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Sergio Ariño Blasco
onto interRAI April 11, 2020 7:20 AM
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Download this DIVERT Scale SQL script and share with your IM/IT staff to generate reports to target patients using based on their most recent interRAI-HC.
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Read the full article at: www.jamda.com
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The Cognitive Performance Scale (CPS) in the widely used interRAI suite of instruments is of interest to clinicians and policy makers as a potential screening mechanism for detecting dementia. Read the full article at: pubmed.ncbi.nlm.nih.gov
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Read the full article at: bmchealthservres.biomedcentral.com
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Background/Objectives Persons with dementia frequently demonstrate distress behaviors in dementia (DBD), associated with poorer outcomes. This study aimed to create a measure of DBD from routinely administered Minimum Data Set (MDS 3.0) behavior section items that demonstrated sensitivity to change, for evaluation of intervention efforts for VA Community Living Center (CLCs) residents exhibiting DBD.
The Distress Behavior in Dementia Indicator (DBDI) was created as a consistent factor with internal consistency, and was related to a validated measure as predicted at baseline and post‐intervention. Sensitivity to change was demonstrated by using change score correlations (r = 0.40–0.50), effect size (d = 0.63), and reliable change indices.
The DBDI is recommended for routine use in CLCs to evaluate impact of intervention effectiveness and provide quality improvement feedback.
Read the full article at: agsjournals.onlinelibrary.wiley.com
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In this cohort of older people with complex needs who had a mandated standardised interRAI-HC assessment, predictive models with 16 and 22 variables respectively provided accurate and precise risk predictions for one-year and three-month mortality. The calibratio was excellent and the AUCs, a measure of the ability of the model to discriminate between those who do and do not die, of 0.78 and 0.84 were good and were high compared with other similar models.
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The study showed that the RUG-III system offers possibilities for identifying persons at risk of institutionalization. Interventions designed to avoid early nursing home admission can make use of the RUG-III system to optimize care planning and the allocation of services and resources. Based on the …
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GERAS Frailty Rehabilitation at Home During COVID-19 - Full Text View.
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To the best of our knowledge, this is the first study to predict hospital admission in older ED patients using a series of geriatric syndromes and functional assessments. We were able to predict hospital admission in older ED patients with good accuracy using the items available in the interRAI ED Contact Assessment. This information can be used to inform decision-making about ED disposition and may expedite admission processes and proactive discharge planning.
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Geriatric assessment upon admission may reveal factors that contribute to adverse outcomes in hospitalized older patients. The purposes of this study were to derive a Frailty Index (FI-PAC) from the interRAI Post-Acute Care instrument (interRAI-PAC) and to analyse the predictive ability of the FI-PAC and interRAI scales for hospital outcomes. This retrospective cohort study was conducted by combining patient data from interRAI-PAC with discharge records from two post-acute care hospitals. The FI-PAC was derived from 57 variables that fulfilled the Frailty Index criteria. Associations of the FI-PAC and interRAI-PAC scales (ADLH for activities of daily living, CPS for cognition, DRS for mood, and CHESS for stability of health status) with hospital outcomes (prolonged hospital stay ≥90 days, emergency department admission during the stay, and in-hospital mortality) were analysed using logistic regression and ROC curves. The Frailty Index derived from interRAI-PAC predicts adverse hospital outcomes. Its predictive ability was similar to that of the ADLH scale, whereas other interRAI-PAC scales had less predictive value. In clinical practice, assessment of functional ability is a simple way to assess a patient’s prognosis.
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An Andalusian delegation visits the Basque Country to learn about the political framework and experiences regarding social and healthcare...
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The pragmatic attitude of the trial towards cluster selection, cluster assignment, participant selection, participant recruitment, informed consent and outcome measurement supports generalisation to other jurisdictions. Postrandomisation selection bias is limited by the use of existing, objective measures of eligibility. The use of secondary data for baseline data collection and follow-upmeasurement increases the a ccuracy of the data collection and limits the loss to follow-up compared with primary collection methods. It is not possible to conceal the treatment assignment, which exposes half of the primary and secondary outcomes measures to placebo and observer-expectancy effects. The jurisdictions included in the study used a convenience, non-probability sampling approach in cluster selection, which may limit external validity.
Sergio Ariño Blasco's insight:
Andrew Costa y su equipo desarrollan un a herramienta de predicción de visitas a urgencias en la población en atención domiciliaria.
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Read the full article at: www.jamda.com
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Read the full article at: pubmed.ncbi.nlm.nih.gov
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Background: Bridging scores generated from different cognitive assessment tools is necessary to efficiently track changes in cognition across the continuum of care. This study linked scores from the Montreal Cognitive Assessment-5 min (MoCA 5-min) to the interRAI cognitive Performance Scale Read the full article at: pubmed.ncbi.nlm.nih.gov
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Read the full article at: philonedtech.com
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Read the full article at: myemail.constantcontact.com
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Read the full article at: www.jamda.com
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Clinicians struggle with whether to prescribe osteoporosis medications for fracture
prevention for older nursing home (NH) residents with dementia, given the lack of evidence in this population. To better understand real-world clinical practice, we conducted a retrospective cohort study examining...
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Frailty measures from the interRAI CA identified patients at higher risk for death, hospital admission and perceived need for CGA. In jurisdictions where the CHESS-CA and AUA are already built into the electronic home care platform, such as Ontario, patients identified as high risk should be prioritized for proactive referral and care planning, and may benefit from greater involvement of primary care and other health professionals in the circle of care.
Sergio Ariño Blasco's insight:
Uso potencial en priorización de pacientes CIMSS para ingreso en Unidades de Larga Estancia Sociosanitaria ante la ausencia de instrumentos alternativos. Otra vez afirmamos que el uso de herramientas universales, estandarizadas y transparentes suponen un plus en el proceso de asignación de recursos.
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John P. Hirdes, Anja Declercq, Harriet Finne-Soveri, Brant E. Fries, Leon Geffen, George Heckman, Terry Lum, Brigette Meehan, Nigel Millar and John N. Morris | Five major changes to long-term care can protect the elderly from the ravages of infectious disease and provide a greater quality of...
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OBJECTIVES To compare the diagnostic accuracy of the Identification of Seniors at Risk, the Flemish version of Triage Risk Screening Tool, and the interRAI Emergency Department for predicting prolonged emergency department (ED) length of stay, hospitalization (following index ED stay), and unplanned ED readmission at 30 and 90 days among older (aged ≥70 years) community-dwelling adults admitted to the ED.
Sergio Ariño Blasco's insight:
Authors conclusion, this study reported that diagnostic charac teristics of ISAR, fTRST, and iEDS are comparable and that none of these tools accurately predicts prolonged ED LOS, hospitalization, and unplanned ED readmission at 30 and 90 days, when used as a stand-alone index.
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Download this DIVERT Scale SQL script and share with your IM/IT staff to generate reports to target patients using based on their most recent interRAI-HC.
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Fedecostante M, Onder G, Eusebi P, Dell'Aquila G, Zengarini E, Carrieri B, et al. Predictors of functional decline in nursing home residents: the Shelter project. J Gerontol A Biol Sci Med Sci. 2019.
The aim of our study was to identify independent predictors of functional decline in older nursing home (NH) residents, taking into account both resident and facility characteristics. Methods Longitudinal observational study involving 1,760 older (≥65 y) residents of NH participating in the SHELTER* study (57 NH in eight countries). All residents underwent a comprehensive geriatric assessment using the interRAI LTCF. Functional decline was defined as an increase of at least one point in the MDS Long Form ADL scale during a 1 year follow-up. Facility and country effects were taken into account. Results During the study period 891 (50.6%), NH residents experienced ADL decline. Residents experiencing ADL decline were older, had lower disability at baseline, were more frequently affected by severe dementia and by urinary incontinence, and used more antipsychotics. In the mixed-effect logistic regression model, factors independently associated with a higher risk of functional decline were dementia and urinary incontinence, whereas the presence of a geriatrician was a protective factor. Conclusions Both resident and facility characteristics are associated with the risk of functional decline in NH residents. Increasing the quality of healthcare by involving a geriatrician in residents’ care might be an important strategy to improve the outcome of this vulnerable population.
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