Derivation and Confirmation of Scales Measuring Medical Directors’ Attitudes About the Hospitalization of Nursing Home Residents

Marcantonio, Edward R.; O’Malley, A. James; Murkofsky, Rachel L.; Caudry, Daryl J.; Buchanan, Joan L.

doi:10.1177/0898264306293617

Cited by 3 publications

(7 citation statements)

References 25 publications

(36 reference statements)

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“…In terms of resident factors, key issues include the acuteness of the illness, its impact on the quality of life of the resident and the likelihood of it causing death or disability (Buchanan et al. 2006, Cohen‐Mansfield & Lipson 2006, Marcantonio et al. 2006).…”

Section: Introductionmentioning

confidence: 99%

“…A further issue is the variability in attitudes of physicians about the importance of aggressive treatments and their confidence in nursing home levels of care (Buchanan et al. 2006, Marcantonio et al. 2006).…”

Section: Introductionmentioning

confidence: 99%

“…In terms of resident factors, key issues include the acuteness of the illness, its impact on the quality of life of the resident and the likelihood of it causing death or disability , Cohen-Mansfield & Lipson 2006, Marcantonio et al 2006. Another important issue is resident preferences and whether these are known to staff (Bottrell et al 2001.…”

Section: Introductionmentioning

confidence: 99%

“…Structural issues play an important role in decisions about transferring a resident to hospital (Carter 2003, Cortes et al 2004, Intrator et al 2004, Porell & Carter 2005, Finn et al 2006, Marcantonio et al 2006. These include the number and skill levels of nursing home staff; the capacity and willingness of these staff to care for residents with high-level needs; alternatives to hospital such as outreach services to the nursing home or ambulatory care clinics; case-mix levels and bed supplies in local hospitals and nursing homes; and clinical support for staff, especially after hours.…”

Section: Introductionmentioning

confidence: 99%

“…Another issue is the poor communication from physicians that is reported by family carers of nursing home residents . A further issue is the variability in attitudes of physicians about the importance of aggressive treatments and their confidence in nursing home levels of care , Marcantonio et al 2006). This point is illustrated by Cohen-Mansfield and Lipson (2006), who compared the decision-making by several physicians in the one nursing home and found the rates of hospitalisation varied from 91-20%.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Decisions about transferring nursing home residents to hospital: highlighting the roles of advance care planning and support from local hospital and community health services

Shanley

Whitmore

Conforti

et al. 2011

Journal of Clinical Nursing

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…In terms of resident factors, key issues include the acuteness of the illness, its impact on the quality of life of the resident and the likelihood of it causing death or disability , Cohen-Mansfield & Lipson 2006, Marcantonio et al 2006. Another important issue is resident preferences and whether these are known to staff (Bottrell et al 2001.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Decisions about transferring nursing home residents to hospital: highlighting the roles of advance care planning and support from local hospital and community health services

Shanley

Whitmore

Conforti

et al. 2011

Journal of Clinical Nursing

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Decision to transfer to an emergency department from residential aged care: A systematic review of qualitative research

Arendts

Quine

Howard

2013

Geriatrics Gerontology Int

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Aim:If developing policies to optimize quality acute care within residential aged care facilities (RACF) is a goal, understanding the factors that influence the decision to transfer a resident from RACF to hospital emergency departments is important. The aim of the present study was to review the published literature pertaining to transfer decisions. Methods:We carried out a systematic review of the qualitative literature to ascertain key influences on transfer decisions amongst three key stakeholder groups -residents, their family and carers.Results: From 11 papers we found two themes encompassing seven domains of influence. Transfers are influenced by an expectation or goal of improved resident clinical or quality of life outcomes -these are domains within the "resident dominant" theme. However, transfers also occur where there is no expectation of resident benefit. These domains, such as inadequate facility resourcing and care planning, are categorized within the "resident subordinate" theme. Conclusion:Transfer decisions are often influenced by considerations beyond expected benefit to the individual resident. Conceptualizing influences on transfer decisions within this framework might assist clinicians and policy makers in the design and delivery of services for RACF residents. Geriatr Gerontol Int 2013; 13: 825-833.

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Remaining in the Nursing Home Versus Transfer to Acute Care: Resident, Family, and Staff Preferences

Tappen¹,

Worch²,

Elkins³

et al. 2014

J Gerontol Nurs

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Resident and family insistence on transfer is a major factor in the occurrence of potentially avoidable transfers from nursing homes (NHs) to acute care. The purpose of this study was to explore resident, family, and staff preferences regarding transfer to acute care. A sample of 271 NH residents, family members, staff, and medical providers were interviewed. Seventy-seven percent of residents reported that they had not given any thought to the question of whether they would want to be transferred to acute care. Family members wanted more information than residents, but more residents (39%) thought they should be fully involved in the transfer decision than their family members (12%) or staff (12%). Staff preferred keeping residents in the NH. Families were divided between transferring residents and having them remain in the NH. More residents indicated that their desire to transfer would depend on the severity of their condition and their prognosis. Ethnic group differences were noted. Results suggest that discussion of this issue should occur soon after admission and that differences in perspectives may be expected from those involved.

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Derivation and Confirmation of Scales Measuring Medical Directors’ Attitudes About the Hospitalization of Nursing Home Residents

Abstract: Medical directors identify multiple determinants of hospitalization for nursing facility residents across several domains. Hospitalization decisions for nursing facility residents are complex and involve clinical and nonclinical factors.

Cited by 3 publications

References 25 publications

Decisions about transferring nursing home residents to hospital: highlighting the roles of advance care planning and support from local hospital and community health services

Decisions about transferring nursing home residents to hospital: highlighting the roles of advance care planning and support from local hospital and community health services

Decision to transfer to an emergency department from residential aged care: A systematic review of qualitative research

Remaining in the Nursing Home Versus Transfer to Acute Care: Resident, Family, and Staff Preferences

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