Nursing homes became epicenters of COVID-19 in the spring of 2020. Due to the substantial case fatality rates within congregate settings, federal agencies recommended restrictions to family visits. ...Six months into the COVID-19 pandemic, these largely remain in place. The objective of this study was to generate consensus guidance statements focusing on essential family caregivers and visitors.
A modified 2-step Delphi process was used to generate consensus statements.
The Delphi panel consisted of 21 US and Canadian post-acute and long-term care experts in clinical medicine, administration, and patient care advocacy.
State and federal reopening statements were collected in June 2020 and the panel voted on these using a 3-point Likert scale with consensus defined as ≥80% of panel members voting "Agree." The consensus statements then informed development of the visitor guidance statements.
The Delphi process yielded 77 consensus statements. Regarding visitor guidance, the panel made 5 strong recommendations: (1) maintain strong infection prevention and control precautions, (2) facilitate indoor and outdoor visits, (3) allow limited physical contact with appropriate precautions, (4) assess individual residents' care preferences and level of risk tolerance, and (5) dedicate an essential caregiver and extend the definition of compassionate care visits to include care that promotes psychosocial well-being of residents.
The COVID-19 pandemic has seen substantial regulatory changes without strong consideration of the impact on residents. In the absence of timely and rigorous research, the involvement of clinicians and patient care advocates is important to help create the balance between individual resident preferences and the health of the collective. The results of this evidence-based Delphi process will help guide policy decisions as well as inform future research.
SED by AD: Prepare to Respect Patient Wishes Haimowitz, Daniel; Pope, Thaddeus M
Journal of the American Medical Directors Association,
10/2023, Letnik:
24, Številka:
10
Journal Article
Assisting with food glorious food Stefanacci, Richard G.; Haimowitz, Daniel
Geriatric nursing (New York),
March-April 2016, 2016 Mar-Apr, 2016-03-00, 20160301, Letnik:
37, Številka:
2
Journal Article
Recenzirano
Food is one of the essentials of life not only for nourishment of the body but mind and soul. Despite the important place that food plays it is not typically thought of in terms of routine health ...care and is often overlooked by nurses and other health care providers. Here, Stefanacci and Haimowitz talk about food preparation.
Geriatric Zebras Stefanacci, Richard G.; Haimowitz, Daniel
Geriatric nursing (New York),
01/2016, Letnik:
37, Številka:
1
Journal Article
Recenzirano
Every provider has a few examples of rare cases that they have come across during their career; often people refer to these cases as 'Zebras' because of their rarity. Because common diseases are much ...more likely to present in an usual fashion in the elderly than an uncommon disease presenting in its typical manner, health care professionals are taught "When people hear hoof beats, think of horses, not zebras." Occasionally though in a field of common everyday horses, these Zebras exist, failing to be recognized because they are so very focused on all of the horses that they normally encounter. Here, Stefanacci and Haimowitz describe several geriatric Zebras.
The Beers criteria for Potentially Inappropriate Medication Use in Older Adults was initially developed by a group of 12 clinicians with expertise in geriatrics and led by Dr Mark Beers as a guide ...for health care professionals to improve the safety of prescribing medications in the nursing home setting. The list, which has recently been updated, emphasizes deprescribing medication which reduces the problems of high risk-benefit ratio, polypharmacy, drug interactions, and adverse drug reactions since this population is particularly at risk for medication-related problems. Stefanacci and Haimowitz present three basic quotes that will provide direction for nurses for improved medication management.
Breathing a little bit easier Stefanacci, Richard G.; Haimowitz, Daniel
Geriatric nursing (New York),
11/2015, Letnik:
36, Številka:
6
Journal Article
Recenzirano
With COPD being one of the top diagnosis for LTC residents, occurring in some 15%, this is a significant and growing problem, one that impacts quality of life as well as use of resources. This is ...witnessed by the fact that half of COPD residents require hospitalization in a given year and almost 7% being hospitalized twice. COPD is usually a progressive illness characterized by persistent airflow obstruction, with a significant inflammatory component. Common symptoms include shortness of breath, cough and chronic sputum production. Stefanacci and Haimowitz discuss COPD diagnosis, treatment, and prevention.
Quick call 911 or maybe not… More than little old women Stefanacci, Richard G.; Haimowitz, Daniel
Geriatric nursing (New York),
July-August 2015, 2015 Jul-Aug, 2015-07-00, 20150701, Letnik:
36, Številka:
4
Journal Article
Recenzirano
The need to recognize the first signs and symptoms for attacks on the brain and heart at the earliest stage starts with the patient themselves. Unfortunately patients may often fail to realize the ...significance of these signs and symptoms. Even when patients do understand the potential importance of their condition and seek out assistance their caregivers may not accurately grasp the need for emergency medical care. These misperceptions require changes so that timely and possible life-saving care can be provided. Early identification and timely notification of these critical "acute" attacks is of the utmost importance since optimal treatment of these conditions is extremely time sensitive. Here, Stefanacci and Haimowitz discuss how to recognize cases of "acute" brain and heart attacks.
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