The Experts below are selected from a list of 9558 Experts worldwide ranked by ideXlab platform
Robert D Mayer - One of the best experts on this subject based on the ideXlab platform.
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use of the agency for health care policy and research urinary incontinence guideline in Nursing homes
Journal of the American Geriatrics Society, 2003Co-Authors: Nancy M Watson, Carol A Brink, James G Zimmer, Robert D MayerAbstract:The objective of this study was to assess the use of the Agency for Health Care Policy and Research (now called the Agency for Healthcare Research and Quality) Urinary Incontinence (UI) Guideline (1996) in Nursing homes (NHs) using retrospective chart review and Nursing Assistant screening interviews. The study was conducted in a nonrandom sample of 52 NHs in upstate New York. Two hundred residents developing new UI or newly admitted with UI on the dayshift and who met criteria for evaluation and treatment/management were evaluated in the 12 weeks after onset of or admission with UI. Fifteen percent of newly admitted residents needed evaluation. Of residents already in NHs, 2.3 per 100 beds developed new UI over the 12 weeks. Aspects of UI evaluation rarely done were rectal examination (15%), digital examination of prostate (15%), and pelvic examination (2%). Sixty-eight percent had a culture/sensitivity, 56% a urinalysis, and 6% a postvoid residual. Eighty-one percent had a reversible cause at the time of onset, but only 34% had all addressed. Few (2%) needed urologist evaluation. Treatment was rare (3%), but management using toileting and absorbent products were common. Only 6% achieved resolution of UI. These results suggest that assessment and treatment of UI is manageable (a total of 4.2 new cases per 100 beds per 12 weeks) but quality is not adequate. On average, only 20% of the standards applicable were met, due primarily to lack of awareness of new UI and lack of familiarity with the guideline. Thus, improvements are needed. Recommendations for guideline revision are made.
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use of the agency for health care policy and research urinary incontinence guideline in Nursing homes
Journal of the American Geriatrics Society, 2003Co-Authors: Nancy M Watson, Carol A Brink, James G Zimmer, Robert D MayerAbstract:The objective of this study was to assess the use of the Agency for Health Care Policy and Research (now called the Agency for Healthcare Research and Quality) Urinary Incontinence (UI) Guideline (1996) in Nursing homes (NHs) using retrospective chart review and Nursing Assistant screening interviews. The study was conducted in a nonrandom sample of 52 NHs in upstate New York. Two hundred residents developing new UI or newly admitted with UI on the dayshift and who met criteria for evaluation and treatment/management were evaluated in the 12 weeks after onset of or admission with UI. Fifteen percent of newly admitted residents needed evaluation. Of residents already in NHs, 2.3 per 100 beds developed new UI over the 12 weeks. Aspects of UI evaluation rarely done were rectal examination (15%), digital examination of prostate (15%), and pelvic examination (2%). Sixty-eight percent had a culture/sensitivity, 56% a urinalysis, and 6% a postvoid residual. Eighty-one percent had a reversible cause at the time of onset, but only 34% had all addressed. Few (2%) needed urologist evaluation. Treatment was rare (3%), but management using toileting and absorbent products were common. Only 6% achieved resolution of UI. These results suggest that assessment and treatment of UI is manageable (a total of 4.2 new cases per 100 beds per 12 weeks) but quality is not adequate. On average, only 20% of the standards applicable were met, due primarily to lack of awareness of new UI and lack of familiarity with the guideline. Thus, improvements are needed. Recommendations for guideline revision are made.
Chinming Chen - One of the best experts on this subject based on the ideXlab platform.
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early mobilization reduces duration of mechanical ventilation and intensive care unit stay in patients with acute respiratory failure
Archives of Physical Medicine and Rehabilitation, 2017Co-Authors: Chihcheng Lai, Willy Chou, Kheesiang Chan, Kuochen Cheng, Kuoshu Yuan, Chienming Chao, Chinming ChenAbstract:Abstract Objective To evaluate the effects of a quality improvement program to introduce early mobilization on the outcomes of patients with mechanical ventilation (MV) in the intensive care unit (ICU). Design A retrospective observational study. Setting Nineteen-bed ICU at a medical center. Participants Adults patients with MV (N=153) admitted to a medical ICU. Interventions A multidisciplinary team (critical care nurse, Nursing Assistant, respiratory therapist, physical therapist, patient's family) initiated the protocol within 72 hours of MV when patients become hemodynamically stable. We did early mobilization twice daily, 5d/wk during family visits (30min each time), and cooperated with family, if possible. Main Outcome Measures MV duration, rate of successful weaning, and length of ICU and hospital stay. Results We enrolled 63 patients in the before protocol group and 90 in the after protocol group. The 2 groups were well matched in age, sex, body height, body weight, body mass index, disease severity, cause of intubation, number of comorbidities, and most underlying diseases. After protocol group patients had shorter MV durations (4.7d vs 7.5d; P Conclusions The introduction of early mobilization for patients with MV in the ICU shortened MV durations and ICU stays. A multidisciplinary team that includes the patient's family can work together to improve the patient's clinical outcomes.
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early mobilization reduces duration of mechanical ventilation and intensive care unit stay in patients with acute respiratory failure
Archives of Physical Medicine and Rehabilitation, 2017Co-Authors: Chihcheng Lai, Willy Chou, Kheesiang Chan, Kuochen Cheng, Kuoshu Yuan, Chienming Chao, Chinming ChenAbstract:Abstract Objective To evaluate the effects of a quality improvement program to introduce early mobilization on the outcomes of patients with mechanical ventilation (MV) in the intensive care unit (ICU). Design A retrospective observational study. Setting Nineteen-bed ICU at a medical center. Participants Adults patients with MV (N=153) admitted to a medical ICU. Interventions A multidisciplinary team (critical care nurse, Nursing Assistant, respiratory therapist, physical therapist, patient's family) initiated the protocol within 72 hours of MV when patients become hemodynamically stable. We did early mobilization twice daily, 5d/wk during family visits (30min each time), and cooperated with family, if possible. Main Outcome Measures MV duration, rate of successful weaning, and length of ICU and hospital stay. Results We enrolled 63 patients in the before protocol group and 90 in the after protocol group. The 2 groups were well matched in age, sex, body height, body weight, body mass index, disease severity, cause of intubation, number of comorbidities, and most underlying diseases. After protocol group patients had shorter MV durations (4.7d vs 7.5d; P P =.001) than did before protocol group patients. Early mobilization was negatively associated with the duration of MV (β=−.269; P Conclusions The introduction of early mobilization for patients with MV in the ICU shortened MV durations and ICU stays. A multidisciplinary team that includes the patient's family can work together to improve the patient's clinical outcomes.
Nancy M Watson - One of the best experts on this subject based on the ideXlab platform.
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use of the agency for health care policy and research urinary incontinence guideline in Nursing homes
Journal of the American Geriatrics Society, 2003Co-Authors: Nancy M Watson, Carol A Brink, James G Zimmer, Robert D MayerAbstract:The objective of this study was to assess the use of the Agency for Health Care Policy and Research (now called the Agency for Healthcare Research and Quality) Urinary Incontinence (UI) Guideline (1996) in Nursing homes (NHs) using retrospective chart review and Nursing Assistant screening interviews. The study was conducted in a nonrandom sample of 52 NHs in upstate New York. Two hundred residents developing new UI or newly admitted with UI on the dayshift and who met criteria for evaluation and treatment/management were evaluated in the 12 weeks after onset of or admission with UI. Fifteen percent of newly admitted residents needed evaluation. Of residents already in NHs, 2.3 per 100 beds developed new UI over the 12 weeks. Aspects of UI evaluation rarely done were rectal examination (15%), digital examination of prostate (15%), and pelvic examination (2%). Sixty-eight percent had a culture/sensitivity, 56% a urinalysis, and 6% a postvoid residual. Eighty-one percent had a reversible cause at the time of onset, but only 34% had all addressed. Few (2%) needed urologist evaluation. Treatment was rare (3%), but management using toileting and absorbent products were common. Only 6% achieved resolution of UI. These results suggest that assessment and treatment of UI is manageable (a total of 4.2 new cases per 100 beds per 12 weeks) but quality is not adequate. On average, only 20% of the standards applicable were met, due primarily to lack of awareness of new UI and lack of familiarity with the guideline. Thus, improvements are needed. Recommendations for guideline revision are made.
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use of the agency for health care policy and research urinary incontinence guideline in Nursing homes
Journal of the American Geriatrics Society, 2003Co-Authors: Nancy M Watson, Carol A Brink, James G Zimmer, Robert D MayerAbstract:The objective of this study was to assess the use of the Agency for Health Care Policy and Research (now called the Agency for Healthcare Research and Quality) Urinary Incontinence (UI) Guideline (1996) in Nursing homes (NHs) using retrospective chart review and Nursing Assistant screening interviews. The study was conducted in a nonrandom sample of 52 NHs in upstate New York. Two hundred residents developing new UI or newly admitted with UI on the dayshift and who met criteria for evaluation and treatment/management were evaluated in the 12 weeks after onset of or admission with UI. Fifteen percent of newly admitted residents needed evaluation. Of residents already in NHs, 2.3 per 100 beds developed new UI over the 12 weeks. Aspects of UI evaluation rarely done were rectal examination (15%), digital examination of prostate (15%), and pelvic examination (2%). Sixty-eight percent had a culture/sensitivity, 56% a urinalysis, and 6% a postvoid residual. Eighty-one percent had a reversible cause at the time of onset, but only 34% had all addressed. Few (2%) needed urologist evaluation. Treatment was rare (3%), but management using toileting and absorbent products were common. Only 6% achieved resolution of UI. These results suggest that assessment and treatment of UI is manageable (a total of 4.2 new cases per 100 beds per 12 weeks) but quality is not adequate. On average, only 20% of the standards applicable were met, due primarily to lack of awareness of new UI and lack of familiarity with the guideline. Thus, improvements are needed. Recommendations for guideline revision are made.
Marie R Squillace - One of the best experts on this subject based on the ideXlab platform.
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why do they stay job tenure among certified Nursing Assistants in Nursing homes
Gerontologist, 2009Co-Authors: Joshua Wiener, Marie R Squillace, Wayne Anderson, Galina KhatutskyAbstract:Purpose: This study identifi es factors related to job tenure among certifi ed Nursing Assistants (CNAs) working in Nursing homes. Design and Methods: The study uses 2004 data from the National Nursing Home Survey, the National Nursing Assistant Survey, and the Area Resource File. Ordinary least squares regression analyses were conducted with length of job tenure as the dependent variable. Tenure of CNAs was hypothesized to be motivated by the extrinsic rewards of their job, initial training and mentoring, reasons for being a CNA, organizational culture, and personal, facility, and market characteristics. Separate analyses were conducted for the overall sample and for CNAs who worked for the facility for more than 1 year. Results: Among policy-relevant domains, extrinsic rewards had the largest number of signifi cant variables (4). Only 1 training and 1 organizational culture variable signifi cantly affected CNA job tenure. Signifi cant variables in domains not readily infl uenced by policy (e.g., personal characteristics and characteristics of the facility and surrounding market area) were often signifi cant in both regressions. Implications: This study underscores the importance of the basic economics of job choice by low-income workers. Wages, fringe benefi ts, job security, and alternative choices of employment are important determinants of job tenure that should be addressed, in addition to training and organizational culture.
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the national Nursing Assistant survey improving the evidence base for policy initiatives to strengthen the certified Nursing Assistant workforce
Gerontologist, 2009Co-Authors: Marie R Squillace, Robin E Remsburg, Lauren D Harriskojetin, Anita Bercovitz, Emily Rosenoff, Beth HanAbstract:PURPOSE: This study introduces the first National Nursing Assistant Survey (NNAS), a major advance in the data available about certified Nursing Assistants (CNAs) and a rich resource for evidence-based policy, practice, and applied research initiatives. We highlight potential uses of this new survey using select population estimates as examples of how the NNAS can be used to inform new policy directions. Design and Methods: The NNAS is a nationally representative survey of 3,017 CNAs working in Nursing homes, who were interviewed by phone in 2004-2005. Key survey components are recruitment; education; training and licensure; job history; family life; management and supervision; client relations; organizational commitment and job satisfaction; workplace environment; work-related injuries; and demographics. RESULTS: One in three CNAs received some kind of means-tested public assistance. More than half of CNAs incurred at least 1 work-related injury within the past year and almost one quarter were unable to work for at least 1 day due to the injury. Forty-two percent of uninsured CNAs cite not participating in their employer-sponsored insurance plan because they could not afford the plan. Years of experience do not translate into higher wages; CNAs with 10 or more years of experience averaged just $2/hr more than aides who started working in the field less than 1 year ago. Implications: This survey can be used to understand CNA workforce issues and challenges and to plan for sustainable solutions to stabilize this workforce. The NNAS can be linked to other existing data sets to examine more comprehensive and complex relationships among CNA, facility, resident, and community characteristics, thereby expanding its usefulness. Language: en
Chihcheng Lai - One of the best experts on this subject based on the ideXlab platform.
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early mobilization reduces duration of mechanical ventilation and intensive care unit stay in patients with acute respiratory failure
Archives of Physical Medicine and Rehabilitation, 2017Co-Authors: Chihcheng Lai, Willy Chou, Kheesiang Chan, Kuochen Cheng, Kuoshu Yuan, Chienming Chao, Chinming ChenAbstract:Abstract Objective To evaluate the effects of a quality improvement program to introduce early mobilization on the outcomes of patients with mechanical ventilation (MV) in the intensive care unit (ICU). Design A retrospective observational study. Setting Nineteen-bed ICU at a medical center. Participants Adults patients with MV (N=153) admitted to a medical ICU. Interventions A multidisciplinary team (critical care nurse, Nursing Assistant, respiratory therapist, physical therapist, patient's family) initiated the protocol within 72 hours of MV when patients become hemodynamically stable. We did early mobilization twice daily, 5d/wk during family visits (30min each time), and cooperated with family, if possible. Main Outcome Measures MV duration, rate of successful weaning, and length of ICU and hospital stay. Results We enrolled 63 patients in the before protocol group and 90 in the after protocol group. The 2 groups were well matched in age, sex, body height, body weight, body mass index, disease severity, cause of intubation, number of comorbidities, and most underlying diseases. After protocol group patients had shorter MV durations (4.7d vs 7.5d; P Conclusions The introduction of early mobilization for patients with MV in the ICU shortened MV durations and ICU stays. A multidisciplinary team that includes the patient's family can work together to improve the patient's clinical outcomes.
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early mobilization reduces duration of mechanical ventilation and intensive care unit stay in patients with acute respiratory failure
Archives of Physical Medicine and Rehabilitation, 2017Co-Authors: Chihcheng Lai, Willy Chou, Kheesiang Chan, Kuochen Cheng, Kuoshu Yuan, Chienming Chao, Chinming ChenAbstract:Abstract Objective To evaluate the effects of a quality improvement program to introduce early mobilization on the outcomes of patients with mechanical ventilation (MV) in the intensive care unit (ICU). Design A retrospective observational study. Setting Nineteen-bed ICU at a medical center. Participants Adults patients with MV (N=153) admitted to a medical ICU. Interventions A multidisciplinary team (critical care nurse, Nursing Assistant, respiratory therapist, physical therapist, patient's family) initiated the protocol within 72 hours of MV when patients become hemodynamically stable. We did early mobilization twice daily, 5d/wk during family visits (30min each time), and cooperated with family, if possible. Main Outcome Measures MV duration, rate of successful weaning, and length of ICU and hospital stay. Results We enrolled 63 patients in the before protocol group and 90 in the after protocol group. The 2 groups were well matched in age, sex, body height, body weight, body mass index, disease severity, cause of intubation, number of comorbidities, and most underlying diseases. After protocol group patients had shorter MV durations (4.7d vs 7.5d; P P =.001) than did before protocol group patients. Early mobilization was negatively associated with the duration of MV (β=−.269; P Conclusions The introduction of early mobilization for patients with MV in the ICU shortened MV durations and ICU stays. A multidisciplinary team that includes the patient's family can work together to improve the patient's clinical outcomes.
