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WORKER INJURIES IN NURSING HOMES: IS SAFE PATIENT HANDLING LEGISLATION THE SOLUTION?
K.L. Lapane, C.E. Dubé, B.M. Jesdale
Jour Nursing Home Res 2016;2:110-117Show summaryHide summary
In 2012, nursing homes were considered the most dangerous workplaces in the United States. While other industries have guidelines that limit manual lifting of stable objects to ≤50 pounds, the same is not so in the nursing home industry where residents requiring physical assistance may weigh over 250 pounds and where the prevalence of obesity among residents is increasing. Safe patient handling legislation in nursing homes has been enacted in nine of the United States since 2005 (Hawaii, Illinois, Maryland, Minnesota, New Jersey, New York, Ohio, Rhode Island, and Texas). This paper reviews the problem of worker injuries in nursing homes, describes the legislation passed to address the problem, and reviews the data available on the effectiveness of the legislation. No national studies evaluating the effectiveness of safe patient handling state policies on nursing home injuries exists, although the National Institute on Occupational Safety and Health has recently funded a national evaluation.
K.L. Lapane ; C.E. Dubé ; B.M. Jesdale (2016): WORKER INJURIES IN NURSING HOMES: IS SAFE PATIENT HANDLING LEGISLATION THE SOLUTION?. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2016.17
WHAT IS THE “RIGHT” NUMBER OF NURSING HOME BEDS FOR POPULATION NEEDS? AN INDICATOR DEVELOPMENT PROJECT
D.M. Wilson, R.R. Brow, R. Playfair
Jour Nursing Home Res 2017;3:16-21Show summaryHide summary
The need for nursing homes is increasing rapidly now with accelerating population aging and other socio-demographic developments. No indicators currently exist to specify the number of nursing home beds that should be available to meet population requirements. To meet this gap, descriptive-comparative information was gathered on the number of nursing home beds that exist in 10 Canadian provinces and 15 high-income countries and other relevant information. Major differences were found in bed numbers relative to population age structures, with a set of three median indicators (109.4, 17.5, and 4.5) developed to identify the mid-range number of citizens of all ages per nursing home bed, citizens aged 65+ per nursing home bed, and citizens aged 80+ per nursing home bed. Indicators such as these enable comparisons of actual to optimal. The devised set of three indicators should raise nursing attention to nursing home bed accessibility, and further policy and planning for the nursing home expansion required with population aging.
D.M. Wilson ; R.R. Brow ; R. Playfair ; (2017): What is the “Right” Number of Nursing Home Beds for Population Needs? An Indicator Development Project. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2017.3
TASTE OF TEN DRUGS FREQUENTLY PRESCRIBED IN NURSING HOMES CRUSHED AND MIXED IN FOOD: OBSERVATIONAL STUDY IN 16 HEALTHY VOLUNTEERS
J. Lamure, P. Brocker, S.M. Schneider, R. Collomp, F. Bertin-Hugault, P. Denormandie, I. Prêcheur
Jour Nursing Home Res 2015;1:55-61Show summaryHide summary
Background & Aims: Many frail elderly patients are polymedicated. Whether they suffer from dysphagia (due to stroke, Parkinson’s disease, etc.) or cognitive troubles (due to Alzheimer’s disease, etc.), they are often given blended food, with drugs crushed and mixed into the food. Health Authorities recommend to crush and to administrate crushed drugs separately, for pharmacologic reasons, but the drugs are usually mixed together to facilitate ease of case by nursing staff. Crushed drugs can have a bad taste, leading to drug / food refusal, worsening malnutrition, but this qualitative aspect has been scarcely studied in geriatric populations. The present study aimed to evaluate the taste of the ten drugs most frequently prescribed in nursing homes, in order to determine which drugs are acceptable or not when crushed and mixed into food. Methods: This one-step observational study was designed like a food or wine tasting. A jury of healthy volunteers was recruited among medical staff (8 volunteers) and other people involved in food and gastronomy (8 volunteers, including a starred Chef). Every tablet or capsule was mixed into 100 mL of berry-flavored jelly or apple sauce. It was a blind tasting of 24 verrines, containing the ten drugs randomly distributed, a control without drug and a combination of the 6 top-list drugs. Twelve jelly verrines were followed by 12 apple sauce verrines. Tasters spat the spoonful content out after they had assessed its taste. Each verrine was scored from 0 (bad taste) to 10 (good). Qualitative and free comments were also recorded. Results: The lowest scores were attributed to the combination of paracetamol, alprazolam, furosemide, levothyroxine sodium, memantine and zopiclone (1.5 + 1.6; 0 to 5), followed by zopiclone (1.9 + 2.3; 0 to 8), clopidogrel (4.3 + 2.1; 1 to 7) and paracetamol (4.6 + 1.8; 1 to 8). All these drugs had a long-lasting bitterness. Zopiclone mixed and alone was qualified as unbearable and one participant exhibited nausea by taking it. Five participants did not take lunch after the study for lack of hunger (5/16: 31.3 %). Drug-free jelly and apple sauce were scored 6.7 + 1.4 (4 to 9) and 7.1 + 1.1 (5-9.5), respectively. Other scores ranged from 6.1 to 7.9, for alprazolam, ramipril, oxazepam, levothyroxine sodium, donezepil and furosemide. Conclusions: The taste of some drugs may be unbearable when they are crushed and mixed into food, and caregivers should avoid mixing a bad-tasting drug with the other drugs. There are wide differences of taste acceptability from one person to another. Thus, during workshops, every patient could taste once separately any single drug in his prescription list. If a bad taste leads to drug refusal, caregivers should inform physicians and pharmacists, who in turn should seek alternative medical solutions (drug discontinuation or substitution). Caregivers could also seek alternative food or administration conditions. On a mid-term basis, pharmaceutical companies should also develop specific pharmaceutical forms, as they do for children.
J. Lamure ; P. Brocker ; S.M. Schneider ; R. Collomp ; F. Bertin-Hugault ; P. Denormandie ; I. Prêcheur (2015): TASTE OF TEN DRUGS FREQUENTLY PRESCRIBED IN NURSING HOMES CRUSHED AND MIXED IN FOOD: OBSERVATIONAL STUDY IN 16 HEALTHY VOLUNTEERS. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2015.12
RECOMMENDATIONS ON PHYSICAL ACTIVITY AND EXERCISE FOR OLDER ADULTS LIVING IN LONG-TERM CARE FACILITIES: A TASKFORCE REPORT
P. de Souto Barreto, J.E. Morley, W. Chodzko-Zajko, K.H. Pitkala, E. Weening-Djiksterhuis, L. Rodriguez-Mañas, M. Barbagallo, E. Rosendahl, A. Sinclair, F. Landi, M. Izquierdo, B. Vellas, Y. Rolland, under the auspices of The International Association of Gerontology and Geriatrics – Global Aging Re
Jour Nursing Home Res 2016;2:7-20Show summaryHide summary
A taskforce, under the auspices of The International Association of Gerontology and Geriatrics – Global Aging Research Network (IAGG-GARN) and the IAGG European Region Clinical Section, composed of experts from the fields of exercise science and geriatrics met in Toulouse, in December 2015, with the aim of establishing recommendations of physical activity and exercise for older adults living in long-term care facilities (LTCF). Due to the high heterogeneity in terms of functional ability and cognitive function that characterizes older adults living in LTCFs, taskforce members established two sets of recommendations: recommendations for reducing sedentary behaviors for all LTCF residents and recommendations for defining specific, evidence-based guidelines for exercise training for subgroups of LTCF residents. In order to promote a successful implementation of recommendations, taskforce experts highlighted the importance of promoting residents’ motivation and pleasure, the key factors that can be increased when taking into account residents’ desires, preferences, beliefs and attitudes toward physical activity and exercise. The importance of organizational factors related to LTCFs and healthcare systems were recognized by the experts. In conclusion, this taskforce report proposes standards for the elaboration of strategies to increase physical activity as well as to prescribe exercise programs for older adults living in LTCFs. This report should be used as a guide for professionals working in LTCFs settings.
P. de Souto Barreto ; J.E. Morley ; W. Chodzko-Zajko ; K.H. Pitkala ; E. Weening-Djiksterhuis ; L. Rodriguez-Mañas ; M. Barbagallo ; E. Rosendahl ; A. Sinclair ; F. Landi ; M. Izquierdo ; B. Vellas ; Y. Rolland ; under the auspices of The International Association of Gerontology and Geriatrics – Global Aging Research Network (IAGG-GARN) and the IAGG European Region Clinical Section (2016): Recommendations on physical activity and exercise for older adults living in long-term care facilities: a taskforce report. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2016.2
PREVALENCE OF RISK OF MALNUTRITION AND ASSOCIATED FACTORS IN HOME CARE CLIENTS
T. Kaipainen, M. Tiihonen, S. Hartikainen, I. Nykänen
Jour Nursing Home Res 2015;1:47-51Show summaryHide summary
Objectives: To describe nutritional status and to detect factors associated with it in home care clients aged 75 years or older. Design: A cross-sectional study with a population-based sample. Setting: Home care.Participants: The study included 267 home care clients in three cities in Finland. Measurements: The outcomes were nutritional status (Mini Nutritional Assessment, MNA), body mass index (BMI), functional ability (Barthel Index, Instrumental Activities of Daily Living, IADL), cognitive function (Mini Mental State Examination, MMSE), depression (Geriatric Depression Scale, GDS-15), comorbidity (Functional Comorbidity Index, FCI), Vitamin D and drug use and levels of blood albumin and haemoglobin. Chewing problems and dry mouth were assessed by using a structured interview. Results: According to the MNA, a majority (86%, n = 229) of all home care clients were at risk of malnutrition or were malnourished. Persons at risk of malnutrition or who were malnourished used more drugs and had a higher depressive score and lower Barthel Index, IADL and MMSE scores than well-nourished participants. Multivariate analysis showed that excessive polypharmacy (OR 3.63, 95% CI:1.51–8.74), a lower MMSE score (OR 1.29, 95% CI:1.12–1.48) and a higher GDS-15 score (OR 1.32, 95% CI:1.07–1.63) appeared to be independently connected to malnutrition or a risk of malnutrition. Conclusions: Malnutrition or a risk of malnutrition is a common problem among home care clients. Excessive polypharmacy, cognitive impairment and depressive symptoms increase malnutrition or the risk of malnutrition. To prevent a further decline in their health status, home care clients should be screened for malnutrition and the risk of malnutrition.
T. Kaipainen ; M. Tiihonen ; S. Hartikainen ; I. Nykänen (2015): PREVALENCE OF RISK OF MALNUTRITION AND ASSOCIATED FACTORS IN HOME CARE CLIENTS. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2015.9