The Importance of a Complete Allergy Assessment in Clinical Stewardship

2019 ◽  
Vol 34 (8) ◽  
pp. 510-513
Author(s):  
Vanessa Moreno ◽  
Charlie L. Nguyen ◽  
Amie Taggart Blaszczyk
Keyword(s):  
Health Care Providers ◽  
Long Term Care ◽  
Care Providers ◽  
Opioid Use ◽  
Term Care ◽  
Care Facilities ◽  
The Right ◽  
Potential Challenge ◽  
Selection Of

National agencies have championed stewardship initiatives to enhance antimicrobial and opioid use in long-term care facilities. Health care providers for these residents have been given the task to ensure "the right drug is used for the right indication at the right time and duration." One potential challenge to this is incorrect or incomplete documentation of allergies. Many long-term care facilities have traditionally, and currently, used a "list format" of allergies in, or on, the resident's chart. This approach is incomplete as it rarely provides detailed information about the reaction to a particular drug. Senior care pharmacists and their students can play a role within long-term care facilities by helping ensure the optimal selection of drugs by providing a detailed allergy assessment that documents detailed reaction information, whenever possible.

scholarly journals Linking Incidents in Long-Term Care Facilities to Worker Activities

2017 ◽  
Vol 65 (10) ◽  
pp. 457-466
Author(s):  
Rose McCloskey ◽  
Cindy Donovan ◽  
Alicia Donovan
Keyword(s):  
Health Care Providers ◽  
Long Term Care ◽  
Occupational Injury ◽  
Worker Safety ◽  
Care Providers ◽  
Cross Sectional ◽  
Term Care ◽  
Care Facilities ◽  
The Impact

This article reports on a study examining staff activities being performed when incidents were reported to have occurred. The risk for injury among health care providers who engage in patient handling activities is widely acknowledged. For those working in long-term care, the risk of occupational injury is particularly high. Although injuries and injury prevention have been widely studied, the work has generally focused on incident rates and the impact of specific assistive devices on worker safety. The purpose of this study was to examine reported staff incidents in relation to staff activities. A multicenter cross-sectional exploratory study used retrospective data from reported staff incidents (2010, 2011, and 2012) and prospective data from 360 hours of staff observations in five long-term care facilities during 2013. Descriptive statistics were used to analyze data. A total of 898 staff incidents were reviewed from the facilities. Incidents were most likely to occur in resident rooms. Resident aides were more likely to be engaged in high-risk activities than other care providers. Times when staff incidents were reported to have occurred were not associated with periods of high staff-to-resident contact. Safe handling during low and moderate risk activities should be promoted. Education on what constitutes a reportable incident and strategies to ensure compliance with reporting policies and procedures may be needed to ensure accuracy and completeness of incident data.

scholarly journals Perspectives and experiences of compassion in long-term care facilities within Canada: a qualitative study of patients, family members and health care providers

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lorraine Smith-MacDonald ◽  
Lorraine Venturato ◽  
Paulette Hunter ◽  
Sharon Kaasalainen ◽  
Tamara Sussman ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Long Term Care ◽  
Family Members ◽  
Care Providers ◽  
Term Care ◽  
Care Facilities

Patient-Centered Communication Survey of Nursing Homes and Rehabilitation Centers

2007 ◽  
Vol 8 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Amy Skinder-Meredith ◽  
Lynn Bye ◽  
Kari Bulthuis ◽  
Angie Schueller
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Long Term Care ◽  
Communication Disorders ◽  
Care Providers ◽  
Patient Centered ◽  
Term Care ◽  
Rehabilitation Centers ◽  
Care Facilities

A surge of research has recently been published on the importance of patient-centered communication (P-CC). However, patients with communication disorders are rarely considered in these discussions. Health care workers in long-term care facilities (L-TCFs) and rehabilitation centers were surveyed in order to: (1) assess the level of P-CC used with people with communication disorders versus those without communication disorders; (2) identify the tools and strategies currently used by health care providers in long-term care facilities and rehabilitation centers to enhance P-CC with people with communication disorders; (3) assess the perceived level of effectiveness of these tools and strategies; and (4) identify the tools desired by health care providers in these settings. The results regarding P-CC levels were fairly consistent across settings. Health care providers reported that they achieve slightly higher P-CC with patients without communication disorders than with those with communication disorders. Respondents in both settings used similar tools and strategies, but the reported level of effectiveness varied greatly between the two settings, with rehabilitation centers indicating better success than L-TCFs. Interestingly, rehabilitation center respondents were more interested in obtaining additional tools than were L-TCF respondents, but the types of tools desired were similar.

scholarly journals Educational Needs of Health Care Providers Working in Long-Term Care Facilities with Regard to Pain Management

2012 ◽  
Vol 17 (5) ◽  
pp. 341-346 ◽  
Author(s):  
Yannick Tousignant-Laflamme ◽  
Michel Tousignant ◽  
David Lussier ◽  
Paule Lebel ◽  
Maryse Savoie ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Continuing Education ◽  
Health Care Providers ◽  
Long Term Care ◽  
Educational Needs ◽  
Care Providers ◽  
Term Care ◽  
Care Facilities

BACKGROUND: The prevalence of chronic pain ranges from 40% to 80% in long-term care facilities (LTCF), with the highest proportion being found among older adults and residents with dementia. Unfortunately, pain in older adults is underdiagnosed, undertreated, inadequately treated or not treated at all. A solution to this problem would be to provide effective and innovative interdisciplinary continuing education to health care providers (HCPs).OBJECTIVE: To identify the educational needs of HCPs working in LTCF with regard to pain management.METHODS: A qualitative research design using the nominal group technique was undertaken. Seventy-two HCPs (21 physicians/pharmacists, 15 occupational/physical therapists, 24 nurses and 21 orderlies) were recruited from three LTCF in Quebec. Each participant was asked to provide and prioritize a list of the most important topics to be addressed within a continuing education program on chronic pain management in LTCF.RESULTS: Forty topics were generated across all groups, and six specific topics were common to at least three out of the four HCP groups. Educational need in pain assessment was ranked the highest by all groups. Other highly rated topics included pharmacological treatment of pain, pain neurophysiology, nonpharmacological treatments and how to distinguish pain expression from other behaviours.CONCLUSION: The present study showed that despite an average of more than 10 years of work experience in LTCF, HCPs have significant educational needs in pain management, especially pain assessment. These results will help in the development of a comprehensive pain management educational program for HCPs in LTCF.

scholarly journals Visual process maps to support implementation efforts: a case example

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Jennifer Kononowech ◽  
Zach Landis-Lewis ◽  
Joan Carpenter ◽  
Mary Ersek ◽  
Robert Hogikyan ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Long Term Care ◽  
Process Mapping ◽  
Care Providers ◽  
Term Care ◽  
Goals Of Care ◽  
Process Maps ◽  
Time Burden ◽  
Centered Care

Abstract Background Process mapping is often used in quality improvement work to examine current processes and workflow and to identify areas to intervene to improve quality. Our objective in this paper is to describe process maps as a visual means of understanding modifiable behaviors and activities, in this case example to ensure that goals of care conversations are part of admitting a veteran in long-term care settings. Methods We completed site visits to 6 VA nursing homes and reviewed their current admission processes. We conducted interviews to document behaviors and activities that occur when a veteran is referred to a long-term care setting, during admission, and during mandatory VA reassessments. We created visualizations of the data using process mapping approaches. Process maps for each site were created to document the admission activities for each VA nursing home and were reviewed by the research team to identify consistencies across sites and to identify potential opportunities for implementing goals of care conversations. Results We identified five consistent behaviors that take place when a veteran is referred and admitted in long-term care. These behaviors are assessing, discussing, decision-making, documenting, and re-assessing. Conclusions Based on the process maps, it seems feasible that the LST note and order template could be completed along with other routine assessment processes. However, this will require more robust multi-disciplinary collaboration among both prescribing and non-prescribing health care providers. Completing the LST template during the current admission process would increase the likelihood that the template is completed in a timely manner, potentially alleviate the perceived time burden, and help with the provision of veteran-centered care.

Mealtimes as Active Processes in Long-term Care Facilities

2005 ◽  
Vol 66 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Amie J. Gibbs-Ward ◽  
Heather H. Keller
Keyword(s):  
Long Term Care ◽  
Comparison Method ◽  
Theory Approach ◽  
Care Providers ◽  
Term Care ◽  
Individualized Care ◽  
People With Dementia ◽  
Care Facilities ◽  
Active Processes

Mealtimes are central to the nutritional care of residents in long-term care facilities. There has been little Canadian research to guide interdisciplinary practice around mealtimes. This study included a grounded theory approach to explore mealtime experiences of 20 people with dementia living in two long-term care facilities, and the meal-related care they received from registered nurses, health care aides, and dietitians. Theoretical sampling directed the collection and analysis of data from mealtime observations in special care units and key informant interviews with care providers. The constant comparison method was used to analyze and conceptualize the data. A substantive theory emerged with three key themes: Each mealtime is a unique process embedded within a long-term care facility's environment. Residents are central to the process through their actions (i.e., arriving, eating, waiting, socializing, leaving, and miscellaneous distracted activities). Internal (i.e., residents’ characteristics) and external (i.e., co-resident, direct caregiving, indirect caregiving, administrative, and government activities) influences affect residents’ actions at mealtimes. The theory suggests that optimal mealtime experiences for residents require individualized care that reflects interdisciplinary, multi-level interventions.

scholarly journals EVENT-SPECIFIC EMOTIONAL EXPRESSION OF PERSONS WITH DEMENTIA IN LONG-TERM CARE: PRELIMINARY RESULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S420-S420
Author(s):  
Kyung Hee Lee ◽  
Ji Yeon Lee ◽  
Bora Kim ◽  
Marie Boltz
Keyword(s):  
Health Care Providers ◽  
Emotional Expression ◽  
Long Term Care ◽  
Well Being ◽  
Emotional Expressions ◽  
Care Providers ◽  
Personal Care ◽  
Term Care ◽  
Meal Time

Abstract Although dementia-related language, comprehension, and memory deficits occur fairly early stage in dementia, persons with dementia retain the ability to express their emotion even in the late stage of disease. However, health care providers do not know how to interpret emotional expressions that could be utilized as important signals of underlying needs and care preferences in persons with dementia. The purpose of this study was to explore the event-specific emotional expressions of persons with dementia in long-term care over a 6-month period. This was a longitudinal study using repeated observations. Emotional expressions were videotaped when three specific events (personal care, meal time, and activity) occurred at baseline, month 3 and month 6. A total of nine observations was made for each participant. We enrolled 13 participants so far; ten participants were completed 6 month follow up. The mean score of MMSE at baseline was 4.38; that of ADL was 16.62. On average, persons with dementia showed 9.93 episodes of positive emotional expression (PEE) per minute and 1.81 episodes of negative emotional expression (NEE) per minute. We found between person variations for both PEE and NEE. PEE and NEE were different by three types of events. Specifically, persons with dementia showed more PEE with activity than personal care and meal time and more NEE with personal care than the other two events. This study will provide better understanding of event-specific emotional expressions, and inform the development of emotion-oriented interventions programs to improve the psychological well-being of persons with dementia.

Intercultural Collaboration: An Approach to Long Term Care for Urban American Indians

2003 ◽  
Vol 4 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Levanne R. Hendrix
Keyword(s):  
American Indian ◽  
American Indians ◽  
Health Care Providers ◽  
Long Term Care ◽  
Extended Family ◽  
Care Providers ◽  
Indian Culture ◽  
Term Care ◽  
Urban American Indians

Most long term care of older urban American Indians is provided in the community by family, extended family, or fictive kin, and American Indians are rarely found in long term care facilities. An approach to American Indian elderly requires some understanding of Indian ways in order to be effective therapeutically and acceptable to the older Indian. Multiple interviews, a focus group, and a survey conducted in an urban Indian community revealed the consistent perception by American Indian elderly and their families that health care providers lacked information, understanding, and respect for Indian culture.

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