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Patient Satisfaction With The Annual Wellness Visit, Maria Espiridion, Raghavendra Mulinti, MD, Suzanne E. Kemper, MPH, Lynne J. Goebel, MD 2016 Marshall University

Patient Satisfaction With The Annual Wellness Visit, Maria Espiridion, Raghavendra Mulinti, Md, Suzanne E. Kemper, Mph, Lynne J. Goebel, Md

Marshall Journal of Medicine

OBJECTIVES - To determine patient satisfaction with the Annual Wellness Visit (AWV)

DESIGN – Survey

SETTING- Charleston Area Medical Center and Marshall Health

PARTICIPANTS – 66 volunteers, average age 74 years

MEASUREMENTS – Patient satisfaction was assessed with a 13 item survey.

RESULTS - Of 1,537 eligible patients, 211 (14%) of these agreed to schedule their AWV. From 66 patients surveyed, 87% of patients said the visit “met expectations,” “would recommend to friends,” and “would do it again.” Only 5 (8%) were disappointed that new problems were not addressed and 2 (3%) were dissatisfied that physical exams and blood tests were not included.

CONCLUSION ...


Malnourished Older Adults With Informal Caregivers Admitted To Rural Rehabilitation Units Remain Malnourished During And After Rehabilitation: A Prospective Cohort Study Of Current Practice, Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring 2016 Bond University

Malnourished Older Adults With Informal Caregivers Admitted To Rural Rehabilitation Units Remain Malnourished During And After Rehabilitation: A Prospective Cohort Study Of Current Practice, Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring

Skye Marshall

Understanding the nutritional journey older adults make from rehabilitation to home may help to engage and support the patient and their informal caregiver during this process. This study aimed to determine the change in nutritional status, physical function and health-related quality of life (HRQoL) amongst malnourished older adults (≥65years) with informal caregivers admitted to rural rehabilitation and 12 weeks post-discharge to the community.


Malnutrition In Geriatric Rehabilitation: Prevalence, Patient Outcomes And Criterion Validity Of The Scored Patient-Generated Subjective Global Assessment (Pg-Sga) And The Mini Nutritional Assessment (Mna), Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring 2016 Bond University

Malnutrition In Geriatric Rehabilitation: Prevalence, Patient Outcomes And Criterion Validity Of The Scored Patient-Generated Subjective Global Assessment (Pg-Sga) And The Mini Nutritional Assessment (Mna), Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring

Skye Marshall

No abstract provided.


Malnourished Older Adults Admitted To Rehabilitation In Rural New South Wales Remain Malnourished Throughout Rehabilitation And Once Discharged Back To The Community: A Prospective Cohort Study, Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring 2016 Bond University

Malnourished Older Adults Admitted To Rehabilitation In Rural New South Wales Remain Malnourished Throughout Rehabilitation And Once Discharged Back To The Community: A Prospective Cohort Study, Skye Marshall, Adrienne Young, Judith Bauer, Elizabeth Isenring

Skye Marshall

No abstract provided.


Malnutrition In Geriatric Rehabilitation: Prevalence, Patient Outcomes And Criterion Validity Of The Scored Patient-Generated Subjective Global Assessment (Pg-Sga) And The Mini Nutritional Assessment (Mna), Skye Marshall, Adrienne Young, Judith Bauer, Liz Isenring 2016 Bond University

Malnutrition In Geriatric Rehabilitation: Prevalence, Patient Outcomes And Criterion Validity Of The Scored Patient-Generated Subjective Global Assessment (Pg-Sga) And The Mini Nutritional Assessment (Mna), Skye Marshall, Adrienne Young, Judith Bauer, Liz Isenring

Skye Marshall

There is strong evidence showing malnutrition is under-recognized and underdiagnosed in the rehabilitation setting. Accurate identification and management of malnutrition is essential so that patient outcomes may be improved and resources used efficaciously.The Scored PG-SGA and MNA require evaluation of their validity in diagnosing malnutrition in rehabilitation. In addition, the prevalence of malnutrition and associated patient outcomes in rural Australian populations has not been reported.


Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone 2016 Department of Geriatrics, Aurora Health Care

Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone

Ariba Khan, MD, MPH

Background: We noted a low reported prevalence of delirium (3%) in hospitalized older patients at a community teaching hospital in north central Wisconsin.

Purpose: This was a quality improvement project to report recognition of delirium by nurses before and after an educational intervention.

Methods: This project was performed on one medical unit in our hospital. Quality improvement data was collected at baseline and after the educational intervention. Data collected included observation by a geriatrician attending weekly interdisciplinary rounds to note any mention by nurses of delirium or confusion. The patient’s electronic health record (EHR) was reviewed to note delirium ...


Prognostic Indices For Hospitalized Older Adults: A Meta-Analysis And Systematic Review, Ariba Khan, Ayesha Maria, James Hocker, Maharaj Singh, Michelle Simpson 2016 Department of Geriatrics, Aurora UW Medical Group

Prognostic Indices For Hospitalized Older Adults: A Meta-Analysis And Systematic Review, Ariba Khan, Ayesha Maria, James Hocker, Maharaj Singh, Michelle Simpson

Ariba Khan, MD, MPH

Background: A prognostication predictive model incorporated into the electronic health record (EHR) may be useful in assisting the health care team in accurately predicting mortality and may be used in appropriately allocating palliative care services.

Purpose: To systematically review and summarize current medical literature regarding the factors predictive of mortality in an inpatient population above 65 years of age.

Methods: Nondisease-specific prognostication indices that predict 1-year mortality in an inpatient population of adults over age 65 were included. We excluded studies that estimated intensive care unit, disease-specific or in-hospital mortality. A MEDLINE, CINAHL, Ovid and Cochrane literature search of English-language ...


An Automated Model Using Electronic Health Record Data To Identify Delirium Among Hospitalized Older Adults: A Pilot Project, Ariba Khan, Maharaj Singh, Hina Singh, Ayesha Maria, Michelle Simpson 2016 Department of Geriatrics, Aurora UW Medical Group

An Automated Model Using Electronic Health Record Data To Identify Delirium Among Hospitalized Older Adults: A Pilot Project, Ariba Khan, Maharaj Singh, Hina Singh, Ayesha Maria, Michelle Simpson

Ariba Khan, MD, MPH

Background: Delirium is a serious change in mental status with adverse outcomes, but remains underrecognized. The electronic health record (EHR) may assist in the identification of delirium.

Purpose: This study was performed to generate an automated delirium identification model using data from the EHR among hospitalized older adults.

Methods: Inpatients 65 years and older were included in this cross-sectional study. The researchers used “confusion assessment method” as the gold standard to identify delirium. Four categories of variables were obtained from the EHR on the day of and the day prior to researcher assessment: 1) hypoactive delirium (any one of the ...


Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone 2016 Department of Geriatrics, Aurora Health Care

Delirium Recognition In Hospitalized Older Patients: A Quality Improvement Project, Jodi Punke, Ariba Khan, Michael L. Malone

Michael Malone, MD

Background: We noted a low reported prevalence of delirium (3%) in hospitalized older patients at a community teaching hospital in north central Wisconsin.

Purpose: This was a quality improvement project to report recognition of delirium by nurses before and after an educational intervention.

Methods: This project was performed on one medical unit in our hospital. Quality improvement data was collected at baseline and after the educational intervention. Data collected included observation by a geriatrician attending weekly interdisciplinary rounds to note any mention by nurses of delirium or confusion. The patient’s electronic health record (EHR) was reviewed to note delirium ...


Workplace Predictors Of Perceived Quality Of Care In Nursing Homes, Winnie Chin, Laura Punnett, Rebecca Gore, Laura Kernan 2016 University of Massachusetts Lowell

Workplace Predictors Of Perceived Quality Of Care In Nursing Homes, Winnie Chin, Laura Punnett, Rebecca Gore, Laura Kernan

UMass Center for Clinical and Translational Science Research Retreat

Nursing home quality of care (QOC) is a matter of public concern and public policy. Higher nurse-to-patient ratios have been shown to decrease rates of adverse outcomes. Positive nurse-doctor relationships also have a positive effect, which might translate to other clinical staff, such as nursing aides, who perform the majority of direct care tasks in nursing homes. This cross-sectional study examined whether workplace factors in nursing homes were associated with QOC as evaluated by staff members themselves. Surveys were distributed to personnel in 24 nursing home facilities in the Northeast U.S. A total of 1463 respondents provided ratings of ...


Hospice And Pain Management In Nursing Home Residents With Cancer, Jacob N. Hunnicutt, Jennifer Tjia, Kate L. Lapane 2016 University of Massachusetts Medical School

Hospice And Pain Management In Nursing Home Residents With Cancer, Jacob N. Hunnicutt, Jennifer Tjia, Kate L. Lapane

UMass Center for Clinical and Translational Science Research Retreat

Background: The prevalence of untreated pain in nursing home residents with cancer is unacceptably high. Hospice may increase the likelihood of receiving pain management at the end of life.

Objectives: To estimate whether receipt of hospice in nursing homes increases the receipt of pain management for nursing home residents with cancer at the end of life.

Methods: We conducted a cross-sectional study on a national sample of Medicare decedents who had cancer and were nursing home residents during the last 90 days of life in 2011–2012. We used the last Minimum Data Set (MDS) 3.0 assessment before death ...


Show Back: Evaluation Of Scoresheet For Identifying Self-Management Medication Problems Of Older Adults, Laura Sanford, Janice B. Foust, Maureen Sarno, Alok Kapoor 2016 University of Massachusetts Medical School

Show Back: Evaluation Of Scoresheet For Identifying Self-Management Medication Problems Of Older Adults, Laura Sanford, Janice B. Foust, Maureen Sarno, Alok Kapoor

UMass Center for Clinical and Translational Science Research Retreat

Purpose The study purpose was to test the feasibility of a scoresheet to screen for problems older adults may have managing medications after discharge from a hospital or nursing home facility.

Background Adverse drug events (ADE) prevention is an important patient safety priority, with ADEs accounting for an estimated one-third of hospital adverse events and approximately 280,000 hospital admissions annually. Home healthcare nurses work with older adults to avoid ADEs and promote self-management of medications. Few, if any, studies have described older adults’ cognitive and psychomotor abilities to manage their medications after being discharged home.

Methods We enrolled patients ...


Triad Of Suffering: Pain, Depression, And Anxiety Among Newly Admitted Nursing Homes Residents, Christine M. Ulbricht, Jacob N. Hunnicutt, Kate L. Lapane 2016 University of Massachusetts Medical School

Triad Of Suffering: Pain, Depression, And Anxiety Among Newly Admitted Nursing Homes Residents, Christine M. Ulbricht, Jacob N. Hunnicutt, Kate L. Lapane

UMass Center for Clinical and Translational Science Research Retreat

Introduction: Depression and anxiety disorders are prevalent among older adults, as is pain. These conditions are independently associated with reduced functioning and quality of life. Despite the frequent co-occurrence of all three of these disorders, little is known about the epidemiology and treatment of these disorders in nursing homes. The objectives of this study were to: 1) describe the prevalence of depression, anxiety disorders, and pain among newly admitted nursing home residents; and 2) describe the treatment of these disorders.

Methods: We used national Minimum Data Set (MDS) version 3.0 data from 2011-2012. Federally-mandated for all residents living in ...


Impact Of Multimorbidity On Clinical Outcomes In Older Adults With Cardiovascular Disease, Mayra Tisminetsky, Robert J. Goldberg, Jerry H. Gurwitz 2016 University of Massachusetts Medical School

Impact Of Multimorbidity On Clinical Outcomes In Older Adults With Cardiovascular Disease, Mayra Tisminetsky, Robert J. Goldberg, Jerry H. Gurwitz

UMass Center for Clinical and Translational Science Research Retreat

Objective: To synthesize the current literature on the magnitude and impact of multiple chronic conditions on clinical outcomes, including total in-hospital and post discharge mortality and hospitalizations, in older patients with cardiovascular disease (CVD).

Methods: A systematic review was conducted. Four electronic databases and article bibliographies were searched for publications from 2005 to 2015 which assessed the impact of multimorbidity on clinical outcomes in the elderly with CVD. Identified studies were screened using pre-defined criteria for eligibility.

Results: Fifteen studies met our inclusion criteria. Multimorbidity was assessed by simple counting of morbidities and by the Charlson and Elixhauser indices. Case-fatality ...


Prognostic Indices For Hospitalized Older Adults: A Meta-Analysis And Systematic Review, Ariba Khan, Ayesha Maria, James Hocker, Maharaj Singh, Michelle Simpson 2016 Department of Geriatrics, Aurora UW Medical Group

Prognostic Indices For Hospitalized Older Adults: A Meta-Analysis And Systematic Review, Ariba Khan, Ayesha Maria, James Hocker, Maharaj Singh, Michelle Simpson

Maharaj Singh

Background: A prognostication predictive model incorporated into the electronic health record (EHR) may be useful in assisting the health care team in accurately predicting mortality and may be used in appropriately allocating palliative care services.

Purpose: To systematically review and summarize current medical literature regarding the factors predictive of mortality in an inpatient population above 65 years of age.

Methods: Nondisease-specific prognostication indices that predict 1-year mortality in an inpatient population of adults over age 65 were included. We excluded studies that estimated intensive care unit, disease-specific or in-hospital mortality. A MEDLINE, CINAHL, Ovid and Cochrane literature search of English-language ...


An Automated Model Using Electronic Health Record Data To Identify Delirium Among Hospitalized Older Adults: A Pilot Project, Ariba Khan, Maharaj Singh, Hina Singh, Ayesha Maria, Michelle Simpson 2016 Department of Geriatrics, Aurora UW Medical Group

An Automated Model Using Electronic Health Record Data To Identify Delirium Among Hospitalized Older Adults: A Pilot Project, Ariba Khan, Maharaj Singh, Hina Singh, Ayesha Maria, Michelle Simpson

Maharaj Singh

Background: Delirium is a serious change in mental status with adverse outcomes, but remains underrecognized. The electronic health record (EHR) may assist in the identification of delirium.

Purpose: This study was performed to generate an automated delirium identification model using data from the EHR among hospitalized older adults.

Methods: Inpatients 65 years and older were included in this cross-sectional study. The researchers used “confusion assessment method” as the gold standard to identify delirium. Four categories of variables were obtained from the EHR on the day of and the day prior to researcher assessment: 1) hypoactive delirium (any one of the ...


Using An Automated Model To Identify Older Patients At Risk For 30-Day Hospital Readmission And 30-Day Mortality, Ariba Khan, Mary L. Hook, Maharaj Singh, Marsha Vollbrecht, Aaron Malsch, Michael L. Malone 2016 Department of Geriatrics, Aurora UW Medical Group

Using An Automated Model To Identify Older Patients At Risk For 30-Day Hospital Readmission And 30-Day Mortality, Ariba Khan, Mary L. Hook, Maharaj Singh, Marsha Vollbrecht, Aaron Malsch, Michael L. Malone

Maharaj Singh

Background: A real-time electronic health record (EHR) predictive model that identifies older patients at risk for readmission and mortality may assist the health care team in improved patient care.

Purpose: This study was performed to generate an automated 30-day readmission and 30-day mortality risk model using data from the EHR in hospitalized older adults.

Methods: This was a retrospective cohort study. Included were patients age 65 years and older admitted to the hospital from July 2012 to December 2013. An automated predictive model was derived from variables collected from the EHR including socioeconomic factors, medical diagnoses and health care utilization ...


Reciprocity: Caring For America's Caregivers, Courtney Dunn 2016 Cleveland State University

Reciprocity: Caring For America's Caregivers, Courtney Dunn

The Downtown Review

Should families be forced to choose between the health of a caregiver and patient? Through the eyes of a woman caring for her husband with Alzheimer's disease, we see that family caregivers suffer tremendous amounts of stress while caring for the patient. Despite the time and efforts required to care for someone with Alzheimer's disease, people every day choose this as an alternative to out-of-home care. This often leads to depression, anxiety, and physical stress which can result in series medical issues. Considering the increase of people with Alzheimer's disease in the United States, this article argues ...


Geriatric Psychology, Robert D. Barraco MD 2016 Lehigh Valley Health Network

Geriatric Psychology, Robert D. Barraco Md

Robert D Barraco MD, MPH

No abstract provided.


Geriatric Medication Therapy: Weighing The Evidence Versus Best Practice, Lindsay Saum, Cathy Ramey 2016 Butler University

Geriatric Medication Therapy: Weighing The Evidence Versus Best Practice, Lindsay Saum, Cathy Ramey

Lindsay Saum

Goals: The goal of this article is to provide a review of available evidence for safe prescribing in older adults and recommend medication therapies based on anticipated pharmacokinetic/physiologic changes in this population.


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