Objectives
To compare the outcomes of readmission, mortality and treatment‐related complications in older people treated by hospital in the home (HITH) for acute decompensated congestive cardiac failure (CCF) with those treated in hospital.
Methods
Retrospective cohort study of patients 65 years and older treated by HITH over a 30‐month period compared with age‐ and sex‐matched patients treated in hospital.
Results
There was no difference between the “HITH” and “Hospital” cohorts in mortality within 60 days of discharge (P = 0.5), time to death (P = 0.8), 30‐day (P = 0.7) and 60‐day (P = 0.4) readmissions, time to readmission (P = 0.9) and complication rate (P = 0.1). HITH patients had longer length of stay (P = 0.001) but lower cost per day of admission ($669.42 vs $1377.58).
Conclusion
In appropriately selected older patients, HITH is a safe, efficacious and cost‐effective alternative to inpatient management of acute decompensated CCF.
Mental health nurses are exposed to high levels of aggressive and challenging patient behaviours. This can cause stress and burnout which is associated with poor staff, patient, and organization outcomes, including unplanned nursing staff leave (UNSL). This study explores the correlation between a patient behaviour tool (RAGE), variations of which are frequently used in mental health and psychogeriatric nursing, and the staff outcome of UNSL. The study is reported according to the STROBE Statement for reporting of observational studies. RAGE scores and ward characteristics were recorded weekly for 26 weeks on an Australian metropolitan psychogeriatric ward and correlated with UNSL for the same week and the following week (allowing for any ‘lag effect’ behaviours may have on leave). There was a moderate negative correlation between mean RAGE score and UNSL for the same week (r = −0.34) and no correlation the following week (r = 0.08). Similarly, there was low to no correlation between ward characteristics and UNSL. The trends seen in this exploratory study should be further interrogated in adequately powered future studies. UNSL is likely influenced by complex factors including staff experience, coping mechanism, and specific patient behaviours such as physical or verbal aggression and whether the behaviours resulted in injury, which should be included in future studies. The novel strategy of utilizing patient‐centred tools to predict staff outcomes is feasible and warrants further exploration.
patients with HIV infection in 2008 are still significantly more likely to present with plantar verrucae after controlling for age, race, and sex. This increased likelihood has not changed significantly across time. Because HAART has increased the life expectancy of patients with HIV, this group of patients with plantar verrucae will continue to represent a significant population in the practice of podiatric medicine.
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