...Evaluating Patient Fall in Hospitals 1 Evaluating Patient Falls in Hospitals Michael Carter Southern Illinois University August 12, 2012 Evaluating Patient Falls In Hospitals 2 Abstract Hospitalization represents a vulnerable time for elderly people. The presence of acute illness, an unfamiliar environment, and the frequent addition of new medications predispose an elderly patient to such iatrogenic hazards of hospitalization as falls, pressure ulcers, and delirium.1 A fall is a seminal event in the life of an elderly person. Even a fall without injury can initiate a vicious circle that begins with a fear of falling and is followed by a self-restriction of mobility, which commonly results in a decline in function.4 Functional decline in the elderly has been shown to predict mortality and nursing home placement.5 Inpatient falls are thought to occur via a complex interplay between medications, inherent patient susceptibilities, and hospital environmental hazards Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic groups, with falls accounting for 70 percent of accidental deaths in persons 75 years of age and older. Falls can...
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...THE CASE FOR A MODEL OF CARE Contemporary health care systems are constantly challenged to revise traditional methods of health care delivery. These challenges are multifaceted and stem from: 1. novel pharmacological and non-pharmacological treatments; 2. changes in consumer demands and expectations; 3. fiscal and resource constraints; 4. changes in societal demographics in particular the ageing of society; 5. an increasing burden of chronic disease; 6. documentation of limitations in traditional health care delivery; 7. an increasing emphasis on transparency and accountability, 8. evidence based practice (EBP) and clinical governance structures; and 9. the increasing cultural diversity of the community. These challenges provoke discussion of the necessity of developing services around a model of care. What do we mean by a model of care? Ambiguity exists in the literature, with the terms, model of care, nursing model, philosophy, paradigm, framework and theory often used interchangeably, despite referring to diverse, yet parallel concepts (Tierney 1998). In their recent review of the literature, the Queensland Government (Australia) reported that they found no consistent definition of ‘model of care’ (Queensland Health 2000). They concluded that a model of care is a multidimensional concept that defines the way in which health care services are delivered (Queensland Health 2000). More specifically, Davidson and Elliott...
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...providers. To facilitate referrals of participating patients, the team first identified the existing service pathways. The hospital medical director distributed an overview document to inform emergency department physicians of the project, and the clinical nurse specialist reviewed the referral process, protocols and documentation with nursing staff. ore than ever, health-care providers need to communicate with each other to stay informed about the services clients receive. Working in collaboration is essential to the delivery of effective, efficient and timely care (D'Amour, Ferrada-Videla, San Martin Rodriguez, & Beaulieu, 2005; Interprofessional Care Steering Committee, 2007). We all had roles on the Geriatric Emergency ManagementFalls Intervention Team (GEM-FIT) project, which was aimed at evaluating an alternative service-delivery pathway to reduce the number and consequences of falls in adults aged 65 and older who presented to an inner-city hospital emergency department. The project was based on the Falls Intervention Team (FIT) study, which had evaluated a best practice, multifactorial fall-prevention program for community-dwelling older adults (Baycrest Centre for...
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...ENVIRONMENTAL CHARACTERISTICS AND STAFF RATINGS OF NEWER AND OLDER SPECIAL CARE UNITS FOR DEMENTIA IN BRITISH COLUMBIA by Annie Murray B.A. St. Thomas University 1998 A PROJECT SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS IN THE GERONTOLOGY PROGRAM Annie Murray 2001 SIMON FRASER UNIVERSITY JUNE 2001 All rights reserved. This work may not be Reproduced in whole or in part, by photocopy Or other means, without the permission of the author. ii APPROVAL Name: Degree: Title of Project: Annie Murray Master of Arts Environmental characteristics and staff ratings of newer and older special care units for dementia in British Columbia Examining Committee: Chair: Dr. Barbara Mitchell _______________________________________________ Dr. Gloria Gutman, Senior Supervisor _______________________________________________ Dr. Kate Oakley, Supervisor _______________________________________________ Dr. Robert Horsfall, External Examiner Date Approved: _______________________________________________ iii Abstract Due to the greater availability of community resources as well as changes in admission policies, seniors are entering care facilities at an older average age and with higher levels of health needs than was the case twenty years ago. The number of dementia cases has also increased dramatically as well as Special Care Units (SCUs) to house persons with dementia. The purpose of this study was twofold. First it described the physical...
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...NIH Public Access Author Manuscript Aging Ment Health. Author manuscript; available in PMC 2008 February 19. NIH-PA Author Manuscript Published in final edited form as: Aging Ment Health. 2005 March ; 9(2): 105–118. Family Involvement in Residential Long-Term Care: A Synthesis and Critical Review* Joseph E. Gaugler The University of Kentucky Abstract The objective of this review is to critically synthesize the existing literature on family involvement in residential long-term care. Studies that examined family involvement in various long-term care venues were identified through extensive searches of the literature. Future research and practice must consider the complexity of family structure, adopt longitudinal designs, provide direct empirical links between family involvement and resident outcomes, and offer rigorous evaluation of interventions in order to refine the literature. NIH-PA Author Manuscript Keywords Family Involvement; Nursing Homes; Assisted Living Facilities; Family Care Homes; Family Caregiving; Informal Care NIH-PA Author Manuscript Over the past several decades, various research studies have demonstrated that family members remain involved in the lives of their loved ones following placement in residential long-term care facilities (e.g., Bowers, 1988; Maas et al., 2000; Rowles & High, 1996; Smith & Bengston, 1979; York & Calsyn, 1977; Zarit & Whitlatch, 1992, to name a few). These collective findings have helped debunk...
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...intervention of change aimed at the individual or the way small teams work. The micro-level change is not to be confused with a service change (Walsh, 2009). When considering a change in practice we need to firstly understand why we need to make a change? Secondly when making a change, we need to justify a decision. This can be achieved by exploring the components which encompass decision making within nursing practice. Cullum et al (2007) identifies four requirements:-Clinical experience, valid researched evidence, available resources and lastly but no less important the patient preferences and experiences. The area of clinical practice to be studied is within a community district nursing team consisting of 7 qualified nurses and 3 health care assistants. The location is situated within a seaside town with a large population of over 65 year olds. Through clinical experience, the author has found a flaw in quality of care when nursing staff are using the overview assessment document which has been adapted from the single assessment process produced by the Department of Health (DOH, 2002). When assessing nutrition there is a series of six questions and an asterisk to consider the “Malnutrition Universal Screening Tool” (MUST, 2003) however experience in practice would suggest the tool (MUST, 2003) isn't used and a local unknown screening tool is used on some rare occasions. The author feels management of these vulnerable patients is lacking and in order to improve patient care...
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...DETAILED TEST PLAN 2010 NCLEX-RN Detailed Test Plan ® Effective | April 2010 Item Writer/Item Reviewer/Nurse Educator Version Mission Statement The National Council of State Boards of Nursing, composed of member boards, provides leadership to advance regulatory excellence for public protection. Purpose and Functions The purpose of the National Council of State Boards of Nursing (NCSBN ) is to provide an organization through which boards of nursing act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing. ® The major functions of NCSBN include developing the NCLEX-RN and NCLEX-PN examinations, performing policy analysis and promoting uniformity in relationship to the regulation of nursing practice, disseminating data related to NCSBN’s purpose and serving as a forum for information exchange for NCSBN members. ® ® Copyright© 2010 National Council of State Boards of Nursing, Inc. (NCSBN) All rights reserved. NCSBN , NCLEX , NCLEX-RN and NCLEX-PN are registered trademarks of NCSBN and this document may not be used, reproduced or disseminated to any third party without written permission from NCSBN. ® ® ® ® Permission is granted to boards of nursing to use or reproduce all or parts of this document for licensure related purposes only. Nonprofit education programs have permission to use or reproduce all or parts of this document for educational...
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...Catanduanes State University Laboratory Schools Virac, Catanduanes SY 2014-2015 Drug Addiction/Drug Usage Lyri Kirsten Anicken T. Gianan Grade 9 – Platinum Mr. Eddie Cabrera February 11, 2015 Report on the Enforcement of the Prohibition Laws of the United States by the National Commission on Law Observance and Enforcement (Wickersham Commission Report on Alcohol Prohibition) I have signed the report of the Commission, although as is probably inevitable when eleven people of different antecedents and temperaments endeavor to agree upon a contentious subject, it is more or less of a compromise of varying opinions. In so far as it states facts, I believe it to be generally accurate. Every effort has been made to make it so. I should have preferred to have it state more facts and fewer broad generalizations from unstated facts. But the difficulties in securing accurate statistics, owing to the unsystematic and unscientific manner in which they are commonly kept in this country, often makes it impossible to get reliable statements of fact, although there may be sufficient available information to afford a fairly reliable basis of generalization. I am in entire accord with the conclusions "that enforcement of the National Prohibition Act made a bad start which has affected enforcement ever since"; that "it was not until after the Senatorial investigation of 1926 had opened people's eyes to the extent of law breaking and corruption that serious efforts were made" to coordinate "the...
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...Today’s Physical Therapist: A Comprehensive Review of a 21st-Century Health Care Profession Prepared by the American Physical Therapy Association January 2011 Foreword The American Physical Therapy Association (APTA) created Today’s Physical Therapist: A Comprehensive Review of a 21st-Century Health Care Profession to provide accurate information for government entities and the public about the history, role, educational preparation, laws governing practice, standards of practice, evidence base of the profession, payment for physical therapy services, and workforce issues unique to the physical therapy profession. As government, private health care entities, and provider groups pursue solutions to the considerable health care provision challenges the United States faces, it is imperative that accurate information about the qualifications and roles of specific providers, in this case physical therapists, be available to inform all entities as they engage in these discussions. APTA is the national professional association representing more than 77,000 physical therapists, physical therapist assistants, and students nationwide. The association acknowledges and thanks the Federation of State Boards of Physical Therapy, the national organization representing 51 boards of physical therapy licensure, for input and assistance with this document. © 2011 American Physical Therapy Association. All rights reserved. i | American Physical Therapy Association Table of Contents ...
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...Homeless Youth: Research, Intervention, and Policy by Karen Spuriel Coleman- MBA Abstract Homelessness among youth in the U.S. is disturbingly common, with an estimated annual prevalence of at least 5 percent for those ages 12 to 17. Although homeless youth appear throughout the nation, they are most visible in major cities. Rigorous research on this special population is sparse, making it difficult to capture an accurate and complete picture. Despite its limitations, recent research describes homeless youth as a large and diverse group. Many homeless youth have multiple overlapping problems including medical, substance abuse, and emotional and mental problems. Literature suggests that comprehensive and tailored services are needed that address both the immediate and long-term needs of homeless youth. Where appropriate, services should include assistance with meeting basic needs as perceived by youth as a gateway to other needed services. In addition to serving those already homeless, interventions are needed to prevent homelessness among at-risk youth. Lessons for Practitioners, Policy Makers, and Researchers • As used here, the term “homeless youth” focuses on minors who have experienced literal homelessness on their own—i.e., who have spent at least one night either in a shelter or "on the streets" without adult supervision. On occasion, where warranted by the research being discussed, the term is also used to describe homeless young adults up to age 24. • Homelessness...
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...PN MENTAL HEALTH NURSING EDITION . CO NT ASTERY SERI ES TM N E R EV MOD IE W LE U PN Mental Health Nursing Review Module Edition 9.0 CONtriButOrs Sheryl Sommer, PhD, RN, CNE VP Nursing Education & Strategy Janean Johnson, MSN, RN Nursing Education Strategist Sherry L. Roper, PhD, RN Nursing Education Strategist Karin Roberts, PhD, MSN, RN, CNE Nursing Education Coordinator Mendy G. McMichael, DNP, RN Nursing Education Specialist and Content Project Coordinator Marsha S. Barlow, MSN, RN Nursing Education Specialist Norma Jean Henry, MSN/Ed, RN Nursing Education Specialist eDitOrial aND PuBlisHiNg Derek Prater Spring Lenox Michelle Renner Mandy Tallmadge Kelly Von Lunen CONsultaNts Deb Johnson-Schuh, RN, MSN, CNE Loraine White, RN, BSN, MA PN MeNtal HealtH NursiNg i PN MeNtal HealtH NursiNg review Module editioN 9.0 intellectual Property Notice ATI Nursing is a division of Assessment Technologies Institute®, LLC Copyright © 2014 Assessment Technologies Institute, LLC. All rights reserved. The reproduction of this work in any electronic, mechanical or other means, now known or hereafter invented, is forbidden without the written permission of Assessment Technologies Institute, LLC. All of the content in this publication, including, for example, the cover, all of the page headers, images, illustrations, graphics, and text, are subject to trademark, service mark, trade dress, copyright, and/or other intellectual property rights or licenses...
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...Chronic Critical Illness Judith E. Nelson1, Christopher E. Cox2, Aluko A. Hope1,3 and Shannon S. Carson4 + Author Affiliations 1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, and Hertzberg Palliative Care Institute, Mount Sinai School of Medicine, New York, New York; 2Division of Pulmonary and Critical Care Medicine, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; 3Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, New York; 4Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of North Carolina, Chapel Hill, School of Medicine, Chapel Hill, North Carolina Correspondence and requests for reprints should be addressed to Judith E. Nelson, M.D., J.D., Box 1232, Mount Sinai School of Medicine, 1 Gustave Levy Place, New York, NY 10029. E-mail: Judith.nelson@mssm.edu Next SectionAbstract Although advances in intensive care have enabled more patients to survive an acute critical illness, they also have created a large and growing population of chronically critically ill patients with prolonged dependence on mechanical ventilation and other intensive care therapies. Chronic critical illness is a devastating condition: mortality exceeds that for most malignancies, and functional dependence persists for most survivors. Costs of treating the chronically critically ill in the United States already exceed $20 billion and are increasing. In...
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...SELECTING AND USING ASSESSMENTS Introduction This chapter will address three issues: (a) the institutional assessment needs of workforce development organizations, (b) the assessment needs of individual youth to help make informed choices about their careers, and (c) the practical needs of practitioners for information about how to select and use different assessment tools. At the end of this chapter, Exhibit 3.1 contains information that can be used to help with the selection and use of assessments, including a directory of commonly used published tests. Meeting Institutional Assessment Needs Agencies and organizations in the workforce system use assessments to meet institutional needs in two ways-to determine a youth's eligibility for services and to document achievement of program goals by assessing the progress of program participants. The number of participants served and achievement of program goals can impact the amount of funding an organization receives. Funding for the youth programs considered in this guide may come from the Department of Education, the Department of Labor, other federal agencies, states, local governmental agencies, or a combination of these. Table 1.2 in Chapter 1 summarizes the eligibility and assessment requirements of IDEA, WIA Title I, and the Rehabilitation Act. More specific information on assessments mandated or permitted by several federal funding sources may be found in Appendix A. (Mandated assessments are those required...
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...Effectiveness Outcomes) 41 7.6: Best 5 Bs (Leadership Outcomes) 45 GLOSSARY OF TERMS AND ABBREVIATIONS APP: Annual Planning Process 5Bs: AtlantiCare’s five “Bests” or performance excellence commitments – Best People and Workplace, Best Quality, Best Customer Service, Best Financial Performance, Best Growth ARMC : AtlantiCare Regional Medical Center ASC: Ambulatory Surgery Center ASPP: Annual Strategic Planning Process A AAAHC: Accreditation Association for Ambulatory Health Care AAI: AtlantiCare Administrators Incorporated AAP: Annual Action Plan B BFP: Best Financial Performance Big Dots: The system-level measurements or targets for each of the 5 Bs (performance excellence commitments). Business units (and their departments) have measurable action plans and goals that align with/support the Big Dots. ABCs: AtlantiCare’s Best Customer Service Standards– AtlantiCare’s customer service training program. BMI: Body Mass Index ABH: AtlantiCare Behavioral Health BOT: Board of Trustees ACS: American College of Surgeons BP: Blood Pressure ACR: American College of Radiology...
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...CR I SI S 2 011 Background Prescription drug abuse is the Nation’s fastest-growing drug problem. While there has been a marked decrease in the use of some illegal drugs like cocaine, data from the National Survey on Drug Use and Health (NSDUH) show that nearly one-third of people aged 12 and over who used drugs for the first time in 2009 began by using a prescription drug non-medically.1 The same survey found that over 70 percent of people who abused prescription pain relievers got them from friends or relatives, while approximately 5 percent got them from a drug dealer or from the Internet.2 Additionally, the latest Monitoring the Future study—the Nation’s largest survey of drug use among young people—showed that prescription drugs are the second most-abused category of drugs after marijuana.3 In our military, illicit drug use increased from 5 percent to 12 percent among active duty service members over a three-year period from 2005 to 2008, primarily attributed to prescription drug abuse.4 Although a number of classes of prescription drugs are currently being abused, this action plan primarily focuses on the growing and often deadly problem of prescription opioid abuse. The number of prescrip tions filled for opioid pain relievers—some of the most powerful medications available—has increased dramatically in recent years. From 1997 to 2007, the milligram per person use of prescription opioids in the U.S. increased from 74 milligrams to 369 milligrams, an increase...
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