scholarly journals Impact of educational intervention on prescribing inappropriate medication to elderly nursing homes residents

2015 ◽  
Vol 143 (3-4) ◽  
pp. 174-179 ◽  
Author(s):  
Darko Ilic ◽  
Zoran Bukumiric ◽  
Slobodan Jankovic
Keyword(s):  
Nursing Homes ◽  
Educational Intervention ◽  
Inappropriate Prescribing ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Inappropriate Drugs ◽  
Start Criteria ◽  
Homes For The Elderly ◽  
Stopp Criteria ◽  
Significant Difference

Introduction. Problems with polypharmacy, adverse drug reactions and non-adherence are especially frequent among elderly nursing home residents. Objective. The aim of our study was to evaluate effectiveness of a specific form of staff education on appropriateness of prescribing in a cluster of nursing homes for the elderly. Methods. The study was designed as before-and-after trial of educational intervention on appropriateness of prescribing in nursing homes for the elderly. In total 20 nursing homes located in Belgrade, Serbia were included in the study with 104 elderly residents and 27 caring physicians. Appropriateness of prescribing was checked against Beers, START and STOPP criteria, before and 6 months after the intervention. Results. There were 349 inappropriately prescribed drugs according to Beers criteria before the intervention and 37 drugs six months after the intervention. According to STOPP criteria there were 70 drugs inappropriately prescribed before the intervention, and 20 drugs 6 months after. When both criteria are taken together, there is a significant difference between the average number of inappropriate drugs per patient before (3.4?0.5) and after (0.6?0.7) educational intervention (t=38.902; p<0.001). Finally, before the intervention 143 appropriate drugs were omitted according to START criteria, while 6 months after the intervention there were only 67 omissions. Conclusion. Simple, but well targeted educational interventions may improve polypharmacy and decrease inappropriate prescribing rate, contributing to a better care of elderly patients in nursing homes.

Assessment of antipsychotic prescribing in Belgian nursing homes

2011 ◽  
Vol 23 (8) ◽  
pp. 1240-1248 ◽  
Author(s):  
Majda Azermai ◽  
Monique Elseviers ◽  
Mirko Petrovic ◽  
Luc van Bortel ◽  
Robert Vander Stichele
Keyword(s):  
Nursing Homes ◽  
Inappropriate Prescribing ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Prescribing Quality ◽  
Homes For The Elderly ◽  
Combined Use ◽  
Antipsychotic Prescribing

ABSTRACTBackground: Given the potential adverse effects of antipsychotics, high use in nursing homes creates concern. Our study goal was to explore the use of antipsychotics in relation to resident characteristics, and to assess the appropriateness of antipsychotic prescribing in Belgian nursing homes.Methods: Data were used from a cross-sectional study (Prescribing in Homes for the Elderly; PHEBE) conducted in 76 nursing homes in Belgium. Antipsychotics were classified into typical and atypical, using the anatomical therapeutic and chemical classification. Ten inappropriate antipsychotic prescribing indicators were selected from the updated Beers criteria (2003), Bergen District Nursing Home Study (BEDNURS) indicators, and Screening Tool of Older People's Prescriptions criteria (STOPP).Results: The residents' mean age was 84.8 years, 78.1% of whom were female. The prevalence of antipsychotic utilization was 32.9%. Antipsychotics were mainly indicated for dementia-related agitation, and psychosis with/without dementia. Higher use of antipsychotics was found for dementia (OR: 3.27; 95% CI: 2.61–4.09), insomnia (OR: 1.38; 95% CI: 1.10–1.73), depression (OR: 1.30; 95% CI: 1.03–1.65), and age <80 years (OR: 1.79; 95% CI: 1.38–2.33). Inappropriate antipsychotic prescribing indicators scoring the highest among users were: long-term use (92.6%), use despite risk of falling (45.6%), combined use with other psychotropics (31.8%), and duplicate use (15.1%). Inappropriate prescribing was associated with depression (OR: 3.41) and insomnia (OR: 2.17).Conclusion: The indicator-driven analysis of antipsychotic prescribing quality revealed a need for improvement, with the main prescribing problems relating to duration and combination of therapies. Risks/benefits of off-label use need to be evaluated more consciously at the start of therapy, and at periodic re-evaluations.

scholarly journals Is there any correlation between Magnesium status and depression in elderly people? A descriptive-analytical study among Tehran-nursing home residents

2021 ◽  
Vol 12 (2) ◽  
pp. 632-639
Author(s):  
Lyly Nazemi ◽  
Ingmar Skoog ◽  
Ingvar Karlsson ◽  
Margda Waern ◽  
Agneta Yngve ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Elderly Population ◽  
Analytical Study ◽  
Depression Scale ◽  
Nursing Home Residents ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Flame Atomic Absorption ◽  
Significant Difference

Background: Very few studies have shown the possible relationship between magnesium (Mg) status and depression. In the present study, the intracellular Mg status of the elderly population living in nursing homes (NHs) was assessed to determine its relationship with depression. Methods: A descriptive-analytical study was conducted on the elderly population living in nursing homes (Tehran-Iran; 2010-2012). Participants' demographic and clinical characteristics were collected and recorded in a checklist. Evaluating the participants’ nutritional status, Mini Nutritional Assessment Method was implemented. Determining participant's depressive symptoms, 15-item Geriatric Depression Scale was used. Final scores were classified into4 categories not depressed, mild, moderate, and severe depression. Mg level in leukocytes was also measured by flame atomic absorption spectrometry. Results: Totally 113 elderly were included and only 9.8% of subjects were not depressed. About 21% of the subjects were well nourished. Of participants who suffered from heart disease, 80.2% were depressed (p=0.03). Regarding correlations between Mg status and depression, results showed no significant difference in Mg levels of two depressed and non-depressed participants (p=0.73). Conclusion: The results of the present study showed notable prevalence rates of depression and malnutrition among nursing home residents. It was also found that the relationship between intracellular Mg levels and depression was not significant. Further studies are needed to determine the major factors related to these preventable psychological and nutritional disorders among elderly NH residents.

scholarly journals Identification of inappropiate prescribing in a Geriatric outpatient clinic using the Criteria Stopp Start

2016 ◽  
Vol 19 (5) ◽  
pp. 871-879 ◽  
Author(s):  
Andressa Stella Kuhn Correia da Rosa ◽  
Bruna Polanski Costa ◽  
Cássia Pinheiro Kapper ◽  
Gabriela Graça Soder Dalmas ◽  
Lissiê Lunardi Sbroglio ◽  
...  
Keyword(s):  
Acetylsalicylic Acid ◽  
Cardiovascular System ◽  
Outpatient Clinic ◽  
Inappropriate Prescribing ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Start Criteria ◽  
Stopp Criteria

Abstract Identified the inappropriate prescription of drugs in elderly assisted geriatric outpatient clinic in the region of Vale do Rio Pardo in Rio Grande do Sul according to the criteria of STOPP and START. Cross-sectional study of 221 elderly, based on retrospective analysis of medical records using comprehensive geriatric assessment data held in the first visit. Descriptive variables were age, sex, number of pathologies and number of medications in use. And the study variables were potentially inappropriate medications (MPI) and potentially omitted medications (MPO), according to the STOPP and START criteria. Descriptive statistics were performed with frequencies, means and standard deviations where appropriate. It was observed 157 (71%) female patients. The average age was 75 (±8.26) years, 49.8% in the range of 75-84 years. The average number of drugs was 3 (±2.27), with 22.63% using 5 or more medications. The average pathologies was 3.45 (±2.02). They identified 194 prescriptions of MPI and observed 93 MPO. The most identified were the MPI for the cardiovascular system, especially β noncardioselective blockers and acetylsalicylic acid. Also MPO were found most of the cardiovascular system, with emphasis on acetylsalicylic acid and inhibitors of angiotensin converting enzyme. This is sample of elderly with significant prevalence of inappropriate prescribing of drugs. Studies using the STOPP criteria and START in different health care settings can qualify the care provided to the elderly.

Characteristics of Aggressive Subjects in Australian (Melbourne) Nursing Homes

2000 ◽  
Vol 12 (2) ◽  
pp. 145-161 ◽  
Author(s):  
Ajit Shah ◽  
Edmond Chiu ◽  
David Ames ◽  
Susan Harrigan ◽  
Dean McKenzie
Keyword(s):  
Nursing Homes ◽  
Aggressive Behavior ◽  
Psychotropic Drugs ◽  
Rating Scale ◽  
Physical Restraint ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Educational Programs ◽  
Homes For The Elderly ◽  
Younger Age

Background: Aggressive behavior is common in nursing homes for the elderly. It causes distress to carers and can lead to hospitalization, overmedication, and physical restraint. Method: A 6-month prospective study examining the characteristics of aggressive subjects in 11 nursing homes in Melbourne using validated, reliable instruments. Results: During the study, 121 and 143 subjects were rated aggressive on the Rating Scale for Aggressive Behavior in the Elderly and the Staff Observation Aggression Scale, respectively. Aggressive behavior was associated with younger age, men, subsequent mortality, and prescription of psychotropic drugs including neuroleptics, antidepressants, and benzodiazepines. Conclusions: Educational programs in the use of psychotropic drugs directed at staff involved in the care of nursing home residents may be of value because these drugs have modest efficacy, have significant side effects, and may simply sedate the patient rather than treat aggressive behavior.

scholarly journals The Difficult Balance between Ensuring the Right of Nursing Home Residents to Communication and Their Safety

2021 ◽  
Vol 18 (5) ◽  
pp. 2484
Author(s):  
Matteo Bolcato ◽  
Marco Trabucco Aurilio ◽  
Giulio Di Mizio ◽  
Andrea Piccioni ◽  
Alessandro Feola ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Prevention Measures ◽  
Social And Emotional ◽  
Homes For The Elderly ◽  
The Social ◽  
The Right ◽  
Council Of Ministers ◽  
Emotional Value

The COVID-19 epidemic has had a profound impact on healthcare systems worldwide. The number of infections in nursing homes for the elderly particularly is significantly high, with a high mortality rate as a result. In order to contain infection risks for both residents and employees of such facilities, the Italian government passed emergency legislation during the initial stages of the pandemic to restrict outside visitor access. On 30 November 2020, the Italian President of the Council of Ministers issued a new decree recognizing the social and emotional value of visits to patients from family and friends. In addition, it indicated prevention measures for the purposes of containing the infection risk within nursing homes for the elderly. This article comments on these new legislative provisions from the medicolegal perspective, providing indications that can be used in clinical practice.

The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

2022 ◽  
Vol 8 (1) ◽  
pp. 51-66
Author(s):  
Vesna Žegarac Leskovar ◽  
Vanja Skalicky Klemenčič
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Architectural Design ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Evaluation Tool ◽  
Negative Effect ◽  
Disproportionate Number ◽  
Role Of Nursing

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

scholarly journals Load on the Low Back of Care Workers in Nursing Homes for the Elderly

2005 ◽  
Vol 47 (4) ◽  
pp. 131-138 ◽  
Author(s):  
Shinji Kumagai ◽  
Hidetsugu Tainaka ◽  
Keiko Miyajima ◽  
Naoko Miyano ◽  
Junko Kosaka ◽  
...  
Keyword(s):  
Nursing Homes ◽  
The Elderly ◽  
Low Back ◽  
Homes For The Elderly ◽  
Care Workers

scholarly journals REVEALING FEATURES OF THE ARCHITECTURAL TYPOLOGY OF NURSING HOMES

2020 ◽  
pp. 33-39
Author(s):  
I. Zhdanova ◽  
A. Kuznecova ◽  
P. Mihaylina
Keyword(s):  
Social Interaction ◽  
Nursing Homes ◽  
Functional Organization ◽  
The Elderly ◽  
Comfort Level ◽  
Functional Improvement ◽  
Foreign Experience ◽  
Homes For The Elderly ◽  
Care Health

The article focuses on the study of modern approaches in the typology of nursing homes. Global data on the increase in the share of older people in the total population are presented. In addition, Rosstat data confirm the relevance of studying this topic. Examples of foreign experience in designing and building homes for the elderly show the developed functional composition of the premises, along with the function of accommodation and care - health care, leisure, trade, sports, food and multifunctional spaces to ensure social interaction of different groups of the population. The research reveals a method of "functional improvement" aimed at developing optimal functional interactions between public and residential spaces. A concept project for a "dynamic" scheme has been developed, showing the inclusion of residential blocks in a multifunctional complex. The chosen functional organization allows the creation of private spaces for residents of retirement age and walking areas for visitors to the complex. It is determined that in Russia it is necessary to implement modern approaches adapted to Russian conditions, based on foreign experience. This will enhance the consumer quality of the facility and the comfort level of the elderly, which will undoubtedly provide social interaction through the introduction of educational and leisure functions, as well as improve the ecological and aesthetic qualities of the environment.

scholarly journals Vaccine effectiveness for influenza in the elderly in welfare nursing homes during an influenza A (H3N2) epidemic

2000 ◽  
Vol 125 (2) ◽  
pp. 393-397 ◽  
Author(s):  
Y. DEGUCHI ◽  
Y. TAKASUGI ◽  
K. NISHIMURA
Keyword(s):  
Nursing Homes ◽  
Influenza Vaccine ◽  
Influenza A ◽  
Hospital Admissions ◽  
Influenza Virus Infection ◽  
Severe Infection ◽  
The Elderly ◽  
Trivalent Influenza Vaccine ◽  
Homes For The Elderly ◽  
Vaccine Effect

Influenza vaccine effect on the occurrence and severity of influenza virus infection in a population residing in nursing homes for the elderly was studied as a cohort study during an influenza A (H3N2) epidemic in Japan. Of 22462 individuals living in 301 welfare nursing homes, 10739 voluntarily received inactivated, sub-unit trivalent influenza vaccine in a programme supported by the Osaka Prefectural Government. There were statistically significantly fewer cases of influenza, hospital admissions due to severe infection, and deaths due to influenza in the vaccinated cohort compared to the unvaccinated controls. No serious adverse reactions to vaccination were recorded. Thus influenza vaccination is effective for preventing influenza disease in persons aged 65 years and over, and should be an integral part of the care of this population residing in nursing homes.

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