The discussion of patient preferences (advance directives) for their health care in an important component of their care across all health care settings. The extent of documentation of this discussion may vary in the Electronic Medical Record (EMR...
Falls are a major quality, safety, reimbursement and regulatory concern for older nursing home (NH) residents. At least 50% of NH residents will experience a fall, of which 5-10% will require emergency department or hospital transfer. These risks...
Rapid growth of assisted living (AL) facilities has occurred as an alternative to nursing homes. Yet it is recognized that the care needs of these residents are higher than the AL was initially conceptualized. The determination of the baseline...
Hydration has been described among SNF residents, hospitalized, and community living older adults yet a description of the hydration levels of Assisted Living Memory Care (ALMC) residents is lacking. An understanding of the hydration levels of ALMC...
The Medical Director of a 165 bed Skilled Nursing Facility was faced with an outbreak of Clostridium difficile infection (CDI). SNF residence and antibiotic use are established risk factors for CDI. The estimated risk of CDI increases 2% for every...
There is evidence that residents are vulnerable to harmful medication errors during transitions from hospital to long-term-care (LTC). Common lapses in communication, documentation and transcription have led to poor coordination of care. Focused on...
Infections including CAUTI are a leading cause of illness and death in Long-Term Care Facilities (LTCFs). Although the prevalence of indwelling urinary catheter use in LTCFs is lower than in acute care settings, CAUTI can lead to complications such...
Many skilled nursing facility (SNF) residents require International Normalized Ratio (INR) monitoring. Nurses often report INRs after-hours, congesting phone lines with non-urgent calls, preventing urgent calls from being addressed expediently. This...
Many barriers to optimal palliative care in long term care (LTC) homes have been identified, including a lack of knowledge, workload demands, and a failure to identify impending death and implement a timely end-of-life care plan. Unfortunately,...
Atrial fibrillation (AF) is the most common pathologic arrhythmia, affecting 6% of the population above the age of 65. Anticoagulation therapy is recommended as first line for AF. Optimal management of anticoagulation therapy in long term care (LTC...
