scholarly journals Improving Continuity of Care Reduces Emergency Department Visits by Long-Term Care Residents

2016 ◽  
Vol 29 (2) ◽  
pp. 201-208 ◽  
Author(s):  
E. G. Marshall ◽  
B. Clarke ◽  
F. Burge ◽  
N. Varatharasan ◽  
G. Archibald ◽  
...  
Keyword(s):  
Emergency Department ◽  
Continuity Of Care ◽  
Long Term Care ◽  
Emergency Department Visits ◽  
Term Care

Understanding Acute Care Usage by Adult Chronically Critically Ill Ventilated Patients: A Chart Review

2020 ◽  
Vol 14 (3) ◽  
pp. 123-129
Author(s):  
Sarah Crowe ◽  
A. Fuchsia Howard ◽  
Gregory Haljan
Keyword(s):  
Emergency Department ◽  
Critically Ill ◽  
Acute Care ◽  
Residential Care ◽  
Long Term Care ◽  
Emergency Department Visits ◽  
Term Care ◽  
Residential Care Facility ◽  
Chronically Critically Ill

ObjectivesTo better understand the rationale for acute care usage among long term care ventilated residents.BackgroundChronically critically ill ventilated individuals experience complex health challenges, with many not surviving one year post initial hospitalization discharge. Recent research reports high acute care readmission rates for chronically critically ill patients, yet most studies have not examined the reasons patients are readmitted, nor the treatment and care provided during these stays.MethodA retrospective medical chart reviews of all emergency department visits and acute care admissions, occurring from August 2014 to August 2016, of chronically critically ill ventilated individuals living in a residential care facility in the province of British Columbia, Canada was conducted.ResultsThere were 49 emergency department visits and 56 acute care admissions over a 2 year period by 20 chronically critically ill ventilated residential care patients. The majority of acute care admissions were related to pneumonia, whereas the majority of emergency department visits were not specified.ConclusionChronically critically ill ventilated long term care residents are high users of acute care resources, frequently admitted for pneumonia.

Frequency and Pattern of Emergency Department Visits by Long-Term Care Residents-A Population-Based Study

2010 ◽  
Vol 58 (3) ◽  
pp. 510-517 ◽  
Author(s):  
Andrea Gruneir ◽  
Chaim M. Bell ◽  
Susan E. Bronskill ◽  
Michael Schull ◽  
Geoffrey M. Anderson ◽  
...  
Keyword(s):  
Emergency Department ◽  
Long Term Care ◽  
Population Based ◽  
Emergency Department Visits ◽  
Term Care ◽  
Population Based Study

Abstract W P340: Emergency Department Nurses Collaborate With Long Term Care Facilities for Stroke Patients

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Jamie L Strom
Keyword(s):  
Emergency Department ◽  
Long Term Care ◽  
Stroke Patients ◽  
Term Care ◽  
Stroke Treatment ◽  
Emergency Department Nurses ◽  
Senior Services ◽  
To Receive ◽  
Education Initiative

Background and Purpose: Stroke treatment is often delayed before patients reach the emergency department (ED). Some patients arrive in time to receive medication that can reverse new stroke symptoms. Some are not as fortunate. They are either admitted to the palliative unit, or discharged only to live with their new disabilities possibly for the rest of their lives. In 2013, nurses observed many long term care (LTC) patients were not getting to the ED in time to receive tPA (tissue plasminogen activator), a medication used to reverse stroke symptoms. The purpose of this process improvement was to increase the number of LTC patients with stroke symptoms arriving in the ED within the tPA window. Methods: To determine how many patients from nursing homes were missing the tPA window, data from the ED’s records was abstracted from the month of June 2013. The sample size was all patients who presented with possible stroke symptoms, and who were also from LTC facilities. Surprisingly, 100% of LTC patients presenting with stroke symptoms missed the tPA window. With the support of ED leadership, we decided to raise awareness about the tPA window in the LTC facilities. No evidence existed from ED’s related to LTC patients and the tPA window. Approximately 1,000 unused stroke pamphlets were collected. A PowerPoint presentation based on AHA guidelines was used. A lecture occurred at the community’s senior services meeting, and many LTC administrators were willing to adopt this education initiative at their facilities. ED staff became involved and helped conduct the in-services. In exchange for their volunteering, they received credit to help with career ladders at their hospital. Results: The number of possible stroke patients from LTC facilities getting to the ED within eight hours of the last time seen normal (LTSN) has increased from 0% in June 2013, to 25% in March 2014. Conclusions: Stroke education teams of ED nurses showed improvement in LTC patients arriving in the ED within the tPA window. In conclusion, it is encouraged that other ED staff volunteer to teach in LTC facilities in their own communities, in assisting their stroke patients as well.

scholarly journals 1442. Effect of Reflex Urine Culturing on Rates of Cultures and Infections in an Acute Care Hospital, Emergency Department, and Two Long-Term Care Facilities

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S526-S526
Author(s):  
Chelsea Lynch ◽  
Andrea Appleby-Sigler ◽  
Jacqueline Bork ◽  
Rohini Dave ◽  
Kimberly C Claeys ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Care ◽  
Long Term Care ◽  
White Blood Cells ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Post Intervention ◽  
Term Care ◽  
Absolute Increase

Abstract Background Urine cultures are often positive in the absence of urinary tract infection (UTI) leading to unnecessary antibiotics. Reflex culturing decreases unnecessary urine culturing in acute care settings but the benefit in other settings is unknown. Methods This was a quasi-experimental study performed at a health system consisting of an acute care hospital, an emergency department (ED), and two long-term care (LTC) facilities. Reflex urine criterion was a urine analysis with > 10 white blood cells/high-power field. Urine cultures performed per 100 bed days of care (BDOC) were compared pre- (August 2016 to July 2017) vs. post-intervention (August 2017 to August 2018) using interrupted time series regression. Catheter-associated UTI (CAUTI) rates were reviewed to determine potential CAUTIs that would have been prevented. Results In acute care, pre-intervention, 894 cultures were performed (3.6 cultures/100 BDOC). Post-intervention, 965 urine cultures were ordered and 507 cultures were performed (1.8 cultures/100 BDOC). Reflex culturing resulted in an immediate 49% decrease in cultures performed (P < 0.001). The CAUTI rate 2 years pre-intervention was 1.8/1000 catheter days and 1.6/1000 catheter days post-intervention. Reflex culturing would have prevented 4/14 CAUTIs. In ED, pre-intervention, 1393 cultures were performed (5.4 cultures/100 visits). Post-intervention, 1959 urine cultures were ordered and 917 were performed (3.3 cultures/100 visits). Reflex culturing resulted in an immediate 47% decrease in cultures performed (P = 0.0015). In LTC, pre-intervention, 257 cultures were performed (0.4 cultures/100 BDOC). Post-intervention, 432 urine cultures were ordered and 354 were performed (0.5 cultures/100 BDOC). Reflex culturing resulted in an immediate 75% increase in cultures performed (P < 0.001). The CAUTI rate 2 years pre-intervention was 1.0/1000 catheter days vs. 1.6/1,000 catheter days post-intervention. Reflex culturing would have prevented 1/13 CAUTIs. Conclusion Reflex culturing canceled 16%-51% of cultures ordered with greatest impact in acute care and the ED and a small absolute increase in LTC. CAUTI rates did not change although reflex culturing would have prevented 29% of CAUTIs in acute care and 8% in LTC. Disclosures All authors: No reported disclosures.

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