Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care settings or home. A patient centered transitional care program was implemented at an outpatient primary care facility to reduce readmission rates. Institutional Review Board approval was obtained.

Twenty adult patients with chronic diseases discharged from an acute setting were identified. A follow up phone call and/or a home visit within 24-72 hours post discharge was employed. The Care Transitions Measure (CTM®) and Medication Discrepancy Tool (MDT®) were utilized to identify quality of care of transition and medication discrepancies. A chart audit collected data on the age of participant, diagnosis for initial hospitalization, CTM score, home visit, and ED visits or re-hospitalizations after 30 days of discharge. The outcome indicated that transitional care within primary care utilizing evidence-based practices is beneficial in reducing readmission rates. A logistic regression showed model significance, p = .002, suggesting that the CTM score was effective for both telephone support (TS) and home visit (HV).

A correlation analysis showed that as age of participants increased, the CTM score decreased, indicating that older adults required more support. A significance p <.001, of a proportional test indicated that readmission rates after the intervention was lower. It is evident that providing a timely and effective transitional care intervention in a primary care setting can reduce hospital readmissions, improve symptom management and quality of life of adult patients with chronic diseases.

Elective cosmetic surgery has grown more popular in the last several decades, including procedures specifically targeted at older adults and anti-aging. The aim of this study is to better understand elective cosmetic surgery rationale for older adults. The first part of the study summarizes literature on elective cosmetic surgery for older adults and determines what factors influence the desire for elective cosmetic procedures. From the research databases PubMed, JSTOR, and ScienceDirect, eighteen sources were referenced in the final review. The review found that there are differences in sociocultural views of men and women as they age as well as internal views of aging. The modest number of studies used in the literature review reflect a current gap in current research studying elective cosmetic surgery in older adults. For the second part of the study, data was collected from a 2018 survey designed to better understand aging, body image, and subjective age. The survey was limited to individuals living in the United States aged 40 and above and was deployed through MTurk (Mechanical Turk). A total of 1199 responses were received. Only participants 55 years and above are included for the purpose of this study. Most participants who answered the question for elective cosmetic surgery rationale answered that their primary rationale is to reduce age-related physical markers. For participants identifying as female, nine percent cited self-esteem as their rationale while no male-identifying participants responded similarly. Future research can include questions on internal and external factors older adults feel have the greatest impact on their decision to have elective cosmetic procedures.

Skin and soft tissue infections (SSTI’s) are a significant health concern with serious potential implications. Evidence suggests the importance of implementing a severity stratification tool to improve early identification of SSTI’s. The aim of this evidence based project is to examine if educating healthcare staff on the use of a severity stratification tool would increase staff knowledge of SSTI's. The sample consisted of 18 participants, 12 healthcare providers and 6 healthcare staff at a correctional facility in the Southwestern United States. A pre-and posttest design, including an educational session was implemented.

A 14-item multiple choice self-developed questionnaire was used to evaluate participants’ knowledge of identifying and ranking SSTI’s using the CREST tool. A one tail paired t-test was performed to compare the pre-and post-test case study scores for the healthcare provider group. A significant increase from pre-test to post-test case study scores was found (t(13)= -6.19, p < 0.00). Of the healthcare providers, 57% found the tool “moderately helpful.” Of the non-provider sample, 50% found the tool “extremely helpful” and plan to use the tool “all of the time.” The findings of this study suggest that implementing an educational session on a wound severity stratification tool improves staff knowledge and increases the likelihood of the tool being used in practice. Recommendations for future research include larger sample sizes across a variety of regional correctional facilities to further explore the use and knowledge of the tool in practice.