EditorialIs This Really an Emergency? Reducing Potentially Preventable Emergency Department Visits Among Nursing Home Residents
Section snippets
Scenario One
Mrs Smith, a 92-year-old woman with moderately advanced Alzheimer disease is found in her NH room on the floor by a certified nursing assistant. The registered nurse is called and finds her vital signs to be normal, her mental status to be at her baseline, and no evidence of injury. Based on the NH's policy, the nurse calls 911 and Mrs Smith is transported to the local hospital's Emergency Department (ED) for further evaluation. In the ED, Mrs Smith's vital signs are normal, and the ED
Scenario Two
Mrs Jones, a 92-year-old woman with moderately advanced Alzheimer disease, is found in her NH room on the floor by a certified nursing assistant. The registered nurse is called and finds her vital signs to be normal, her mental status to be at her baseline, and no evidence of injury. Based on the NH's policy, the nurse carefully records her findings on a structured progress note, and initiates the NH's post–fall protocol for such occurrences that includes checking vital signs, mental status,
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Liaison geriatrics with nursing homes in COVID time. A new coordination model arrived to stay
2021, Revista Espanola de Geriatria y GerontologiaThe Temporal Trend in the Transfer of Older Adults to the Emergency Department for Traumatic Injuries: A Retrospective Analysis According to Their Place of Residence
2019, Journal of the American Medical Directors AssociationCitation Excerpt :This finding suggests that some of these ED transfers for trauma could be avoidable. NH staff often believe that care in the ED is better than care provided in NHs.15 However, the presence of better-educated nursing staff such as geriatric nurse practitioners has shown to reduce the number of ED transfers by an improved capacity to detect and to manage acute situations.16–19
Impact of Contextual Factors on Interventions to Reduce Acute Care Transfers II Implementation and Hospital Readmission Rates
2017, Journal of the American Medical Directors AssociationPrevention of Functional Decline by Reframing the Role of Nursing Homes?
2017, Journal of the American Medical Directors AssociationCitation Excerpt :Potentially avoidable hospitalizations are another high risk for NH residents. Hospitalizations are often associated with added disabilities due to iatrogenic events.36–38 Workforce issues also are important when considering the role of prevention.
Hospital Transfers of Skilled Nursing Facility (SNF) Patients Within 48 Hours and 30 Days After SNF Admission
2016, Journal of the American Medical Directors Association
J.G.O. is a full-time employee of Florida Atlantic University (FAU) and serves as a consultant to Think Research. He has received support through FAU to conduct research evaluating the Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement program from the National Institutes of Health, the Centers for Medicare and Medicaid Services, The Commonwealth Fund, the Retirement Research Foundation, PointClickCare, Medline Industries, and PatientOrderSets (now Think Research). J.G.O. and his wife have ownership interest in INTERACT Training, Education, and Management (“I TEAM”) Strategies, a business that has a license agreement with FAU for use of INTERACT materials for training and management consulting. J.G.O.'s work on INTERACT-related projects is subject to terms of Conflicts of Interest Management plans developed and approved by the FAU Division of Research Financial Conflict of Interest Committee. J.F.S. has funding from the Centers for Medicare and Medicaid Services for work on the INTERACT Quality Improvement Program. J.H. declares no conflicts of interest.