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Franziska Z, Ramona T, Hansruedi S, Monique SS, Franziska V, Kornelia K. Advanced practice nurses' daily practices delivering primary care to residents in long-term care facilities: a qualitative study. BMC PRIMARY CARE 2024; 25:203. [PMID: 38851705 PMCID: PMC11161973 DOI: 10.1186/s12875-024-02455-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/30/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Globally, there is a growing shortage of primary care professionals, including those who serve residents in long-term care facilities (LTCFs). In recent decades, numerous new care models have been implemented to improve these residents' care. Many incorporate Advanced Practice Nurses (APNs) into interprofessional healthcare teams. In Switzerland, little is known about how these models function, and few facilities have integrated APNs. This study aims to explore the everyday practice of APNs employed at a medical centre in the Bernese Seeland region delivering care to LTC residents and collaborating with LTCFs staff. METHODS This qualitative study uses the "Interpretive Description" methodology, which builds on existing knowledge and examines phenomena interpreted through a social constructivist approach. We conducted six semi-structured individual interviews, one semi-structured focus group interview, and an examination of secondary data. Our thematic analysis followed Braun and Clarke's guidelines for data analysis. RESULTS In LTCFs, APNs perform tasks similar to those of primary care physicians, e.g., patient visits and therapy adjustments, within the limits set by their supervising physicians. In addition, they contribute significantly to facility-wide quality improvement. We identified three fundamental elements for successful collaboration between APNs and LTCF staff: 1) clarifying roles and responsibilities; 2) establishing well-defined communication methods and pathways; and 3) building and maintaining trust. Together with LTCF staff, APNs provide multidimensional, person-centred care that focuses on medical, social, and nursing issues with the goal of maintaining the residents' best possible quality of life. CONCLUSIONS Our results suggest that integrating APNs into the LTCF care system improves care quality for residents and increases staff members' job satisfaction.
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Affiliation(s)
- Zúñiga Franziska
- Department of Public Health, Institute of Nursing Science, University of Basel, Bernoullistrasse 28, Basel, 4056, Switzerland.
| | | | | | | | | | - Kotkowski Kornelia
- Department of Public Health, Institute of Nursing Science, University of Basel, Bernoullistrasse 28, Basel, 4056, Switzerland
- Kantonalspital Aarau, Aarau, Switzerland
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Parent Perspectives of Receiving Early Information About Palliative and End-of-Life Care Options From Their Child's Pediatric Providers. Cancer Nurs 2020; 42:E22-E30. [PMID: 29620556 DOI: 10.1097/ncc.0000000000000589] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Parents of children diagnosed with cancer may experience decision regret about cancer treatment decisions and dissatisfaction with the perceived clarity in information received from their child's providers. OBJECTIVE The aim of this study was to describe parental perspectives about receiving an early palliative care and end-of-life (PC/EOL) communication intervention titled "Communication Plan: Early through End of Life Intervention" (COMPLETE) from an interprofessional team of physician and registered nurse providers. METHODS Ten parents participated in semistructured interviews after receiving the COMPLETE intervention. The COMPLETE intervention included 3 sessions delivered shortly after diagnosis and at the next 2 cancer treatment evaluations. Sessions of COMPLETE focused on early PC/EOL care discussions at diagnosis and after tumor response evaluations with their child's providers. RESULTS Results included 2 theme categories: (1) COMPLETE nurtures realistic hope and meaningful dialogue by parents connecting with healthcare providers as a dyad, and (2) benefits of COMPLETE helped parents to make informed decisions. In addition, there were offered suggestions to improve COMPLETE. CONCLUSION The COMPLETE intervention provided a unique mechanism to foster early discussions about PC/EOL options between parents and an interprofessional team during the first 6 months of the child's cancer treatment. Future study is needed using a randomized clinical control-group design to evaluate COMPLETE with a large sample of parents. IMPLICATIONS FOR PRACTICE Findings provide promising evidence of parents' preference and receptivity to receive early information about PC/EOL care options for a child with a brain tumor with a poor prognosis. The COMPLETE intervention provided a mechanism to help encourage parental consideration of realistic hoped-for goals for their child's condition and care.
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Dassel KB, Flattes V, Eaton J, Towsley G, Moyers L, Edelman L. Development of a Gerontology Graduate Certificate in Post-Acute and Long-Term Care. J Gerontol Nurs 2019; 45:47-52. [PMID: 31560076 DOI: 10.3928/00989134-20190825-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 07/23/2019] [Indexed: 11/20/2022]
Abstract
Nurse practitioners (NPs) can provide safe, effective, quality care to older adults in post-acute and long-term care (PALTC) settings. However, there is a paucity of exposure to PALTC settings in most NP educational programs. Therefore, the current authors developed an elective graduate certificate in gerontology with an emphasis in PALTC for NP students. The graduate certificate curriculum was developed by faculty with expertise in nursing and gerontology education. The PALTC certificate comprises 15 credit hours of online didactic courses, 80 leadership hours, 200 clinical hours, and a scholarly project dedicated to PALTC. Completion of a graduate certificate in PALTC is a novel model for preparing NP students for practice in PALTC settings. The current article serves as a framework for other programs to reference as they develop individualized graduate certificate PALTC programs in their academic institutions. [Journal of Gerontological Nursing, 45(10), 47-52.].
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Tsai HH, Tsai YF. Development, validation and testing of a nursing home to emergency room transfer checklist. J Clin Nurs 2017; 27:115-122. [PMID: 28401615 DOI: 10.1111/jocn.13853] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2017] [Indexed: 12/23/2022]
Abstract
AIMS AND OBJECTIVES To develop and test the feasibility of an instrument to support patients' nursing home to emergency room transfer. BACKGROUND Transfers from a nursing home care facility to an acute care facility such as a hospital emergency room are common. However, the prevalence of an information gap for transferring residents' health data to acute care facility is high. An evidence-based transfer instrument, which could fill this gap, is lacking. DESIGN Development of a nursing home to emergency room transfer checklist, validation of items using the Delphi method and testing the feasibility and benefits of using the nursing home to emergency room transfer checklist. METHODS Items were developed based on qualitative data from previous research. Delphi validation, retrospective chart review (baseline data) and a 6-month prospective study design were applied to test the feasibility of using the checklist. Variables for testing the feasibility of the checklist included residents' 30-day readmission rate and length of hospital stay. RESULTS Development of the nursing home to emergency room transfer checklist resulted in four main parts: (i) demographic data of the nursing home resident; (ii) critical data for nursing home to emergency room transfer; (iii) contact information and (iv) critical data for emergency room to nursing home transfer. Two rounds of Delphi validation resulted in a mean score (standard deviation) ranging from 4.39 (1.13)-4.98 (.15). Time required to complete the checklist was 3-5 min. Use of the nursing home to emergency room transfer checklist resulted in a 30-day readmission rate of 13.4%, which was lower than the baseline rate of 15.9%. CONCLUSIONS The nursing home to emergency room transfer checklist was developed for transferring nursing home residents to an emergency room. The instrument was found to be an effective tool for this process. RELEVANCE TO CLINICAL PRACTICE Use of the nursing home to emergency room transfer checklist for nursing home transfers could fill the information gap that exists when transferring older adults between facilities such as nursing homes and hospitals.
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Affiliation(s)
- Hsiu-Hsin Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Tao-Yuan, Taiwan
| | - Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
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Sato N, Akazawa K, Mitadera Y, Suzuki T, Ibe N, Hirose Y. Clarifying Problems with Emergency Healthcare Systems in Japanese Long-Term Care Facilities for Older People. Health (London) 2017. [DOI: 10.4236/health.2017.98084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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6
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Morley JE. The Future of Long-Term Care. J Am Med Dir Assoc 2017; 18:1-7. [DOI: 10.1016/j.jamda.2016.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/01/2016] [Indexed: 02/07/2023]
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7
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Fougère B, Morley JE, Decavel F, Nourhashémi F, Abele P, Resnick B, Rantz M, Lai CKY, Moyle W, Pédra M, Chicoulaa B, Escourrou E, Oustric S, Vellas B. RETRACTED: Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care. J Am Med Dir Assoc 2016; 17:782-8. [PMID: 27321868 DOI: 10.1016/j.jamda.2016.05.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 11/22/2022]
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the Editors-in-Chief. The authors have plagiarized part of a report that had already appeared in Delamaire M-L, Lafortune G. Nurses in Advanced Roles: A Description and Evaluation of Experiences in 12 Developed Countries. OECD Health Working Papers No. 54. Paris: Organisation for Economic Co-operation and Development, 2010. One of the conditions of submission of a paper for publication is that authors declare explicitly that their work is original and has not appeared in a publication elsewhere. Re-use of any data should be appropriately cited. As such this article represents a severe abuse of the scientific publishing system. The scientific community takes a very strong view on this matter and apologies are offered to readers of the journal that this was not detected during the submission process.
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Affiliation(s)
- Bertrand Fougère
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France.
| | - John E Morley
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St Louis, MO
| | - Frédérique Decavel
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Fati Nourhashémi
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France
| | - Patricia Abele
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St Louis, MO
| | | | - Marilyn Rantz
- Sinclair School of Nursing and Family and Community Medicine, University of Missouri, Columbia, MO
| | - Claudia Kam Yuk Lai
- School of Nursing, The Hong Kong Polytechnic University, Special Administrative Region of the People's Republic of China
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Maryse Pédra
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Bruno Chicoulaa
- Département Universitaire de Médecine Générale, Université de Toulouse III Paul Sabatier, France
| | - Emile Escourrou
- Département Universitaire de Médecine Générale, Université de Toulouse III Paul Sabatier, France
| | - Stéphane Oustric
- Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France; Département Universitaire de Médecine Générale, Université de Toulouse III Paul Sabatier, France
| | - Bruno Vellas
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Inserm UMR1027, Université de Toulouse III Paul Sabatier, Toulouse, France
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Zheng RM, Sim YF, Koh GCH. Attitudes towards interprofessional collaboration among primary care physicians and nurses in Singapore. J Interprof Care 2016; 30:505-11. [PMID: 27269233 DOI: 10.3109/13561820.2016.1160039] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Interprofessional collaboration (IPC) has been shown to improve patient outcomes, cost efficiency, and health professional satisfaction, and enhance healthy workplaces. We determined the attitudes of primary care physicians and nurses towards IPC and factors facilitating IPC using a cross-sectional study design in Singapore. A self-administered anonymous questionnaire, based on the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC), was distributed to primary healthcare physicians and nurses working in National Healthcare Group Polyclinics (N = 455). We found that the mean JSAPNC score for physicians was poorer than that for nurses (50.39 [SD = 4.67] vs. 51.61 [SD = 4.19], respectively, mean difference, MD = 1.22, CI = 0.35-2.09, p = .006). Nurses with advanced education had better mean JSAPNC score than nurses with basic education (52.28 [SD = 4.22] vs. 51.12 [SD = 4.11], respectively, MD = 1.16, CI = 0.12-2.20, p = .029). Male participants had poorer mean JSAPNC score compared to females (50.27 [SD = 5.02] vs. 51.38 [SD = 4.22], respectively MD = 1.11, CI = 0.07-2.14, p = .036). With regression analysis, only educational qualification among nurses was independently and positively associated with JSAPNC scores (p = .018). In conclusion, primary care nurses in Singapore had more positive attitudes towards IPC than physicians. Among nurses, those with advanced education had more positive attitudes than those with basic education. Greater emphasis on IPC education in training of physicians and nurses could help improve attitudes further.
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Affiliation(s)
- Ruth Mingli Zheng
- a Bukit Batok Polyclinic, National Healthcare Group Polyclinics , Singapore
| | - Yu Fan Sim
- a Bukit Batok Polyclinic, National Healthcare Group Polyclinics , Singapore
| | - Gerald Choon-Huat Koh
- b Saw Swee Hock School of Public Health , National University of Singapore , Singapore
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9
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Abele P, Morley JE. Advance Directives: The Key to a Good Death? J Am Med Dir Assoc 2016; 17:279-83. [PMID: 26952570 DOI: 10.1016/j.jamda.2016.01.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 01/29/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Patricia Abele
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St Louis, MO
| | - John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St Louis, MO; Division of Endocrinology, Saint Louis University School of Medicine, St Louis, MO.
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10
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Shum CK, Ip MW, Chan YW, Yiu D, Pang WS, Kwok WY, Lam YM, Chan NH, Kwan YK, Mok CK. A Quality Improvement Project to Improve and Reduce the Use of Hand Mitt Restraints in Nursing Home Residents. J Am Med Dir Assoc 2016; 17:272-3. [DOI: 10.1016/j.jamda.2015.12.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Accepted: 12/07/2015] [Indexed: 01/14/2023]
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Morley JE. Opening Pandora's Box: The Reasons Why Reducing Nursing Home Transfers to Hospital are so Difficult. J Am Med Dir Assoc 2016; 17:185-7. [DOI: 10.1016/j.jamda.2015.12.098] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 12/31/2015] [Indexed: 11/25/2022]
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12
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Tsai HH, Tsai YF, Huang HL. Nursing home nurses’ experiences of resident transfers to the emergency department: no empathy for our work environment difficulties. J Clin Nurs 2016; 25:610-8. [DOI: 10.1111/jocn.13084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2015] [Indexed: 01/15/2023]
Affiliation(s)
- Hsiu-Hsin Tsai
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Yun-Fang Tsai
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
- Department of Nursing; Chang Gung Memorial Hospital at Keelung; Keelung Taiwan
| | - Hsiu-Li Huang
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
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Intrator O, Miller EA, Gadbois E, Acquah JK, Makineni R, Tyler D. Trends in Nurse Practitioner and Physician Assistant Practice in Nursing Homes, 2000-2010. Health Serv Res 2015; 50:1772-86. [PMID: 26564816 DOI: 10.1111/1475-6773.12410] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine nurse practitioner (NP) and physician assistant (PA) practice in nursing homes (NHs) during 2000-2010. DATA SOURCES Data were derived from the Online Survey Certification and Reporting system and Medicare Part B claims (20 percent sample). METHODS NP/PA state average employment, visit per bed year (VPBY), and providers per NH were examined. State fixed-effect models examined the association between state regulations and NP/PA use. PRINCIPAL FINDINGS NHs using any NPs/PAs increased from 20.4 to 35.0 percent during 2000-2010. Average NP/PA VPBY increased from 1.0/0.3 to 3.0/0.6 during 2000-2010. Average number of NPs/PAs per NH increased from 0.2/0.09 to 0.5/0.14 during 2000-2010. The impact of state scope-of-practice regulations was mixed. CONCLUSIONS NP and PA scope-of-practice regulations impact their practice in NHs, not always as intended.
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Affiliation(s)
- Orna Intrator
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY.,Canandaigua VA Medical Center, Canandaigua, NY.,Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI
| | - Edward Alan Miller
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI.,Department of Gerontology and Gerontology Institute, John W. McCormack Graduate School of Policy & Global Studies, University of Massachusetts Boston, Boston, MA.,Center for Gerontology & Health Care Research, Brown University School of Public Health, Providence, RI
| | - Emily Gadbois
- Center for Gerontology & Health Care Research, Brown University School of Public Health, Providence, RI.,Department of Gerontology, John W. McCormack Graduate School of Policy & Global Studies, University of Massachusetts Boston, Boston, MA
| | | | - Rajesh Makineni
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI.,Center for Gerontology & Health Care Research, Brown University School of Public Health, Providence, RI.,ProvidenceVA Medical Center, Providence, RI
| | - Denise Tyler
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI.,Center for Gerontology & Health Care Research, Brown University School of Public Health, Providence, RI.,ProvidenceVA Medical Center, Providence, RI
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Abdallah LM, Van Etten D, Lee AJ, Melillo KD, Remington R, Gautam R, Gore RJ. A Medicare Current Beneficiary Survey–Based Investigation of Alternative Primary Care Models in Nursing Homes: Functional Ability and Health Status Outcomes. Res Gerontol Nurs 2015; 8:85-93. [DOI: 10.3928/19404921-20150121-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 10/21/2014] [Indexed: 11/20/2022]
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16
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Morley JE. Adverse events in post-acute care: the Office of the Inspector General's report. J Am Med Dir Assoc 2014; 15:305-6. [PMID: 24726233 DOI: 10.1016/j.jamda.2014.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 03/07/2014] [Indexed: 11/26/2022]
Affiliation(s)
- John E Morley
- Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, St. Louis, MO.
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17
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Intrator O, Lima J, Wetle TF. Nursing home control of physician resources. J Am Med Dir Assoc 2014; 15:273-80. [PMID: 24508327 PMCID: PMC4193661 DOI: 10.1016/j.jamda.2013.12.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 12/16/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Physician services are increasingly recognized as important contributors to quality care provision in nursing homes (NH)s, but knowledge of ways in which NHs manage/control physician resources is lacking. DATA Primary data from surveys of NH administrators and directors of nursing from a nationally representative sample of 1938 freestanding United States NHs in 2009-2010 matched to Online Survey Certification and Reporting, aggregated NH Minimum Data Set assessments, Medicare claims, and county information from the Area Resource File. METHODS The concept of NH Control of Physician Resources (NHCOPR) was measured using NH administrators' reports of management implementation of rules, policies, and procedures aimed at coordinating work activities. The NHCOPR scale was based on measures of formal relationships, physician oversight and credentialing. Scale values ranged from weakest (0) to tightest (3) control. Several hypotheses of expected associations between NHCOPR and other measures of NH and market characteristics were tested. RESULTS The full NHCOPR score averaged 1.58 (standard deviation = 0.77) on the 0-3 scale. Nearly 30% of NHs had weak control (NHCOPR ≤1), 47.5% had average control (NHCOPR between 1 and 2), and the remaining 24.8% had tight control (NHCOPR >2). NHCOPR exhibited good face- and predictive-validity as exhibited by positive associations with more beds, more Medicare services, cross coverage, and number of physicians in the market. CONCLUSIONS The NHCOPR scale capturing NH's formal structure of control of physician resources can be useful in studying the impact of NH's physician resources on residents' outcomes with potential for targeted interventions by education and promotion of NH administration regarding physician staff.
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Affiliation(s)
- Orna Intrator
- Department of Public Health Sciences, University of Rochester, 265 Crittenden
Blvd., Rochester, NY 14642, Phone: 585-275-2191,
AND Canandaigua VAMC, 400 Fort Hill
Ave, Canandaigua, NY 14424, Phone: 585-276-6892,
| | - Julie Lima
- Brown University, Center for Gerontology and Health Care Research, 121 South
Main St., Providence, RI 02912, Phone: 972 355-7814,
| | - Terrie Fox Wetle
- Brown University, School of Public Health, 121 South Main St., Providence, RI
02912, Phone: 401 863-9858,
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Abstract
The focus of this column is the interface between policy and end-of-life care, particularly as provided by advanced nurse practitioners. The complexities of end-of-life along with barriers in practice can diminish quality of life for patients and their families. Changes in policy are needed to enable nurse practitioners their full scope of practice in a way that benefits patients and families at end-of-life. Three areas particularly relevant to policy for nursing practitioners and end-of-life care are addressed: scope of practice, reimbursement, and prescribing practices. Other recommendations for policy and end-of-life care are discussed.
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Flaherty JH, Morley JE. Delirium in the Nursing Home. J Am Med Dir Assoc 2013; 14:632-4. [DOI: 10.1016/j.jamda.2013.06.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 06/26/2013] [Indexed: 10/26/2022]
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Morley JE. JAMDA Impact Factor. J Am Med Dir Assoc 2013; 14:629-31. [DOI: 10.1016/j.jamda.2013.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 07/03/2013] [Indexed: 01/10/2023]
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Tolson D, Rolland Y, Katz PR, Woo J, Morley JE, Vellas B. An international survey of nursing homes. J Am Med Dir Assoc 2013; 14:459-62. [PMID: 23702606 DOI: 10.1016/j.jamda.2013.04.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 04/15/2013] [Indexed: 11/18/2022]
Abstract
This article reports the results of an exploratory survey of nursing home care in 30 countries. Most countries used either a social or nursing home model, with a physician model being less common. Resident Assessment Instruments were used in only 35% of countries. Physician visits to the nursing home occurred in 37%. All but 2 countries used advanced practice nurses. Medication use was high, with 82% of countries reporting residents taking 6 or more medicines a day.
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Affiliation(s)
- Debbie Tolson
- Alzheimer's Scotland Centre for Policy and Practice, The University of Western Scotland, Hamilton, Scotland, UK
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22
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Morley JE. Frailty, Falls, and Fractures. J Am Med Dir Assoc 2013; 14:149-51. [DOI: 10.1016/j.jamda.2012.12.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 12/18/2012] [Indexed: 12/24/2022]
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Arcand M, Brazil K, Nakanishi M, Nakashima T, Alix M, Desson JF, Morello R, Belzile L, Beaulieu M, MPM Hertogh C, T van der Steen J, Toscani F. Educating families about end-of-life care in advanced dementia: acceptability of a Canadian family booklet to nurses from Canada, France, and Japan. Int J Palliat Nurs 2013; 19:67-74. [DOI: 10.12968/ijpn.2013.19.2.67] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marcel Arcand
- Research Center on Ageing, Sherbrooke (CDRV), and Department of Family Medicine, University of Sherbrooke, Canada
| | - Kevin Brazil
- School of Nursing and Midwifery, Queen’s University Belfast, Northern Ireland
| | | | - Taeko Nakashima
- Institute for Health Economics and Policy (IHEP) Tokyo, Japan
| | - Michel Alix
- Département de Gériatrie et de Gérontologie, Centre Hospitalier de La Rochelle, France
| | | | - Rémy Morello
- Unite de Biostatistique et Recherche Clinique, Centre Hospitalier Universitaire de Caen, France
| | | | | | | | - Jenny T van der Steen
- EMGO Institute for Health and Care Research, Department of General Practice & Elderly Care Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Franco Toscani
- Lino Maestroni-Palliative Medicine Research Institute, Cremona, Italy
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24
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Journal of the American Medical Directors Association: The State of the Journal. J Am Med Dir Assoc 2012; 13:571-3. [DOI: 10.1016/j.jamda.2012.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 07/27/2012] [Indexed: 01/14/2023]
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25
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Holmerová I, Koopmans R, Skela Savič B, Egervári A, Hermann B, Ruseckiene R, Tolson D. Advancing Long Term Care: Central European Perspectives. J Am Med Dir Assoc 2012; 13:578-80. [DOI: 10.1016/j.jamda.2012.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 05/02/2012] [Indexed: 10/28/2022]
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26
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27
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The Successful Development of a Subacute Care Service Associated With a Large Academic Health System. J Am Med Dir Assoc 2012; 13:564-7. [DOI: 10.1016/j.jamda.2012.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 01/24/2012] [Accepted: 03/01/2012] [Indexed: 01/16/2023]
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High Technology Coming to a Nursing Home Near You. J Am Med Dir Assoc 2012; 13:409-12. [DOI: 10.1016/j.jamda.2012.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 04/02/2012] [Indexed: 12/22/2022]
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Tolson D, Morley JE. Physical Restraints: Abusive and Harmful. J Am Med Dir Assoc 2012; 13:311-3. [DOI: 10.1016/j.jamda.2012.02.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Accepted: 02/16/2012] [Indexed: 11/16/2022]
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Predictors of Hospitalization in Italian Nursing Home Residents: The U.L.I.S.S.E. Project. J Am Med Dir Assoc 2012; 13:84.e5-10. [DOI: 10.1016/j.jamda.2011.04.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 04/01/2011] [Accepted: 04/01/2011] [Indexed: 11/20/2022]
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32
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Dickerson JB, Smith ML, Dowdy DM, McKinley A, Ahn S, Ory MG. Advanced Practice Nurses' Perspectives on the Use of Health Optimization Strategies for Managing Chronic Disease Among Older Adults in Different Care Settings: Pushing the Boundaries of Self-Management Programs. Geriatr Nurs 2011; 32:429-38. [DOI: 10.1016/j.gerinurse.2011.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Revised: 08/30/2011] [Accepted: 09/05/2011] [Indexed: 01/14/2023]
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33
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Lieble K, Katz P, Brechtelsbauer D. Collaboration and the Physician/Advanced Practice Nurse Team. J Am Med Dir Assoc 2011; 12:541-2. [DOI: 10.1016/j.jamda.2011.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 05/27/2011] [Indexed: 01/30/2023]
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AMDA—A Leader in Developing International Long-Term Care. J Am Med Dir Assoc 2011; 12:319-20. [DOI: 10.1016/j.jamda.2011.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 03/31/2011] [Indexed: 11/23/2022]
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Tolson D, Morley JE, Rolland Y, Vellas B. Advancing Nursing Home Practice: The International Association of Geriatrics and Gerontology Recommendations. Geriatr Nurs 2011; 32:195-7. [DOI: 10.1016/j.gerinurse.2011.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 03/01/2011] [Accepted: 03/07/2011] [Indexed: 01/28/2023]
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Rolland Y, Aquino JP, Andrieu S, Beard J, Benetos A, Berrut G, Coll-Planas L, Dartigues JF, Dong B, Forette F, Franco A, Franzoni S, Hornez T, Metais P, Ruault G, Stephan E, Swagerty D, Tolson D, Volicer L, Vellas B, Morley J. Identification of the main domains for quality of care and clinical research in nursing homes. J Nutr Health Aging 2011; 15:410-24. [PMID: 21528170 DOI: 10.1007/s12603-011-0091-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Y Rolland
- Department of Geriatric Medicine, Toulouse University Hospital, Toulouse, France
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Abstract
With the advent of the graying of the baby boomers, there is an urgent need to enhance care in the nursing home. This article focuses on the areas where high-quality care can improve outcomes.
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Affiliation(s)
- Debbie Tolson
- Scottish Centre for Evidence Based Care of Older People, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 OBA, UK
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