Exploring Overt Racial and Ethnic Conflict in Resident-to-Resident Aggression in Long-Term Care Facilities.

Objectives: Resident-to-resident aggression (RRA) in long-term care facilities is gaining recognition as a serious problem. Racial/ethnic conflict may be a contributing factor to RRA incidents, but it remains insufficiently studied. Our goal was to explore overt racial/ethnic conflict in RRA.

Risk Factors for All-Cause Mortality in Patients Diagnosed with Advanced Heart Failure: A Scoping Review.

Identifying the evolving needs of patients with advanced heart failure (AdHF) and triaging those at high risk of death can facilitate timely referrals to palliative care and advance patient-centered individualized care. There are limited models specific for patients with end-stage HF. We aim to identify risk factors associated with up to three-year all-cause mortality (ACM) and describe prognostic models developed or validated in AdHF populations.

Post-acute and long-term care: a practical and novel curriculum for medical students.

Most physicians will not practice in post-acute or long-term care (PALTC), yet many will care for older adults who transition across these settings. However, medical student education on PALTC is extremely limited. This is a pilot study of a curriculum on PALTC.

Transition to end-of-life care in patients with neurological diseases in an acute hospital ward.

Background: Transitioning to end-of-life care and thereby changing the focus of treatment directives from life-sustaining treatment to comfort care is important for neurological patients in advanced stages. Late transition to end-of-life care for neurological patients has been described previously.

Objective: To investigate whether previous treatment directives, primary medical diagnoses, and demographic factors predict the transition to end-of-life care and time to eventual death in patients with neurological diseases in an acute hospital setting.

The association between rurality, places of care and the location of death of long-term care home residents with dementia: A population-based study.

Background: Most individuals prefer to spend their final moments of life outside a hospital setting. This study compares the places of care and death of long-term care (LTC) home residents in Ontario in the last 90 days of life, according to LTC home rurality.

Data And Methods: This retrospective cohort study was conducted using health administrative data from ICES (formerly known as the Institute for Clinical Evaluative Sciences).

The impact of palliative care on the frailty-stroke continuum: from theoretical concepts to practical aspects.

With a constant increase in prevalence and incidence worldwide, stroke remains a public health issue in the 21 century. Additionally, population aging inevitably leads to increased vulnerability in the general population, a clinical state known as frailty. While there are adequate guidelines on the treatment of stroke in the acute setting, there are a lot of gaps regarding the chronic management of stroke patients, particularly the frail ones.

Improving patients', carers' and primary care healthcare professionals' experiences of discharge communication from specialist palliative care to community settings: a protocol for a qualitative interview study.

Background: Patients who have benefited from specialist intervention during periods of acute/complex palliative care needs often transition from specialist-to-primary care once such needs have been controlled. Effective communication between services is central to co-ordination of care to avoid the potential consequences of unmet needs, fragmented care, and poor patient and family experience. Discharge communications are a key component of care transitions.

[Shared decision-making in acute life-threatening situations: two cases].

When making critical treatment decisions, shared decision-making (SDM) between healthcare providers and patients is essential. SDM involves discussing care options, considering patient preferences, and ensuring decisions align with patient values and medical conditions. This process becomes challenging in life-threatening emergencies, where time constraints hinder thorough discussions and coordination among healthcare providers, potentially leading to inappropriate care.

Intravenous Opioid Administration During Mechanical Ventilation and Use After Hospital Discharge.

Importance: Guidelines recommend an analgesia-first strategy for sedation during mechanical ventilation, but associations between opioids provided during mechanical ventilation and posthospitalization opioid-related outcomes are unclear.

Objective: To evaluate associations between an intravenous opioid dose received during mechanical ventilation and postdischarge opioid-related outcomes in medical (nonsurgical) patients.

Design, Setting, And Participants: This retrospective cohort study evaluated adults receiving mechanical ventilation lasting 24 hours or more for acute respiratory failure and surviving hospitalization.

Cross-cultural adaptation and psychometric validation of the French version of the Defense and Veterans Pain Rating Scale for acute and chronic pain: a prospective clinical study.

Background: Pain assessment and proper evaluation of pain are prerequisites for treatment of acute and chronic pain. Until now, most evaluations have used only resting pain intensity and a unidimensional scale, although multidimensional pain assessment and especially assessment of functional pain impact on activities are recommended. The Defense and Veterans Pain Rating Scale (DVPRS) permits this multidimensional assessment, but no validated French translation exists.

Patient and proxy perspectives in decision-making for geriatric hip fracture management in the Netherlands: a qualitative study.

Objective: The objective of this study was to explore the perspectives with the decision-making process between surgery and palliative, non-operative management of geriatric hip fracture patients and their proxies.

Design: qualitative interview study was performed. Patients and proxies were asked to participate in semi-structured interviews.

Respect for the Patient-Oncologist Relationship May Limit Serious Illness Communication by Acute and Postacute Care Clinicians After Discharge to a Skilled Nursing Facility.

Purpose: There is a need to increase palliative care access for hospitalized older adults with cancer discharged to a skilled nursing facility (SNF) at risk of poor outcomes. Assessing and Listening to Individual Goals and Needs (ALIGN) is a palliative care intervention developed to address this gap. This study gathered perspectives from clinicians across care settings to describe perceptions on serious illness communication and care coordination for patients with cancer after discharge to a SNF to guide ALIGN refinements.

Exploring Antipsychotic Use for Delirium Management in Adults in Hospital, Sub-Acute Rehabilitation and Aged Care Settings: A Systematic Literature Review.

Background: International guidelines discourage antipsychotic use for delirium; however, concerns persist about their continued use in clinical practice.

Objectives: We aimed to describe the prevalence and patterns of antipsychotic use in delirium management with regard to best-practice recommendations. Primary outcomes investigated were prevalence of use, antipsychotic type, dosage and clinical indication.

Palliative Care of Stroke Patients.

Critical care clinicians frequently care for patients with acute brain injury, such as stroke. Regardless of the severity of the neurologic insult, these patients have life-altering deficits that threaten their personal identity and quality of life. The sudden nature of the injury often means that there has been little discussion between patients and their families about life-sustaining treatments, and most patients are unable to speak for themselves because of impaired cognition and communication.

Quality indicators to monitor the quality and safety of care for older people: a scoping review protocol.

Objective: The objective of this review is to identify quality indicators used to monitor the quality and safety of care provided to older people (≥ 65 years old) in 8 care settings: primary care; hospital/acute care; aged care (including residential aged care and home or community care); palliative care; rehabilitation care; care transitions; dementia care; and care in rural areas.

Introduction: There is a need for high-quality, holistic, person-centered care for older people. Older people receive care across multiple care settings, and population-level monitoring of quality and safety of care across settings represents a significant challenge.

A systematic review on the impact of sub-epidermal moisture assessments on pressure ulcer/injury care delivery pathways.

To assess all published studies which describe what happens to the delivery of pressure ulcer/injury (PI/PU) care pathways as a result of detecting raised sub-epidermal moisture (SEM) delta (∆ ≥ 0.6). We undertook a systematic review of the literature, and included original research studies using either a prospective or retrospective study design that report the impact that assessment using SEM assessments have on healthcare practitioners' delivery of PI/PU care pathways in adults at risk of developing PI/PUs.

In-Hospital vs 30-Day Sepsis Mortality at US Safety-Net and Non-Safety-Net Hospitals.

Importance: In-hospital mortality of patients with sepsis is frequently measured for benchmarking, both by researchers and policymakers. Prior studies have reported higher in-hospital mortality among patients with sepsis at safety-net hospitals compared with non-safety-net hospitals; however, in critically ill patients, in-hospital mortality rates are known to be associated with hospital discharge practices, which may differ between safety-net hospitals and non-safety-net hospitals.

Objective: To assess how admission to safety-net hospitals is associated with 2 metrics of short-term mortality (in-hospital mortality and 30-day mortality) and discharge practices among patients with sepsis.

Long-Term Engagement of Patients With Advanced Cancer: Results From the EPAC Randomized Clinical Trial.

Importance: The long-term effect of interventions that assist patients with establishing their end-of-life care preferences among patients with cancer remain relatively unknown.

Objective: To evaluate the association of a long-term intervention of a lay health worker-led advance care planning intervention among patients with advanced stages of cancer with overall survival and end-of-life health care use and costs.

Design, Setting, And Participants: This follow-up study of the EPAC randomized clinical trial conducted between August 2013 and February 2015 used data from 9.

Exploring the use of body worn cameras in acute mental health wards: a mixed-method evaluation of a pilot intervention.

Background: Body worn cameras (BWC) are mobile audio and video capture devices that can be secured to clothing allowing the wearer to record some of what they see and hear. This technology is being introduced in a range of healthcare settings as part of larger violence reduction strategies aimed at reducing incidents of aggression and violence on inpatient wards, however limited evidence exists to understand if this technology achieves such goals.

Aim: This study aimed to evaluate the implementation of BWCs on two inpatient mental health wards, including the impact on incidents, the acceptability to staff and patients, the sustainability of the resource use and ability to manage the use of BWCs on these wards.