OR = 1.7 (1.0–2.8), prolonged LOS (> 17 days): rates = 20.3% versus 33.9%, OR = 2.2 (1.3–3.3), discharge to residential/nursing care: rates = 4.5% vs 12.3%, OR = 3.0 (1.4–6.4), and any two of failure to mobilise, prolonged LOS or discharge to residential/nursing care: rates = 10.5% versus 28.6%, 3.4 (95% CI 1.9–6.0), and stayed 4.1 days (1.5–6.7 days) longer in hospital. High NHFS associates with increased risk of mortality, prolonged LOS and discharge to residential/nursing care, lending further support for its use to identify adverse events.

Clustered Randomized Controlled Trial of a Hand Hygiene Intervention Involving Pocket-Sized Containers of Alcohol-Based Hand Rub for the Control of Infections in Long-Term Care Facilities

2011 ◽  
Vol 32 (1) ◽  
pp. 67-76 ◽  
Author(s):  
Wing Kin Yeung ◽  
Wai San Wilson Tam ◽  
Tze Wai Wong
Keyword(s):  
Treatment Group ◽  
Hand Hygiene ◽  
Controlled Trial ◽  
Control Group ◽  
Term Care ◽  
Randomized Controlled ◽  
Serious Infections ◽  
Care Facilities ◽  
To Receive

Objective.To investigate the effectiveness of a multifaceted hand hygiene program involving the use of pocket-sized containers of antiseptic gel in long-term care facilities (LTCFs) with elderly residents.Methods.In this clustered randomized controlled trial, Hong Kong LTCFs for elderly persons were recruited via snowball sampling. Staff hand hygiene adherence was directly observed, and residents' infections necessitating hospitalization were recorded. After a 3-month preintervention period, LTCFs were randomized to receive pocket-sized containers of alcohol-based gel, reminder materials, and education for all HCWs (treatment group) or to receive basic life support education and workshops for all healthcare workers (HCWs) (control group). A 2-week intervention period (April 1-15, 2007) was followed by 7 months of postintervention observations.Results.In the 3 treatment LTCFs, adherence to hand rubbing increased from 5 (1.5%) of 333 to 233 (15.9%) of 1,465 hand hygiene opportunities (P = .001) and total hand hygiene adherence increased from 86 (25.8%) of 333 to 488 (33.3%) of 1,465 opportunities (P = .01) after intervention; the 3 control LTCFs showed no significant change. In the treatment group, the incidence of serious infections decreased from 31 cases in 21,862 resident-days (1.42 cases per 1,000 resident-days) to 33 cases in 50,441 resident-days (0.65 cases per 1,000 resident-days) (P = .002), whereas in the control group, it increased from 16 cases in 32,726 resident-days (0.49 cases per 1,000 resident-days) to 85 cases in 81,177 resident-days (1.05 cases per 1,000 resident-days) (P = .004). In the treatment group, the incidence of pneumonia decreased from 0.91 to 0.28 cases per 1,000 resident-days (P = .001) and the death rate due to infection decreased from 0.37 to 0.10 deaths per 1,000 resident-days (P = .01); the control group revealed no significant change.Conclusions.A hand hygiene program involving the use of pocket-sized containers of antiseptic gel and education could effectively increase adherence to hand rubbing and reduce the incidence of serious infections in LTCFs with elderly residents.

scholarly journals CINOLOGY IN A GENERAL EDUCATION SCHOOL

2020 ◽  
Vol 26 (1) ◽  
pp. 70-74
Author(s):  
Dainius Statkevičius
Keyword(s):  
Health Care ◽  
General Education ◽  
Social Activity ◽  
Health Care Facilities ◽  
Social Aspects ◽  
Positive Effects ◽  
Care Facilities ◽  
Education School ◽  
Integrated Project

Dogs for 15,000 years have been an integral part of all humanity in our life and culture. In recent times, canitherapy has gained in popularity as a therapeutic approach based on the positive effects of human-dog interaction on the physical, psychological and social aspects of humans. This method is often used in institutions for child care and education (kindergartens, schools, care homes), health care facilities, retirement homes and other special facilities for children and adults with various mental disorders. In order to introduce pupils to the basics of cynology, to promote canitherapy, charity and social activities, various activities are organized at Kaunas Vyturys Gymnasium in order to involve as many pupils as possible. This activity is also being integrated into the long-term project “Sustainable School”. It is also sought and emphasized that a person must go to a kennel if he wants to have a certain breed of dog, but if he wants to have dog (does not matter breed), he must go to a shelter. This way is to combat breeding of undocumented breeding dogs. The gymnasium organizes educational classes with dogs for primary school learners, social campaigns "Support the homeless", integrated project "Use waste and help the homeless", quizzes "Do you know dogs and their breeds". Also it is planned to prepare an elective subject for students of grades 11-12 “Basics of Cynology”. Keywords: cynology, canitherapy, social activity, education with dogs.

scholarly journals Quantifying transmissibility of COVID-19 and impact of intervention within long-term health care facilities

2021 ◽  
Author(s):  
Jessica E. Stockdale ◽  
Sean C. Anderson ◽  
Andrew M. Edwards ◽  
Sarafa A. Iyaniwura ◽  
Nicola Mulberry ◽  
...  
Keyword(s):  
Health Care ◽  
Credible Interval ◽  
Health Care Facilities ◽  
Total Size ◽  
Bayesian Hierarchical ◽  
Standard Methods ◽  
Risk Environments ◽  
Global Pandemic ◽  
Care Facilities

AbstractEstimates of the basic reproduction number (R0) for Coronavirus disease 2019 (COVID-19) are particularly variable in the context of transmission within locations such as long-term health care (LTHC) facilities. We sought to characterise the heterogeneity of R0 across known outbreaks within these facilities. We used a unique comprehensive dataset of all outbreaks that have occurred within LTHC facilities in British Columbia, Canada. We estimated R0 with a Bayesian hierarchical dynamic model of susceptible, exposed, infected, and recovered individuals, that incorporates heterogeneity of R0 between facilities. We further compared these estimates to those obtained with standard methods that utilize the exponential growth rate and maximum likelihood. The total size of an outbreak varied dramatically, with a range of attack rates of 2%–86%. The Bayesian analysis provides more constrained overall estimates of R0 = 2.19 (90% CrI [credible interval] 0.19–6.69) than standard methods, with a range within facilities of 0.48–10.08. We further estimated that intervention led to 57% (47%–66%) of all cases being averted within the LTHC facilities, or 73% (63%–78%) when using a model with multi-level intervention effect. Understanding the risks and impact of intervention are essential in planning during the ongoing global pandemic, particularly in high-risk environments such as LTHC facilities.

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