Care management journals : Journal of case management ; The journal of long term home health care
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Describe and evaluate a method for assessing whether physical restraint prevalence differs by timing and frequency of data collection and to determine the minimum period of observation necessary to provide accurate prevalence estimates on both Intensive Care Unit (ICU) and medical-surgical units. ⋯ Direct observation by trained observers, supplemented by nurse report and medical record documentation over brief monitoring periods, results in accurate, nonintrusive, cost-efficient estimates of physical restraint prevalence. As few as seven consecutive or nonconsecutive days in measuring restraint prevalence is sufficient to obtain accurate estimates, although the number of days may vary depending on patient mix and unit type.
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On June 11, 2007, the U. S. ⋯ This article discusses the legal issues argued in the case and the legal rationales for the court's decision. The article then identifies the important public policy questions involving the maintenance of a sufficient, competent home care workforce that were left unanswered by the legal ruling and outlines some of the pragmatic implications of potential responses to these public policy questions.
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Incorporating home care education into the medical school curriculum is essential for providing a learning experience not duplicated elsewhere. Students rotating through family medicine write a reflection paper on their experiences. The papers about home visits from July 2000 to June 2004 were analyzed by a constant comparison technique developing seven themes: student paradigm shift in their understanding of causes vs. efects of disease, misconceptions about treatment, access to care, a return to the roots of medicine, quality of family caregiving, broader implications of providing care, and controversial issues. The students'papers demonstrate the unique environment of home visits.
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Comprehensive geriatric assessment (CGA) provides guidance in planning care for elderly patients. The goals of CGA include reduction of health care cost, early recognition and treatment of geriatric syndromes and improved survival and quality of life for patients. ⋯ Strategies for fall prevention, appropriate use of pharmacotherapy, and prevention of in-hospital delirium have grown out of the application of this multidisciplinary tool. Future research focused on a more precise definition of the potential financial benefits of CGA may facilitate the task of communicating its value to decision makers.