Background: To better meet long-term care (LTC) residents' (patients in LTC) needs, nurse practitioners (NPs) were proposed as part of a quality improvement initiative. No research has been conducted in LTC in Québec Canada, where NP roles are new. We collected provider interviews, field notes and resident outcomes to identify how NPs in LTC influence care quality and inform the wider implementation of these roles in Québec. This paper reports on resident outcomes and field notes.
Methods: This mixed methods quality improvement study included a prospective cohort study in six LTC facilities in Québec. Data were collected from September 2015-August 2016. The cohort consisted of all residents ( = 538) followed by the nurse practitioners. Nurse practitioner interventions ( = 3798) related to medications, polypharmacy, falls, restraint use, transfers to acute care and pressure ulcers were monitored. Bivariate analyses and survival analysis of occurrence of events over time were conducted. Content analysis was used for the qualitative data.
Results: Nurse practitioners ( = 6) worked half-time in LTC with an average caseload ranging from 42 to 80 residents. Sites developed either a shared care or a consultative model. The average age of residents was 82, and two thirds were women. The most common diagnosis on admission was dementia (62%, = 331). The number of interventions/resident (range: 2.2-16.3) depended on the care model. The average number of medications/resident decreased by 12% overall or 10% for each 30-day period over 12 months. The incidence of polypharmacy, falls, restraint use, and transfers to acute care decreased, and very few pressure ulcers were identified.
Conclusions: The implementation of NPs in LTC in Québec can improve care quality for residents. Results show that the average number of medications per day per resident, the incidence of polypharmacy, falls, restraint use, and transfers to acute care all decreased during the study, suggesting that a wider implementation of NP roles in LTC is a useful strategy to improve resident care. Although additional studies are needed, the implementation of a consultative model should be favoured as our project provides preliminary evidence of the contributions of these new roles in LTC in Québec.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6990528 | PMC |
http://dx.doi.org/10.1186/s12912-019-0395-2 | DOI Listing |
Trials
January 2025
Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Background: With the population ageing, more victims of community crime are likely to be older adults. The psychological impact of crime on older victims is significant and sustained, but only feasibility trials have been published regarding potential interventions. The integration of public health and care services and cross-agency working is recommended, but there is little information on how this should be undertaken.
View Article and Find Full Text PDFBMC Plant Biol
January 2025
National Key Laboratory of Cotton Bio-breeding and Integrated Utilization, Institute of Cotton Research, Chinese Academy of Agricultural Sciences, Anyang, Henan, 455000, China.
Background: Salinity stress impairs cotton growth and fiber quality. Protoplasts enable elucidation of early salt-responsive signaling. Elucidating crop tolerance mechanisms that ameliorate these diverse salinity-induced stresses is key for improving agricultural productivity under saline conditions.
View Article and Find Full Text PDFBMC Musculoskelet Disord
January 2025
Department of Orthopaedics, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands.
Background: Patellofemoral pain (PFP) is a common musculoskeletal disorder resulting in anterior knee pain. Physiotherapy is the current standard treatment, while surgical intervention (tibial tubercle transfer [TTT]) is reserved for chronic cases when nonoperative treatment has failed. TTT can result in clinically meaningful improvement in patients with patellofemoral maltracking without instability.
View Article and Find Full Text PDFAesthetic Plast Surg
January 2025
Plastic, Reconstructive and Aesthetic Surgery Department, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Roma, Italy.
Introduction: Renuvion was the first FDA approved helium plasma device utilized for subdermal tissue heating to reduce skin laxity. The purpose of this study was to demonstrate that the use of Renuvion improves the outcomes, skin quality and reduces the edema faster after lipoabdominoplasty.
Materials And Methods: Patients with abdominal skin laxity after a weight loss of at least 20 kg, nonsmokers, without major comorbidities, with a minimum 2-year follow-up and standardized pre- and postoperative photographs were included in this study.
Nat Plants
January 2025
Beijing Key Laboratory of Growth and Developmental Regulation for Protected Vegetable Crops, College of Horticulture, China Agricultural University, Beijing, China.
Parthenocarpy is a pivotal trait that enhances the yield and quality of fruit crops by enabling the development of seedless fruits. Here we unveil a molecular framework for the regulation and domestication of parthenocarpy in cucumber (Cucumis sativus L.).
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!