Publications

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Reporting and Reducing Clostridioides Difficile in Nursing Homes

JAMDA
March 1, 2020
Clostridioides difficile (C. difficile) definition: “a germ (bacteria) that causes life-threatening diarrhea. It is usually a side-effect of taking antibiotics.” According to the Centers for Disease Control and Prevention (CDC) 2015 report, over 100...

Reducing End-of-Life Hospitalizations in Long-Term Care: A Team-Based Approach

JAMDA
March 1, 2020
An increasing number of older adults are spending their end of life in the nursing home, and many are being hospitalized in the last few months of life. This is often unwanted by patients and their families. We hypothesize that identifying patients...

Preventing Loss of Independence Through Exercise (PLIÉ): A Novel Program to Improve Care of Older Veterans in Long-Term Care

JAMDA
March 1, 2020
At San Francisco Veterans Affairs Health Care System (SFVA) Community Living Center (CLC), most veterans have dementia plus co-occurring mental illness. Many demonstrate distressed behavior that interferes with care. CLC restorative care and mental...

Post Fall Process Improvement-An Interdisciplinary Huddle Process

JAMDA
March 1, 2020
The Sunflower Memory Center Long-Term Care Community Living Center had seen an increase in falls. We recognized that our post-fall process was not optimally implemented or utilized, and the decision was made to explore this element to reduce our...

Post Acute Readmissions? Not with your Nurse Practitioner in Charge!

JAMDA
March 1, 2020
Deaconess Health System developed a post-acute embedded Nurse Practitioner (NP) program in partnered skilled nursing facilities (SNF) to improve patient transitions and coordination of care. This model has improved patient care, lowered 30-day...

Pneumococcal Immunization Standing Order Protocol: A DNP Project

JAMDA
March 1, 2020
Background Streptococcus pneumonia is a significant cause of morbidity and mortality in adults who are immunocompromised and of advanced age. It is the standard of care to vaccinate all high-risk adults (18-64 years) and adults 65 years and older...

One Size Doesn’t Fit All: A Quality Improvement Initiative to Reduce Hypoglycemia in Diabetics in an Acute Rehabilitation Center

JAMDA
March 1, 2020
Management of diabetes in post-acute settings needs special considerations. Hypoglycemia in the skilled nursing and rehabilitation facilities can lead to readmissions and complications including falls. Current EHR care-sets may not make a...

Leading The Patient Safety Charge-Keeping Our Patients Wound-Free

JAMDA
March 1, 2020
Levindale Hebrew Geriatric Center and Specialty Hospital brings together a Long-Term care facility as well as an acute care specialty hospital. Acute care hospital (120 beds). Long Term Care (210 beds). High Risk Patient Population. Chronic Wounds...

Improving Recognition of Abnormal Vital Signs: A Key Area of Intervention for Earlier Sepsis Diagnosis and Management

JAMDA
March 1, 2020
Sepsis is one of the leading causes of hospital admissions of skilled nursing facility residents and is associated with poor outcomes. Prompt recognition and timely treatment is essential. A key component of early sepsis recognition is the nursing...

Improving Heart Failure Management in Post-Acute and Long-Term Care: A Pilot Study

JAMDA
March 1, 2020
Heart failure (HF) is a leading cause of mortality and hospital readmissions in the United States. A large proportion of these patients are readmitted from skilled nursing facilities (SNF). The implementation of quality initiatives, such as staff...