Journal of the American Geriatrics Society
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Randomized Controlled Trial
Randomized controlled trial of a prehospital decision system by emergency medical services to ensure optimal treatment for older adults in Sweden.
To evaluate the feasibility and appropriateness of a prehospital system allowing ambulance nurses to transport older adults directly to geriatric care at a community-based hospital (CH) or to an emergency department (ED). ⋯ Ambulance nurses are able to send older adults to an alternative healthcare facility with the help of a prehospital decision support system. In this geographical setting, this appears to be a promising method to optimize resources and improve emergency care of elderly adults.
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Randomized Controlled Trial Multicenter Study
A standardized, bundled approach to providing geriatric-focused acute care.
To determine whether a bundled intervention can increase detection of delirium and facilitate safer use of high-risk medications. ⋯ An intervention focused on delirium prevention and recognition by bedside staff combined with computerized decision support facilitates safer prescribing of high-risk medications and possibly results in less need for extended care.
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Randomized Controlled Trial
Integrated telehealth care for chronic illness and depression in geriatric home care patients: the Integrated Telehealth Education and Activation of Mood (I-TEAM) study.
To evaluate an integrated telehealth intervention (Integrated Telehealth Education and Activation of Mood (I-TEAM)) to improve chronic illness (congestive heart failure, chronic obstructive pulmonary disease) and comorbid depression in the home healthcare setting. ⋯ Integrated telehealth care for older adults with chronic illness and comorbid depression can reduce symptoms and postdischarge ED use in home health settings.
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Randomized Controlled Trial
An electronic health record-based intervention to increase follow-up office visits and decrease rehospitalization in older adults.
To assess the effect of an electronic health record-based transitional care intervention involving automated alerts to primary care providers and staff when older adults were discharged from the hospital. ⋯ This electronic health record-based intervention did not have a significant effect on the timeliness of office visits to primary care providers after hospitalization or risk of rehospitalization.
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Randomized Controlled Trial Multicenter Study
Successfully reducing antibiotic prescribing in nursing homes.
To determine whether antibiotic prescribing can be reduced in nursing homes using a quality improvement (QI) program that involves providers, staff, residents, and families. ⋯ This magnitude of effect is unusual in efforts to reduce antibiotic use in nursing homes. Outcomes could be attributed to the commitment of the providers; outreach to providers and staff; and a focus on common clinical situations in which antibiotics are generally not indicated; and suggest that similar results can be achieved on a wider scale if similar commitment is obtained and education provided.