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Transitional Care of Adults with Chronic Diseases Post-Discharge from Acute Settings

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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

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.

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2020-05-05

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Elder Abuse: Issues and Remediation

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The topic of elder abuse is relatively unknown and not talked about among the general public. Traditionally, society values one’s life the younger that person is on the grounds that the younger person has most likely not experienced life to

The topic of elder abuse is relatively unknown and not talked about among the general public. Traditionally, society values one’s life the younger that person is on the grounds that the younger person has most likely not experienced life to the fullest extent as much as the older person has. The point of bringing up this way of thinking is not to refute it but to point out that a product of this societal mindset is that the elderly population is often forgotten about or placed on a lower priority level when considering medical and safety issues. This is a major factor that contributes to the vulnerability of older persons, who often must give up their autonomy due to the aging process and learn to live while being dependent on a caretaker. Elders are often in situations where they are isolated from the rest of the world and place their trust in their caretakers to help them live out the rest of their lives. Unfortunately, the process of aging and becoming dependent opens up the opportunity for this vulnerable age group to be taken advantage of and abused. The National Council on Aging reported that about 1 in 10 elderly Americans that are 60 years old or older have been abused in some capacity, and only about 1 in 14 of these cases are reported (NCOA, 2020). As the world population ages, these statistics face the risk of getting worse and exposing more elders to abuse while less and less abuse cases are reported to authorities. This presents the opportunity for elder abuse research to guide healthcare institutions that are related to caring for the elderly on how to care for and prevent elder abuse from occurring; however, this research is quite limited in comparison to the research, treatments, and prevention programs developed for other types of domestic abuse. The aim of this paper is to create an overall understanding of elder abuse as a whole and get a sense of the state of elder abuse so recommendations can be made on how to proceed in bettering the current issues elder abuse faces.

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2020-05

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Use of Virtual Reality Videos to Reduce Anxiety for Radiation Oncology Patients

Description

Purpose: To implement a non-pharmacologic approach to reduce anxiety in patients receiving radiation treatment.

Background and Significance: Anxiety is a prevalent health problem affecting up to 30% of the general population. Over 95% of radiation oncology patients report anxiety often related

Purpose: To implement a non-pharmacologic approach to reduce anxiety in patients receiving radiation treatment.

Background and Significance: Anxiety is a prevalent health problem affecting up to 30% of the general population. Over 95% of radiation oncology patients report anxiety often related to not knowing what to expect during treatments. The current guideline for management of anxiety is the use of benzodiazepines; which can impose a risk to patients. Evidence demonstrates virtual reality videos can be an effective non-pharmacologic approach to reduce anxiety..

Design: Observational cohort evidence based project.

Setting: Outpatient radiation oncology facility in the Southwest United States.

Sample: 40 patients who have not previously undergone radiation therapy, but have been prescribed radiation treatments for malignant or non malignant conditions.

Methods: Patients who had not previously undergone radiation treatments were identified based on chart review and consented for participation in the project. The patient's were assessed for both their general (trait) anxiety and situational (state) anxiety using The State Trait Anxiety inventory (STAI). They were then shown a virtual reality video that walked them through what they would experience during their radiation treatment. The patient's were re-administered the STAI questionnaire following the video to assess any change in anxiety levels.

Variables: Trait and State anxiety scores before and after the virtual reality video intervention.

Findings/Outcomes: A paired t-test was conducted to assess the data. There was a significant difference in the state anxiety scores pre intervention (m = 32.65, SD = 11.47) and post intervention (M = 25.50, SD 8.95), p =< 0.001.

Conclusions: The use of virtual reality videos was an effective non-pharmacological approach to reduce anxiety in patients receiving radiation treatment.

Implications for nursing: The results provide support for the use of a virtual reality intervention as a non-pharmacologic option to reduce anxiety for patients.

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2017-05-02