Utilization of healthcare services in postpartum women in the Philippines who delivered at home and the effects on their health: a cross-sectional analytical study.

Science.gov (United States)

Yamashita, Tadashi; Reyes Tuliao, Maria Teresa; Concel Meana, Magdalena; Suplido, Sherri Ann; Llave, Cecilia L; Tanaka, Yuko; Matsuo, Hiroya

2017-01-01

A low ratio of utilization of healthcare services in postpartum women may contribute to maternal deaths during the postpartum period. The maternal mortality ratio is high in the Philippines. The aim of this study was to examine the current utilization of healthcare services and the effects on the health of women in the Philippines who delivered at home. This was a cross-sectional analytical study, based on a self-administrated questionnaire, conducted from March 2015 to February 2016 in Muntinlupa, Philippines. Sixty-three postpartum women who delivered at home or at a facility were enrolled for this study. A questionnaire containing questions regarding characteristics, utilization of healthcare services, and abnormal symptoms during postpartum period was administered. To analyze the questionnaire data, the sample was divided into delivery at home and delivery at a facility. Chi-square test, Fisher's exact test, and Mann-Whitney U test were used. There were significant differences in the type of birth attendant, area of residence, monthly income, and maternal and child health book usage between women who delivered at home and those who delivered at a facility ( P Financial and environmental barriers might hinder the utilization of healthcare services by women who deliver at home in the Philippines. Low utilization of healthcare services in women who deliver at home might result in more frequent abnormal symptoms during postpartum.

[Role of Visiting Nursing Care in Japanese Home Healthcare].

Science.gov (United States)

Yu, Sang-Ju

2018-02-01

Taiwan's rapidly aging society is expected to make it a super-aged society in 2026. By 2060, people aged 65 or older will account for 40% of the population, a ratio that will approximate that in Japan. In Japan, the elderly population was 27.3% in 2016. By 2025, when the baby-boomers become 75 years old in Japan, issues of long-term care and end-of-life care will be more important and challenging. Since 1976, more Japanese have died in hospital settings than in home settings. Although the percentage of people dying at home increased slightly to 12.7% in 2016, after the recent introduction and promotion of home healthcare, Japan will face a significant challenge to deal with the healthcare 'tsunami' of high natural death rates, which is expected to impose a heavy death burdened on society by 2040, when the death rate is expected to reach 1,670,000/year. Therefore, the Japanese authorities have begun to promote the Community-based Integrated Care System, in which home healthcare and visiting nursing play crucial roles. This article summarizes the historical trend and current situation of visiting nursing in Japan. Japan uses a hybrid payment system for visiting nursing that is financially supported both through private medical insurance policies and Kaigo insurance (Japanese long-term care insurance). The total of 8613 visiting nursing stations that were active in community settings in 2016 cooperated with 14,000 support clinics for home healthcare and cared for 570,000 patients in home settings. We believe that visiting nursing will play an important role in home healthcare in Taiwan in the future.

Mobile Anwendungssysteme zur Unterstützung ambulanter Pflegedienstleistungen: Anforderungsanalyse und Einsatzpotenziale / Mobile application systems for home nursing services support: requirements analysis and usage potentials

Directory of Open Access Journals (Sweden)

Robert, Sebastian

2011-01-01

Full Text Available Ambulatory nursing services increasingly gain significance due to immediate implications of demographic developments. However, portable application systems have only been established sporadically in home nursing environments unlike in the comparable domain of technical field service. This paper identifies a new mobile usage scenario by matching healthcare requirements with state-of-the-art concepts. Potentials concerning the support of the actual nursing care processes can be concluded on that basis. The results are of relevance not only to patients and nurses but also to various providers of healthcare and IT solutions.

Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes.

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Gordon, Adam L; Goodman, Claire; Davies, Sue L; Dening, Tom; Gage, Heather; Meyer, Julienne; Schneider, Justine; Bell, Brian; Jordan, Jake; Martin, Finbarr C; Iliffe, Steve; Bowman, Clive; Gladman, John R F; Victor, Christina; Mayrhofer, Andrea; Handley, Melanie; Zubair, Maria

2018-01-05

care home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use. a realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners. context-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which 'wraps around' care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites. activities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Geriatrics Society.

Creating a meaningful infection control program: one home healthcare agency's lessons.

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Poff, Renee McCoy; Browning, Sarah Via

2014-03-01

Creating a meaningful infection control program in the home care setting proved to be challenging for agency leaders of one hospital-based home healthcare agency. Challenges arose when agency leaders provided infection control (IC) data to the hospital's IC Committee. The IC Section Chief asked for national benchmark comparisons to align home healthcare reporting to that of the hospital level. At that point, it was evident that the home healthcare IC program lacked definition and structure. The purpose of this article is to share how one agency built a meaningful IC program.

Smart Homes for Elderly Healthcare-Recent Advances and Research Challenges.

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Majumder, Sumit; Aghayi, Emad; Noferesti, Moein; Memarzadeh-Tehran, Hamidreza; Mondal, Tapas; Pang, Zhibo; Deen, M Jamal

2017-10-31

Advancements in medical science and technology, medicine and public health coupled with increased consciousness about nutrition and environmental and personal hygiene have paved the way for the dramatic increase in life expectancy globally in the past several decades. However, increased life expectancy has given rise to an increasing aging population, thus jeopardizing the socio-economic structure of many countries in terms of costs associated with elderly healthcare and wellbeing. In order to cope with the growing need for elderly healthcare services, it is essential to develop affordable, unobtrusive and easy-to-use healthcare solutions. Smart homes, which incorporate environmental and wearable medical sensors, actuators, and modern communication and information technologies, can enable continuous and remote monitoring of elderly health and wellbeing at a low cost. Smart homes may allow the elderly to stay in their comfortable home environments instead of expensive and limited healthcare facilities. Healthcare personnel can also keep track of the overall health condition of the elderly in real-time and provide feedback and support from distant facilities. In this paper, we have presented a comprehensive review on the state-of-the-art research and development in smart home based remote healthcare technologies.

Home Healthcare Workers: How to Prevent Latex Allergies

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... can help prevent allergic reactions for both home healthcare workers and their clients. LATEX EXPOSURE REACTIONS Three ... being used). • Inform your employer and your personal healthcare professionals that you have latex allergy. • Wear a ...

Does a medical home mediate racial disparities in unmet healthcare needs among children with special healthcare needs?

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Bennett, Amanda C; Rankin, Kristin M; Rosenberg, Deborah

2012-12-01

This study extends mediation analysis techniques to explore whether and to what extent differential access to a medical home explains the black/white disparity in unmet healthcare needs among children with special healthcare needs (CSHCN). Data were obtained from the 2007 National Survey of Children's Health, with analyses limited to non-Hispanic white and black CSHCN (n = 14,677). The counterfactual approach to mediation analysis was used to estimate odds ratios for the natural direct and indirect effects of race on unmet healthcare needs. Overall, 43.0 % of white CSHCN and 60.4 % of black CSHCN did not have a medical home. Additionally, 8.8 % of white CSHCN and 15.3 % of black CSHCN had unmet healthcare needs. The natural indirect effect indicates that the odds of unmet needs among black CSHCN are elevated by approximately 20 % as a result of their current level of access to the medical home rather than access at a level equal to white CSHCN (OR(NIE) = 1.2, 95 % CI = 1.1, 1.3). The natural direct effect indicates that even if black CSHCN had the same level of access to a medical home as white CSHCN, blacks would still have 60 % higher odds of unmet healthcare needs than whites (OR(NDE) = 1.6, 95 % CI = 1.1, 2.4). The racial disparity in unmet healthcare needs among CSHCN is only partially explained by disparities in having a medical home. Ensuring all CSHCN have equal access to a medical home may reduce the racial disparity in unmet needs, but will not completely eliminate it.

Home Healthcare Medical Devices: Infusion Therapy - Getting the Most Out of Your Pump

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... Medical Procedures Home Health and Consumer Devices Brochure - Home Healthcare Medical Devices: Infusion Therapy - Getting the Most ... if needed. What is the role of your home healthcare provider and supplier in your infusion therapy? ...

Beyond Self-Monitoring: Understanding Non-functional Aspects of Home-based Healthcare Technology

DEFF Research Database (Denmark)

Grönvall, Erik; Verdezoto, Nervo

2013-01-01

the appropriation of healthcare technologies and people with comorbidity may have diverse but co-existing monitoring needs. In this paper, we seek to understand home-based health monitoring practices to better design and integrate them into people’s everyday life. We perform an analysis of socio......-technical complexities in home-based healthcare technologies through three case studies of self-monitoring: 1) pre-eclampsia (i.e. pregnancy poisoning), 2) heart conditions, and 3) preventive care. Through the analysis seven themes emerged (people, resources, places, routines, knowledge, control and motivation) that can...... facilitate the understanding of home-based healthcare activities. We present three modes of self-monitoring use and provide a set of design recommendations for future Ubicomp designs of home-based healthcare technology....

Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention.

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Markkanen, Pia; Galligan, Catherine; Laramie, Angela; Fisher, June; Sama, Susan; Quinn, Margaret

2015-04-11

Home healthcare is one of the fastest growing sectors in the United States. Percutaneous injuries from sharp medical devices (sharps) are a source of bloodborne pathogen infections among home healthcare workers and community members. Sharps use and disposal practices in the home are highly variable and there is no comprehensive analysis of the system of sharps procurement, use and disposal in home healthcare. This gap is a barrier to effective public health interventions. The objectives of this study were to i) identify the full range of pathways by which sharps enter and exit the home, stakeholders involved, and barriers for using sharps with injury prevention features; and ii) assess the leverage points for preventive interventions. This study employed qualitative research methods to develop two systems maps of the use of sharps and prevention of sharps injuries in home healthcare. Twenty-six in-depth interview sessions were conducted including home healthcare agency clinicians, public health practitioners, sharps device manufacturers, injury prevention advocates, pharmacists and others. Interview transcripts were audio-recorded and analyzed thematically using NVIVO qualitative research analysis software. Analysis of supporting archival material also was conducted. All findings guided development of the two maps. Sharps enter the home via multiple complex pathways involving home healthcare providers and home users. The providers reported using sharps with injury prevention features. However, home users' sharps seldom had injury prevention features and sharps were commonly re-used for convenience and cost-savings. Improperly discarded sharps present hazards to caregivers, waste handlers, and community members. The most effective intervention potential exists at the beginning of the sharps systems maps where interventions can eliminate or minimize sharps injuries, in particular with needleless treatment methods and sharps with injury prevention features

Future Directions of Applying Healthcare Cloud for Home-based Chronic Disease Care

OpenAIRE

Hu, Yan; Eriksén, Sara; Lundberg, Jenny

2017-01-01

The care of chronic disease has become the main challenge for healthcare institutions around the world. To meet the growing needs of patients, moving the front desk of healthcare from hospital to home is essential. Recently, cloud computing has been applied to healthcare domain; however, adapting to and using this technology effectively for home-based care is still in its initial phase. We have proposed a conceptual hybrid cloud model for home-based chronic disease care, and have evaluated it...

Use Contexts and Usage Patterns of Interactive Case Simulation Tools by HIV Healthcare Providers in a Statewide Online Clinical Education Program.

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Wang, Dongwen

2017-01-01

We analyzed four interactive case simulation tools (ICSTs) from a statewide online clinical education program. Results have shown that ICSTs are increasingly used by HIV healthcare providers. Smart phone has become the primary usage platform for specific ICSTs. Usage patterns depend on particular ICST modules, usage stages, and use contexts. Future design of ICSTs should consider these usage patterns for more effective dissemination of clinical evidence to healthcare providers.

Healthcare costs attributable to secondhand smoke exposure at home for U.S. adults.

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Yao, Tingting; Sung, Hai-Yen; Wang, Yingning; Lightwood, James; Max, Wendy

2018-03-01

To estimate healthcare costs attributable to secondhand smoke (SHS) exposure at home among nonsmoking adults (18+) in the U.S. We analyzed data on nonsmoking adults (N=67,735) from the 2000, 2005, and 2010 (the latest available data on SHS exposure at home) U.S. National Health Interview Surveys. This study was conducted from 2015 to 2017. We examined hospital nights, home care visits, doctor visits, and emergency room (ER) visits. For each, we analyzed the association of SHS exposure at home with healthcare utilization with a Zero-Inflated Poisson regression model controlling for socio-demographic and other risk characteristics. Excess healthcare utilization attributable to SHS exposure at home was determined and multiplied by unit costs derived from the 2014 Medical Expenditures Panel Survey to determine annual SHS-attributable healthcare costs. SHS exposure at home was positively associated with hospital nights and ER visits, but was not statistically associated with home care visits and doctor visits. Exposed adults had 1.28 times more hospital nights and 1.16 times more ER visits than non-exposed adults. Annual SHS-attributable healthcare costs totaled $4.6 billion (including $3.8 billion for hospital nights and $0.8 billion for ER visits, 2014 dollars) in 2000, $2.1 billion (including $1.8 billion for hospital nights and $0.3 billion for ER visits) in 2005, and $1.9 billion (including $1.6 billion for hospital nights and $0.4 billion for ER visits) in 2010. SHS-attributable costs remain high, but have fallen over time. Tobacco control efforts are needed to further reduce SHS exposure at home and associated healthcare costs. Copyright © 2017. Published by Elsevier Inc.

Parkinson’s Disease and Home Healthcare Use and Expenditures among Elderly Medicare Beneficiaries

Directory of Open Access Journals (Sweden)

Sandipan Bhattacharjee

2015-01-01

Full Text Available This study estimated excess home healthcare use and expenditures among elderly Medicare beneficiaries (age ≥ 65 years with Parkinson’s disease (PD compared to those without PD and analyzed the extent to which predisposing, enabling, need factors, personal health choice, and external environment contribute to the excess home healthcare use and expenditures among individuals with PD. A retrospective, observational, cohort study design using Medicare 5% sample claims for years 2006-2007 was used for this study. Logistic regressions and Ordinary Least Squares regressions were used to assess the association of PD with home health use and expenditures, respectively. Postregression nonlinear and linear decomposition techniques were used to understand the extent to which differences in home healthcare use and expenditures among elderly Medicare beneficiaries with and without PD can be explained by individual-level factors. Elderly Medicare beneficiaries with PD had higher home health use and expenditures compared to those without PD. 27.5% and 18% of the gap in home health use and expenditures, respectively, were explained by differences in characteristics between the PD and no PD groups. A large portion of the differences in home healthcare use and expenditures remained unexplained.

Ethical Issues of Social Media Usage in Healthcare.

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Denecke, K; Bamidis, P; Bond, C; Gabarron, E; Househ, M; Lau, A Y S; Mayer, M A; Merolli, M; Hansen, M

2015-08-13

Social media, web and mobile technologies are increasingly used in healthcare and directly support patientcentered care. Patients benefit from disease self-management tools, contact to others, and closer monitoring. Researchers study drug efficiency, or recruit patients for clinical studies via these technologies. However, low communication barriers in socialmedia, limited privacy and security issues lead to problems from an ethical perspective. This paper summarizes the ethical issues to be considered when social media is exploited in healthcare contexts. Starting from our experiences in social-media research, we collected ethical issues for selected social-media use cases in the context of patient-centered care. Results were enriched by collecting and analyzing relevant literature and were discussed and interpreted by members of the IMIA Social Media Working Group. Most relevant issues in social-media applications are confidence and privacy that need to be carefully preserved. The patient-physician relationship can suffer from the new information gain on both sides since private information of both healthcare provider and consumer may be accessible through the Internet. Physicians need to ensure they keep the borders between private and professional intact. Beyond, preserving patient anonymity when citing Internet content is crucial for research studies. Exploiting medical social-media in healthcare applications requires a careful reflection of roles and responsibilities. Availability of data and information can be useful in many settings, but the abuse of data needs to be prevented. Preserving privacy and confidentiality of online users is a main issue, as well as providing means for patients or Internet users to express concerns on data usage.

Home care services for sick children: Healthcare professionals' conceptions of challenges and facilitators.

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Castor, Charlotte; Hallström, Inger; Hansson, Helena; Landgren, Kajsa

2017-09-01

To explore healthcare professionals' conceptions of caring for sick children in home care services. Families often prefer home care to hospital care, and the number of home care services for children is increasing. Caring for children at home has been recognised as challenging for healthcare professionals in home care services used to providing care predominately for adults. An inductive qualitative design. Seven focus group interviews were performed with 36 healthcare professionals from multidisciplinary home care services. Data were analysed stepwise using a phenomenographic analysis. Three description categories emerged: "A challenging opportunity", "A child perspective", and "Re-organise in accordance with new prerequisites." Providing home care services for children was conceived to evoke both professional and personal challenges such as feelings of inadequacy and fear and professional growth such as increased competence and satisfaction. Conceptions of whether the home or the hospital was the best place for care differed. Adapting to the child's care was conceived as important. Cooperation with paediatric departments and a well-functioning team work were important organisational aspects. Providing home care for children was a challenging but rewarding task for healthcare professionals used to care for adults. To provide care with a child perspective was experienced as important even though there were conflicting conceptions of how this should be done. Close cooperation with paediatric departments and teamwork were prerequisites that make up for the low number of paediatric patients and facilitate confidence and competence. A sufficient number of referred children and enabling healthcare professionals to be part of the re-organising and implementation processes might facilitate the home care services for sick children. Enough time and good teamwork must be emphasised. Early referrals, continuous cooperation with paediatric clinics complemented with

Socio-Economic Factors Affecting Home Internet Usage Patterns in Central Queensland

Directory of Open Access Journals (Sweden)

Wal J. Taylor

2003-01-01

Full Text Available Governments and other policy makers are concerned with the gap in home Internet usage between people from metropolitan and rural areas. A survey conducted in Central Queensland, Australia examined differences in home Internet usage patterns between young and old, male and female, people in urban and rural areas, married and unmarried, well-educated and less educated, rich and poor, and employed and unemployed and found significant differences. These results highlight areas for further research and provide a basis for government agencies and industries to consider these associations in future policy formulation for regional development using ICT. The research suggested that further research should be conducted to monitor consuming behaviors of the youngest age group in Internet use for entertainment and information search in order to detect possible Internet overuse or addiction. In addition, further research should be conducted to find out what people search for on the Internet, and if for employment opportunities, financial incentives are suggested for the unemployed people.

Computer usage among nurses in rural health-care facilities in South Africa: obstacles and challenges.

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Asah, Flora

2013-04-01

This study discusses factors inhibiting computer usage for work-related tasks among computer-literate professional nurses within rural healthcare facilities in South Africa. In the past two decades computer literacy courses have not been part of the nursing curricula. Computer courses are offered by the State Information Technology Agency. Despite this, there seems to be limited use of computers by professional nurses in the rural context. Focus group interviews held with 40 professional nurses from three government hospitals in northern KwaZulu-Natal. Contributing factors were found to be lack of information technology infrastructure, restricted access to computers and deficits in regard to the technical and nursing management support. The physical location of computers within the health-care facilities and lack of relevant software emerged as specific obstacles to usage. Provision of continuous and active support from nursing management could positively influence computer usage among professional nurses. A closer integration of information technology and computer literacy skills into existing nursing curricula would foster a positive attitude towards computer usage through early exposure. Responses indicated that change of mindset may be needed on the part of nursing management so that they begin to actively promote ready access to computers as a means of creating greater professionalism and collegiality. © 2011 Blackwell Publishing Ltd.

Antimicrobial biocides in the healthcare environment: efficacy, usage, policies, and perceived problems.

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Maillard, Jean-Yves

2005-12-01

Biocides are heavily used in the healthcare environment, mainly for the disinfection of surfaces, water, equipment, and antisepsis, but also for the sterilization of medical devices and preservation of pharmaceutical and medicinal products. The number of biocidal products for such usage continuously increases along with the number of applications, although some are prone to controversies. There are hundreds of products containing low concentrations of biocides, including various fabrics such as linen, curtains, mattresses, and mops that claim to help control infection, although evidence has not been evaluated in practice. Concurrently, the incidence of hospital-associated infections (HAIs) caused notably by bacterial pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) remains high. The intensive use of biocides is the subject of current debate. Some professionals would like to see an increase in their use throughout hospitals, whereas others call for a restriction in their usage to where the risk of pathogen transmission to patients is high. In addition, the possible linkage between biocide and antibiotic resistance in bacteria and the role of biocides in the emergence of such resistance has provided more controversies in their extensive and indiscriminate usage. When used appropriately, biocidal products have a very important role to play in the control of HAIs. This paper discusses the benefits and problems associated with the use of biocides in the healthcare environment and provides a constructive view on their overall usefulness in the hospital setting.

A fuzzy-based particle swarm optimisation approach for task assignment in home healthcare

Directory of Open Access Journals (Sweden)

Mutingi, Michael

2014-11-01

Full Text Available Home healthcare (HHC organisations provide coordinated healthcare services to patients at their homes. Motivated by the ever-increasing need for home-based care, the assignment of tasks to available healthcare staff is a common and complex problem in homecare organisations. Designing high quality task schedules is critical for improving worker morale, job satisfaction, service efficiency, service quality, and competitiveness over the long term. The desire is to provide high quality task assignment schedules that satisfy the patient, the care worker, and the management. This translates to maximising schedule fairness in terms of workload assignments, avoiding task time window violation, and meeting management goals as much as possible. However, in practice, these desires are often subjective as they involve imprecise human perceptions. This paper develops a fuzzy multi-criteria particle swarm optimisation (FPSO approach for task assignment in a home healthcare setting in a fuzzy environment. The proposed approach uses a fuzzy evaluation method from a multi-criteria point of view. Results from illustrative computational experiments show that the approach is promising.

Utilization of healthcare services in postpartum women in the Philippines who delivered at home and the effects on their health: a cross-sectional analytical study

Directory of Open Access Journals (Sweden)

Yamashita T

2017-09-01

Full Text Available Tadashi Yamashita,1 Maria Teresa Reyes Tuliao,2 Magdalena Concel Meana,2 Sherri Ann Suplido,3 Cecilia L Llave,4 Yuko Tanaka,5 Hiroya Matsuo6 1Kobe City College of Nursing, Kobe, Japan; 2Health Department of Muntinlupa, Muntinlupa, Philippines; 3Department of Obstetrics and Gynecology, Philippine General Hospital, Manila, Philippines; 4College of Medicine (CM, University of the Philippine (UP, Manila, Philippines; 5Department of School of Health Sciences, Faculty of Medicine, Tokushima University Graduate School, Tokushima, Japan; 6Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Japan Background: A low ratio of utilization of healthcare services in postpartum women may contribute to maternal deaths during the postpartum period. The maternal mortality ratio is high in the Philippines. The aim of this study was to examine the current utilization of healthcare services and the effects on the health of women in the Philippines who delivered at home. Methods: This was a cross-sectional analytical study, based on a self-administrated questionnaire, conducted from March 2015 to February 2016 in Muntinlupa, Philippines. Sixty-three postpartum women who delivered at home or at a facility were enrolled for this study. A questionnaire containing questions regarding characteristics, utilization of healthcare services, and abnormal symptoms during postpartum period was administered. To analyze the questionnaire data, the sample was divided into delivery at home and delivery at a facility. Chi-square test, Fisher’s exact test, and Mann–Whitney U test were used. Results: There were significant differences in the type of birth attendant, area of residence, monthly income, and maternal and child health book usage between women who delivered at home and those who delivered at a facility (P<0.01. There was significant difference in the utilization of antenatal checkup (P<0.01 during pregnancy, whilst there was no

Registered nurses' clinical reasoning in home healthcare clinical practice: A think-aloud study with protocol analysis.

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Johnsen, Hege Mari; Slettebø, Åshild; Fossum, Mariann

2016-05-01

The home healthcare context can be unpredictable and complex, and requires registered nurses with a high level of clinical reasoning skills and professional autonomy. Thus, additional knowledge about registered nurses' clinical reasoning performance during patient home care is required. The aim of this study is to describe the cognitive processes and thinking strategies used by recently graduated registered nurses while caring for patients in home healthcare clinical practice. An exploratory qualitative think-aloud design with protocol analysis was used. Home healthcare visits to patients with stroke, diabetes, and chronic obstructive pulmonary disease in seven healthcare districts in southern Norway. A purposeful sample of eight registered nurses with one year of experience. Each nurse was interviewed using the concurrent think-aloud technique in three different patient home healthcare clinical practice visits. A total of 24 home healthcare visits occurred. Follow-up interviews were conducted with each participant. The think-aloud sessions were transcribed and analysed using three-step protocol analysis. Recently graduated registered nurses focused on both general nursing concepts and concepts specific to the domains required and tasks provided in home healthcare services as well as for different patient groups. Additionally, participants used several assertion types, cognitive processes, and thinking strategies. Our results showed that recently graduated registered nurses used both simple and complex cognitive processes involving both inductive and deductive reasoning. However, their reasoning was more reactive than proactive. The results may contribute to nursing practice in terms of developing effective nursing education programmes. Copyright © 2016 Elsevier Ltd. All rights reserved.

Reducing Electricity Demand Peaks by Scheduling Home Appliances Usage

DEFF Research Database (Denmark)

Rossello Busquet, Ana; Kardaras, Georgios; Iversen, Villy Bæk

2011-01-01

Nowadays there is a tendency to consume electricity during the same period of the day leading to demand peaks. Regular energy consumption habits lead to demand peaks at specific temporal intervals, because users consume power at the same time. In order to avoid demand peaks, users’ appliances...... should consume electricity in a more temporarily distributed way. A new methodology to schedule the usage of home appliances is proposed and analyzed in this paper. The main concept behind this approach is the aggregation of home appliances into priority classes and the definition of a maximum power...... consumption limit, which is not allowed to be exceeded during peak hours. The scenario simulated describes a modern household, where the electrical devices are classified in low and high priority groups. The high priority devices are always granted power in order to operate without temporal restrictions...

One Family's Journey: Medical Home and the Network of Supports It Offers Children and Youth with Special Healthcare Needs--Medical Homes in Hospital Systems. Part Six

Science.gov (United States)

Macdonald, Sarah; Hoffman, Alisa; Hagenbach, Tracy; Rusert, Julia

2008-01-01

In this 12 installment Medical Home series, "Exceptional Parent" presents a case study about the American Academy of Pediatrics' Medical Home Initiative. A "Medical Home" is not a building but an approach to providing healthcare services to children with special healthcare needs. This sixth part of the Medical Home series describes the experiences…

Flexible technologies and smart clothing for citizen medicine, home healthcare, and disease prevention.

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Axisa, Fabrice; Schmitt, Pierre Michael; Gehin, Claudine; Delhomme, Georges; McAdams, Eric; Dittmar, André

2005-09-01

Improvement of the quality and efficiency of healthcare in medicine, both at home and in hospital, is becoming more and more important for patients and society at large. As many technologies (micro technologies, telecommunication, low-power design, new textiles, and flexible sensors) are now available, new user-friendly devices can be developed to enhance the comfort and security of the patient. As clothes and textiles are in direct contact with about 90% of the skin surface, smart sensors and smart clothes with noninvasive sensors are an attractive solution for home-based and ambulatory health monitoring. Moreover, wearable devices or smart homes with exosensors are also potential solutions. All these systems can provide a safe and comfortable environment for home healthcare, illness prevention, and citizen medicine.

Passive RFID Localisation Framework in Smart Homes Healthcare Settings.

Science.gov (United States)

Alsinglawi, Belal; Liu, Tony; Nguyen, Quang Vinh; Gunawardana, Upul; Maeder, Anthony; Simoff, Simeon

2016-01-01

In recent years, Smart Homes have become a solution to benefit impaired individuals and elderly in their daily life settings. In healthcare applications, pervasive technologies have enabled the practicality of personal monitoring using Indoor positioning technologies. Radio-Frequency Identification (RFID) is a promising technology, which is useful for non-invasive tracking of activities of daily living. Many implementations have focused on using battery-enabled tags like in RFID active tags, which require frequent maintenance and they are costly. Other systems can use wearable sensors requiring individuals to wear tags which may be inappropriate for elders. Successful implementations of a tracking system are dependent on multiple considerations beyond the physical performance of the solution, such as affordability and human acceptance. This paper presents a localisation framework using passive RFID sensors. It aims to provide a low cost solution for subject location in Smart Homes healthcare.

Perceptions of telecare training needs in home healthcare services: a focus group study.

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Guise, Veslemøy; Wiig, Siri

2017-02-23

The implementation and use of telecare requires significant changes to healthcare service organisation and delivery, including new ways of working for staff. Competency development and training for healthcare professionals is therefore required to enable necessary adaptation of clinical practice and ensure competent provision of telecare services. It is however unclear what skills healthcare staff need when providing care at a distance and there is little empirical evidence on effective training strategies for telecare practice. Training should however emphasise the experiences and preferences of prospective trainees to ensure its relevance to their educational needs. The aim of this study was to explore healthcare professionals' perceptions of training related to the general use of telecare, and to identify specific training needs associated with the use of virtual visits in the home healthcare services. Six focus group interviews were held with a total of 26 participants working in the home healthcare services in Norway, including registered nurses, enrolled nurses, physiotherapists, occupational therapists, social workers, health workers, and healthcare assistants. The data material was analysed by way of systematic text condensation. The analysis resulted in five categories relevant to telecare training for healthcare professionals: Purposeful training creates confidence and changes attitudes; Training needs depend on ability to cope with telecare; The timing of training; Training must facilitate practical insight into the patients' perspective; and Training content must focus on the telecare process. Findings are discussed in light of implications for the form and content of a training program for healthcare professionals on how to undertake virtual home healthcare visits. Appropriate preparation and training for telecare use is important for healthcare professionals and must be taken seriously by healthcare organisations. To facilitate the knowledge, skills

Care relationships at stake? Home healthcare professionals' experiences with digital medicine dispensers - a qualitative study.

Science.gov (United States)

Nakrem, Sigrid; Solbjør, Marit; Pettersen, Ida Nilstad; Kleiven, Hanne Hestvik

2018-01-15

Although digital technologies can mitigate the burdens of home healthcare services caused by an ageing population that lives at home longer with complex health problems, research on the impacts and consequences of digitalised remote communication between patients and caregivers is lacking. The present study explores how home healthcare professionals had experienced the introduction of digital medicine dispensers and their influence on patient-caregiver relationships. The multi-case study comprised semi-structured interviews with 21 healthcare professionals whose home healthcare service involved using the digital medicine dispensers. The constant comparative method was used for data analyses. Altogether, interviewed healthcare professionals reported three main technology-related impacts upon their patient-caregiver relationships. First, national and local pressure to increase efficiency had troubled their relationships with patients who suspected that municipalities have sought to lower costs by reducing and digitalising services. Participants reported having to consider such worries when introducing technologies into their services. Second, participants reported a shift towards empowering patients. Digital technology can empower patients who value their independence, whereas safety is more important for other patients. Healthcare professionals needed to ensure that replacing care tasks with technology implies safe and improved care. Third, the safety and quality of digital healthcare services continues to depend upon surveillance and control mechanisms that compensate for less face-to-face monitoring. Participants did not consider the possibility that surveillance exposes information about patients' everyday lives to be problematic, but to constitute opportunities for adjusting services to meet patients' needs. Technologies such as digital medicine dispensers can improve the efficiency of healthcare services and enhance patients' independence when introduced in a

Care relationships at stake? Home healthcare professionals’ experiences with digital medicine dispensers – a qualitative study

OpenAIRE

Nakrem, Sigrid; Solbjør, Marit; Pettersen, Ida Nilstad; Kleiven, Hanne Hestvik

2018-01-01

Background Although digital technologies can mitigate the burdens of home healthcare services caused by an ageing population that lives at home longer with complex health problems, research on the impacts and consequences of digitalised remote communication between patients and caregivers is lacking. The present study explores how home healthcare professionals had experienced the introduction of digital medicine dispensers and their influence on patient-caregiver relationships. Methods...

Quality improvement in healthcare delivery utilizing the patient-centered medical home model.

Science.gov (United States)

Akinci, Fevzi; Patel, Poonam M

2014-01-01

Despite the fact that the United States dedicates so much of its resources to healthcare, the current healthcare delivery system still faces significant quality challenges. The lack of effective communication and coordination of care services across the continuum of care poses disadvantages for those requiring long-term management of their chronic conditions. This is why the new transformation in healthcare known as the patient-centered medical home (PCMH) can help restore confidence in our population that the healthcare services they receive is of the utmost quality and will effectively enhance their quality of life. Healthcare using the PCMH model is delivered with the patient at the center of the transformation and by reinvigorating primary care. The PCMH model strives to deliver effective quality care while attempting to reduce costs. In order to relieve some of our healthcare system distresses, organizations can modify their delivery of care to be patient centered. Enhanced coordination of services, better provider access, self-management, and a team-based approach to care represent some of the key principles of the PCMH model. Patients that can most benefit are those that require long-term management of their conditions such as chronic disease and behavioral health patient populations. The PCMH is a feasible option for delivery reform as pilot studies have documented successful outcomes. Controversy about the lack of a medical neighborhood has created concern about the overall sustainability of the medical home. The medical home can stand independently and continuously provide enhanced care services as a movement toward higher quality care while organizations and government policy assess what types of incentives to put into place for the full collaboration and coordination of care in the healthcare system.

A home healthcare system in the cloud - Addressing security and privacy challenges

OpenAIRE

Deng M.; Petkovic M.; Nalin M.; Baroni I.

2011-01-01

Cloud computing is an emerging technology that is expected to support Internet scale critical applications which could be essential to the healthcare sector. Its scalability, resilience, adaptability, connectivity, cost reduction, and high performance features have high potential to lift the efficiency and quality of healthcare. However,it is also important to understand specific risks related to security and privacy that this technology brings. This paper focuses on a home healthcare system ...

Attitudes among healthcare professionals towards ICT and home follow-up in chronic heart failure care.

Science.gov (United States)

Gund, Anna; Lindecrantz, Kaj; Schaufelberger, Maria; Patel, Harshida; Sjöqvist, Bengt Arne

2012-11-28

eHealth applications for out-of-hospital monitoring and treatment follow-up have been advocated for many years as a promising tool to improve treatment compliance, promote individualized care and obtain a person-centred care. Despite these benefits and a large number of promising projects, a major breakthrough in everyday care is generally still lacking. Inappropriate organization for eHealth technology, reluctance from users in the introduction of new working methods, and resistance to information and communication technology (ICT) in general could be reasons for this. Another reason may be attitudes towards the potential in out-of-hospital eHealth applications. It is therefore of interest to study the general opinions among healthcare professionals to ICT in healthcare, as well as the attitudes towards using ICT as a tool for patient monitoring and follow-up at home. One specific area of interest is in-home follow-up of elderly patients with chronic heart failure (CHF). The aim of this paper is to investigate the attitudes towards ICT, as well as distance monitoring and follow-up, among healthcare professionals working with this patient group. This paper covers an attitude survey study based on responses from 139 healthcare professionals working with CHF care in Swedish hospital departments, i.e. cardiology and medicine departments. Comparisons between physicians and nurses, and in some cases between genders, on attitudes towards ICT tools and follow-up at home were performed. Out of the 425 forms sent out, 139 were collected, and 17 out of 21 counties and regions were covered in the replies. Among the respondents, 66% were nurses, 30% physicians and 4% others. As for gender, 90% of nurses were female and 60% of physicians were male. Internet was used daily by 67% of the respondents. Attitudes towards healthcare ICT were found positive as 74% were positive concerning healthcare ICT today, 96% were positive regarding the future of healthcare ICT, and 54% had high

Simple MoCap System for Home Usage

Directory of Open Access Journals (Sweden)

Martin Magdin

2017-08-01

Full Text Available Nowadays many MoCap systems exist. Generating 3D facial animation of characters is currently realized by using the motion capture data (MoCap data, which is obtained by tracking the facial markers from an actor/actress. In general it is a professional solution that is sophisticated and costly. This paper presents a solution with a system that is inexpensive. We propose a new easy-to-use system for home usage, through which we are making character animation. In its implementation we paid attention to the elimination of errors from the previous solutions. In this paper the authors describe the method how motion capture characters on a treadmill and as well as an own Java application that processes the video for its further use in Cinema 4D. This paper describes the implementation of this technology of sensing in a way so that the animated character authentically imitated human movement on a treadmill.

An integrated healthcare system for personalized chronic disease care in home-hospital environments.

Science.gov (United States)

Jeong, Sangjin; Youn, Chan-Hyun; Shim, Eun Bo; Kim, Moonjung; Cho, Young Min; Peng, Limei

2012-07-01

Facing the increasing demands and challenges in the area of chronic disease care, various studies on the healthcare system which can, whenever and wherever, extract and process patient data have been conducted. Chronic diseases are the long-term diseases and require the processes of the real-time monitoring, multidimensional quantitative analysis, and the classification of patients' diagnostic information. A healthcare system for chronic diseases is characterized as an at-hospital and at-home service according to a targeted environment. Both services basically aim to provide patients with accurate diagnoses of disease by monitoring a variety of physical states with a number of monitoring methods, but there are differences between home and hospital environments, and the different characteristics should be considered in order to provide more accurate diagnoses for patients, especially, patients having chronic diseases. In this paper, we propose a patient status classification method for effectively identifying and classifying chronic diseases and show the validity of the proposed method. Furthermore, we present a new healthcare system architecture that integrates the at-home and at-hospital environment and discuss the applicability of the architecture using practical target services.

A telemedicine system for wireless home healthcare based on Bluetooth and the Internet.

Science.gov (United States)

Zhao, Xiaoming; Fei, Ding-Yu; Doarn, Charles R; Harnett, Brett; Merrell, Ronald

2004-01-01

The VitalPoll Telemedicine System (VTS) was designed and developed for wireless home healthcare. The aims of this study were: to design the architecture and communication methods for a telemedicine system; to implement a physiologic routing hub to collect data from different medical devices and sensors; and to evaluate the feasibility of this system for applications in wireless home healthcare. The VTS was built using Bluetooth wireless and Internet technologies with client/server architecture. Several medical devices, which acquire vital signs, such as real-time electrocardiogram signals, heart rate, body temperature, and activity (physical motion), were integrated into the VTS. Medical information and data were transmitted over short-range interface (USB, RS232), wireless communication, and the Internet. The medical results were stored in a database and presented using a web browser. The patient's vital signals can be collected, transmitted, and displayed in real time by the VTS. The experiments verified no data loss during Bluetooth and Internet communication. Bluetooth and the Internet provide enough bandwidth channels to tranmit these vital signs. The experimental results show that VTS may be suitable for a practical telemedicine system in home healthcare.

The ALIVE program: developing a web-based professional development program for nursing leaders in the home healthcare sector.

Science.gov (United States)

Lankshear, Sara; Huckstep, Sherri; Lefebre, Nancy; Leiterman, Janis; Simon, Deborah

2010-05-01

Home healthcare nurses often work in isolation and rarely have the opportunity to meet or congregate in one location. As a result, nurse leaders must possess unique leadership skills to supervise and manage a dispersed employee base from a distance. The nature of this dispersed workforce creates an additional challenge in the ability to identify future leaders, facilitate leadership capacity, and enhance skill development to prepare them for future leadership positions. The ALIVE (Actively Leading In Virtual Environments) web-based program was developed to meet the needs of leaders working in virtual environments such as the home healthcare sector. The program, developed through a partnership of three home healthcare agencies, used nursing leaders as content experts to guide program development and as participants in the pilot. Evaluation findings include the identification of key competencies for nursing leaders in the home healthcare sector, development of program learning objectives and participant feedback regarding program content and delivery.

Market adoption barriers of multi-stakeholder technology: smart homes for the aging population

NARCIS (Netherlands)

Ehrenhard, Michel Léon; Kijl, Björn; Nieuwenhuis, Lambertus Johannes Maria

2014-01-01

For more than a decade, the Smart Home has promised to offer a better quality of life by connecting in-house devices and monitoring their usage. Such platform-based configurational technology has demonstrated the potential to improve comfort, healthcare, safety and security, and energy conservation

Treating Dehydration at Home Avoids Healthcare Costs Associated With Emergency Department Visits and Hospital Readmissions for Adult Patients Receiving Home Parenteral Support.

Science.gov (United States)

Konrad, Denise; Roberts, Scott; Corrigan, Mandy L; Hamilton, Cindy; Steiger, Ezra; Kirby, Donald F

2017-06-01

Administration of home parenteral support (HPS) has proven to be cost-effective over hospital care. Avoiding hospital readmissions became more of a focus for healthcare institutions in 2012 with the implementation of the Affordable Care Act. In 2010, our service developed a protocol to treat dehydration at home for HPS patients by ordering additional intravenous fluids to be kept on hand and to focus patient education on the symptoms of dehydration. A retrospective analysis was completed through a clinical management database to identify HPS patients with dehydration. The hospital finance department and homecare pharmacy were utilized to determine potential cost avoidance. In 2009, 64 episodes (77%) of dehydration were successfully treated at home versus 6 emergency department (ED) visits (7.5%) and 13 readmissions (15.5%). In 2010, we successfully treated 170 episodes (84.5%) at home, with 9 episodes (4.5%) requiring ED visits and 22 hospital readmissions (11%). The number of dehydration episodes per patient was significantly higher in 2010 ( P dehydration identified and treated at home in 2010 versus 2009. Our protocol helped educate and provide the resources required to resolve dehydration at home when early signs were recognized. By reducing ED visits and hospital readmissions, healthcare costs were avoided by a factor of 29 when home treatment was successful.

Bringing healthcare closer to home: one province's approach to home care.

Science.gov (United States)

Witmer, E

2000-01-01

Ontario is implementing a number of steps to address the growing need for home care and continuing care. One of these steps is the establishment of Ontario's network of 43 Community Care Access Centres (CCACs). Responsible for aiding Ontario residents who seek community-based long-term healthcare, CCACs coordinate access to home services such as nursing and homemaking, manage placement to long-term care facilities and provide information and referral services. In 2000/01 the Ontario government announced 92.5 million Canadian dollars in new funding for long-term community services. This new funding includes 70.1 million Canadian dollars for CCACs. During this time, the provincial government will spend more than 1.6 billion Canadian dollars for long-term-care community-based services. Of this amount, 1.1 Canadian dollars billion will go to CCACs. Community Care Access Centres served more than 400,000 people in 1998/99 and are estimated to serve more than 420,000 in 2000/01. The administrative funds saved by this province-wide system are reinvested in front-line health services.

Identifying risk factors for healthcare-associated infections from electronic medical record home address data

Directory of Open Access Journals (Sweden)

Rosenman Marc B

2010-09-01

Full Text Available Abstract Background Residential address is a common element in patient electronic medical records. Guidelines from the U.S. Centers for Disease Control and Prevention specify that residence in a nursing home, skilled nursing facility, or hospice within a year prior to a positive culture date is among the criteria for differentiating healthcare-acquired from community-acquired methicillin-resistant Staphylococcus aureus (MRSA infections. Residential addresses may be useful for identifying patients residing in healthcare-associated settings, but methods for categorizing residence type based on electronic medical records have not been widely documented. The aim of this study was to develop a process to assist in differentiating healthcare-associated from community-associated MRSA infections by analyzing patient addresses to determine if residence reported at the time of positive culture was associated with a healthcare facility or other institutional location. Results We identified 1,232 of the patients (8.24% of the sample with positive cultures as probable cases of healthcare-associated MRSA based on residential addresses contained in electronic medical records. Combining manual review with linking to institutional address databases improved geocoding rates from 11,870 records (79.37% to 12,549 records (83.91%. Standardization of patient home address through geocoding increased the number of matches to institutional facilities from 545 (3.64% to 1,379 (9.22%. Conclusions Linking patient home address data from electronic medical records to institutional residential databases provides useful information for epidemiologic researchers, infection control practitioners, and clinicians. This information, coupled with other clinical and laboratory data, can be used to inform differentiation of healthcare-acquired from community-acquired infections. The process presented should be extensible with little or no added data costs.

Virtualized healthcare delivery: understanding users and their usage patterns of online medical consultations.

Science.gov (United States)

Jung, Changmi; Padman, Rema

2014-12-01

Virtualization of healthcare delivery via patient portals has facilitated the increasing interest in online medical consultations due to its benefits such as improved convenience and flexibility, lower cost, and time savings. Despite this growing interest, adoption by both consumers and providers has been slow, and little is known about users and their usage and adoption patterns. To learn characteristics of online healthcare consumers and understand their patterns of adoption and usage of online clinical consultation services (or eVisits delivered via the portal) such as adoption time for portal users, whether adoption hazard changes over time, and what factors influence patients to become early/late adopters. Using online medical consultation records between April 1, 2009 and May 31, 2010 from four ambulatory practices affiliated with a major healthcare provider, we conduct simple descriptive analysis to understand the users of online clinical consults and their usage patterns. Multilevel Logit regression is employed to measure the effect of patient and primary care provider characteristics on the likelihood of eVisit adoption by the patient, and survival analysis and Ordered Logit regression are applied to study eVisit adoption patterns that delineate elements describing early or late adopters. On average, eVisit adopters are younger and predominantly female. Their primary care providers participate in the eVisit service, highlighting the importance of physician's role in encouraging patients to utilize the service. Patients who are familiar with the patient portal are more likely to use the service, as are patients with more complex health issues. Younger and female patients have higher adoption hazard, but gender does not affect the decision of adopting early vs. late. These adopters also access the patient portal more frequently before adoption, indicating that they are potentially more involved in managing their health. The majority of eVisits are submitted

Location Planning Problem of Service Centers for Sustainable Home Healthcare: Evidence from the Empirical Analysis of Shanghai

Directory of Open Access Journals (Sweden)

Gang Du

2015-11-01

Full Text Available It is of theoretical and practical significance to understand what factors influence the sustainable development of home healthcare services in China. Based on a face-to-face survey, we find that the location planning, which is decisive for the improvement of patient satisfaction, can effectively reduce the risks, as well as the costs of redundant construction and re-construction of service centers for home healthcare and, thus, helps ensure the sustainability of health and the environment. The purposes of this paper are to investigate the existing problem of home healthcare in Shanghai and to find the optimum location planning scheme under several realistic constraints. By considering differentiated services provided by the medical staff at different levels and the degrees of patient satisfaction, a mixed integer programming model is built to minimize the total medical cost. The IBM ILOGCPLEX is used to solve the above model. Finally, a case study of Putuo district in Shanghai is conducted to validate the proposed model and methodology. Results indicate that the model used in this paper can effectively reduce the total medical cost and enhance the medical sustainability, and therefore, the results of the model can be used as a reference for decision makers on the location planning problem of home healthcare services in China.

Work related characteristics, work-home and home-work interference and burnout among primary healthcare physicians: a gender perspective in a Serbian context.

Science.gov (United States)

Putnik, Katarina; Houkes, Inge

2011-09-23

Little information exists on work and stress related health of medical doctors in non-EU countries. Filling this knowledge gap is needed to uncover the needs of this target population and to provide information on comparability of health related phenomena such as burnout across countries. This study examined work related characteristics, work-home and home-work interference and burnout among Serbian primary healthcare physicians (PHPs) and compared burnout levels with other medical doctors in EU countries. Data were collected via surveys which contained Maslach Burnout Inventory and other validated instruments measuring work and home related characteristics. The sample consisted of 373 PHPs working in 12 primary healthcare centres. Data were analysed using t-tests and Chi square tests. No gender differences were detected on mean scores of variables among Serbian physicians, who experience high levels of personal accomplishment, workload, job control and social support, medium to high levels of emotional exhaustion, medium levels of depersonalisation and work-home interference, and low levels of home-work interference. There were more women than men who experienced low job control and high depersonalisation. Serbian physicians experienced significantly higher emotional exhaustion and lower depersonalisation than physicians in some other European countries. To diminish excessive workload, the number of physicians working in primary healthcare centres in Serbia should be increased. Considering that differences between countries were detected on all burnout subcomponents, work-related interventions for employees should be country specific. The role of gender needs to be closely examined in future studies as well.

Work related characteristics, work-home and home-work interference and burnout among primary healthcare physicians: A gender perspective in a Serbian context

Directory of Open Access Journals (Sweden)

Houkes Inge

2011-09-01

Full Text Available Abstract Background Little information exists on work and stress related health of medical doctors in non-EU countries. Filling this knowledge gap is needed to uncover the needs of this target population and to provide information on comparability of health related phenomena such as burnout across countries. This study examined work related characteristics, work-home and home-work interference and burnout among Serbian primary healthcare physicians (PHPs and compared burnout levels with other medical doctors in EU countries. Methods Data were collected via surveys which contained Maslach Burnout Inventory and other validated instruments measuring work and home related characteristics. The sample consisted of 373 PHPs working in 12 primary healthcare centres. Data were analysed using t-tests and Chi square tests. Results No gender differences were detected on mean scores of variables among Serbian physicians, who experience high levels of personal accomplishment, workload, job control and social support, medium to high levels of emotional exhaustion, medium levels of depersonalisation and work-home interference, and low levels of home-work interference. There were more women than men who experienced low job control and high depersonalisation. Serbian physicians experienced significantly higher emotional exhaustion and lower depersonalisation than physicians in some other European countries. Conclusions To diminish excessive workload, the number of physicians working in primary healthcare centres in Serbia should be increased. Considering that differences between countries were detected on all burnout subcomponents, work-related interventions for employees should be country specific. The role of gender needs to be closely examined in future studies as well.

Healthcare costs of burn patients from homes without fire sprinklers.

Science.gov (United States)

Banfield, Joanne; Rehou, Sarah; Gomez, Manuel; Redelmeier, Donald A; Jeschke, Marc G

2015-01-01

The treatment of burn injuries requires high-cost services for healthcare and society. Automatic fire sprinklers are a preventive measure that can decrease fire injuries, deaths, property damage, and environmental toxins. This study's aim was to conduct a cost analysis of patients with burn or inhalation injuries caused by residential fires and to compare this with the cost of implementing residential automatic fire sprinklers. We conducted a cohort analysis of adult burn patients admitted to our provincial burn center (1995-2012). Patient demographics and injury characteristics were collected from medical records and clinical and coroner databases. Resource costs included average cost per day at our intensive care and rehabilitation program, transportation, and property loss. During the study period, there were 1557 residential fire-related deaths province-wide and 1139 patients were admitted to our provincial burn center as a result of a flame injury occurring at home. At our burn center, the average cost was CAN$84,678 per patient with a total cost of CAN$96,448,194. All resources totaled CAN$3,605,775,200. This study shows the considerable healthcare costs of burn patients from homes without fire sprinklers.

Helping Older Adults Improve Their Medication Experience (HOME) by Addressing Medication Regimen Complexity in Home Healthcare.

Science.gov (United States)

Sheehan, Orla C; Kharrazi, Hadi; Carl, Kimberly J; Leff, Bruce; Wolff, Jennifer L; Roth, David L; Gabbard, Jennifer; Boyd, Cynthia M

In skilled home healthcare (SHHC), communication between nurses and physicians is often inadequate for medication reconciliation and needed changes to the medication regimens are rarely made. Fragmentation of electronic health record (EHR) systems, transitions of care, lack of physician-nurse in-person contact, and poor understanding of medications by patients and their families put patients at risk for serious adverse outcomes. The aim of this study was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules. We used human computer interaction design and evaluation principles, automated extraction from standardized forms, and modification of existing EHR fields to highlight key medication-related insights that had arisen during the SHHC visit. Separate versions of the tool were developed for physicians/nurses and patients/caregivers. A pilot of the tool was conducted using 20 SHHC encounters. Home care nurses and physicians found the tool useful for communication. Home care nurses were able to implement the HOME tool into their clinical workflow and reported improved communication with physicians about medications. This simple and largely automated tool improves understanding and communication around medications in SHHC.

Usage monitoring of electrical devices in a smart home.

Science.gov (United States)

Rahimi, Saba; Chan, Adrian D C; Goubran, Rafik A

2011-01-01

Profiling the usage of electrical devices within a smart home can be used as a method for determining an occupant's activities of daily living. A nonintrusive load monitoring system monitors the electrical consumption at a single electrical source (e.g., main electric utility service entry) and the operating schedules of individual devices are determined by disaggregating the composite electrical consumption waveforms. An electrical device's load signature plays a key role in nonintrusive load monitoring systems. A load signature is the unique electrical behaviour of an individual device when it is in operation. This paper proposes a feature-based model, using the real power and reactive power as features for describing the load signatures of individual devices. Experimental results for single device recognition for 7 devices show that the proposed approach can achieve 100% classification accuracy with discriminant analysis using Mahalanobis distances.

Effect of workplace- versus home-based physical exercise on musculoskeletal pain among healthcare workers

DEFF Research Database (Denmark)

Jakobsen, Markus D.; Sundstrup, Emil; Brandt, Mikkel

2015-01-01

among healthcare workers. METHODS: The randomized controlled trial (RCT) comprised 200 female healthcare workers from 18 departments at 3 hospitals. Participants were randomly allocated at the cluster level to ten weeks of: (i) workplace physical exercise (WORK) performed during working hours for 5.......05). Between-group differences at follow-up (WORK versus HOME) was -0.7 points for pain intensity [95% confidence interval (95% CI) -1.0- -0.3], 5.5 Nm for back muscle strength (95% CI 2.0-9.0), and -0.4 days per week for use of analgesics (95% CI -0.7- -0.2). The effect size for between-group differences...... intensity (0-10 scale) in the low back and neck/shoulder was the primary outcome. RESULTS: Per week, 2.2 (SD 1.1) and 1.0 (SD 1.2) training sessions were performed in WORK and HOME groups, respectively. Pain intensity, back muscle strength and use of analgesics improved more following WORK than HOME (P

"Making Do" Decisions: How Home Healthcare Personnel Manage Their Exposure to Home Hazards.

Science.gov (United States)

Wills, Celia E; Polivka, Barbara J; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

2016-04-01

This study describes the decision-making processes home healthcare personnel (HHP) use to manage their personal health and safety when managing hazards in client homes. A professionally diverse national sample of 68 HHP participated in individual semi-structured interviews and focus group discussions, and described their decision making and strategies for hazard management in their work environments. HHP described 353 hazard management dilemmas within 394 specifically identified hazards, which were clustered within three broader categories: electrical/fire, slip/trip/lift, and environmental exposures. HHP described multiple types of "making do" decisions for hazard management solutions in which perceived and actual resource limitations constrained response options. A majority of hazard management decisions in the broader hazards categories (72.5%, 68.5%, and 63.5%, respectively) were classifiable as less than optimal. These findings stress the need for more support of HHPs, including comprehensive training, to improve HHP decision making and hazard management strategies, especially in context of resource constraints. © The Author(s) 2015.

Autonomous home-care nursing staff are more engaged in their work and less likely to consider leaving the healthcare sector: a questionnaire survey.

Science.gov (United States)

Maurits, Erica E M; de Veer, Anke J E; van der Hoek, Lucas S; Francke, Anneke L

2015-12-01

The need for home care is rising in many Western European countries, due to the ageing population and governmental policies to substitute institutional care with home care. At the same time, a general shortage of qualified home-care staff exists or is expected in many countries. It is important to retain existing nursing staff in the healthcare sector to ensure a stable home-care workforce for the future. However, to date there has been little research about the job factors in home care that affect whether staff are considering leaving the healthcare sector. The main purpose of the study was to examine how home-care nursing staff's self-perceived autonomy relates to whether they have considered leaving the healthcare sector and to assess the possible mediating effect of work engagement. The questionnaire-based, cross-sectional study involved 262 registered nurses and certified nursing assistants employed in Dutch home-care organisations (mean age of 51; 97% female). The respondents were members of the Dutch Nursing Staff Panel, a nationwide group of nursing staff members in various healthcare settings (67% response rate). The questionnaire included validated scales concerning self-perceived autonomy and work engagement and a measure for considering pursuing an occupation outside the healthcare sector. Logistic regression and mediation analyses were conducted to test associations between self-perceived autonomy, work engagement and considering leaving the healthcare sector. Nursing staff members in home care who perceive more autonomy are more engaged in their work and less likely to have considered leaving the healthcare sector. The positive association between self-perceived autonomy and considering leaving, found among nursing staff members regardless of their level of education, is mediated by work engagement. In developing strategies for retaining nursing staff in home care, employers and policy makers should target their efforts at enhancing nursing staff

Factors related to home health-care transition in trisomy 13.

Science.gov (United States)

Kitase, Yuma; Hayakawa, Masahiro; Kondo, Taiki; Saito, Akiko; Tachibana, Takashi; Oshiro, Makoto; Ieda, Kuniko; Kato, Eiko; Kato, Yuichi; Hattori, Tetsuo; Hayashi, Seiji; Ito, Masatoki; Hyodo, Reina; Muramatsu, Yukako; Sato, Yoshiaki

2017-10-01

Trisomy 13 (T13) is accompanied by severe complications, and it can be challenging to achieve long-term survival without aggressive treatment. However, recently, some patients with T13 have been receiving home care. We conducted this study to investigate factors related to home health-care transition for patients with T13.We studied 28 patients with T13 born between January 2000 and December 2014. We retrospectively compared nine home care transition patients (the home care group) and 19 patients that died during hospitalization (the discharge at death group). The median gestational age of the patients was 36.6 weeks, with a median birth weight of 2,047 g. Currently, three patients (11%) have survived, and 25 (89%) have died. The home care group exhibited a significantly longer gestational age (38.9 vs. 36.3 weeks, p = 0.039) and significantly larger occipitofrontal circumference Z score (-0.04 vs. -0.09, p = 0.019). Congenital heart defects (CHD) was more frequent in the discharge at death group, with six patients in the home care group and 18 patients in the discharge at death group (67% vs. 95%, p = 0.047), respectively. Survival time was significantly longer in the home care group than in the discharge at death group (171 vs. 19 days, p = 0.012). This study has shown that gestational age, occipitofrontal circumference Z score at birth, and the presence of CHD are helpful prognostic factors for determining treatment strategy in patients with T13. © 2017 Wiley Periodicals, Inc.

Home-based music therapy--a systematic overview of settings and conditions for an innovative service in healthcare.

Science.gov (United States)

Schmid, Wolfgang; Ostermann, Thomas

2010-10-14

Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from music therapists, patients and their

Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

Directory of Open Access Journals (Sweden)

Ostermann Thomas

2010-10-01

Full Text Available Abstract Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8, were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely

Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

Science.gov (United States)

2010-01-01

Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from

A videoconferencing tool acting as a home-based healthcare monitoring robot for elderly patients.

Science.gov (United States)

Mapundu, Zamikhaya; Simonnet, Thierry; van der Walt, J S

2012-01-01

Currently, healthcare costs associated with aging at home can be prohibitive if individuals require continual/periodical supervision and assistance because of Alzheimer's disease. Open-source tools and videoconferencing tools are attracting more significant organizations; it has been observed that another way to reduce medical care costs is to reduce the length of the patient's hospitalization and reinforce home sanitary support by medical professionals with family care givers. Videoconferencing has been around for a while and presently this technology is the leading way in reducing healthcare costs, thus making medical care more available and convenient for both doctors and patients. This article portrays how the videoconferencing tool can be utilized to improve communication practices for patient monitoring using a Robot Companion. SWOT analysis method is also presented in a form of a summary and was utilized to evaluate the user's point of view.

[Nursing home placement of people with dementia: a secondary analysis of qualitative data and literature review on perspectives of informal caregivers and healthcare professionals].

Science.gov (United States)

Nguyen, Natalie; Renom-Guiteras, Anna; Meyer, Gabriele; Stephan, Astrid

2018-06-01

Background: Nursing home placement of people with dementia can become necessary when informal care is no longer sufficient. Informal carers experience the transition period as an additional burden. Aim: Experiences and views of informal carers and healthcare professionals regarding the transition from people with dementia to a nursing home are investigated to improve the support for informal carers. Method: This secondary analysis included data from all five focus groups with n = 30 informal carers and healthcare professionals conducted as part of the “RightTimePlaceCare” project. To supplement the material which resulted from a single interview question, a literature analysis with the same focus was conducted. Results: The merged results indicated that informal carers needed professional support early on at home until after the nursing home placement. Concerns regarding nursing homes, financial aspects and family related issues were important aspects in the decision making. Healthcare professionals recommended provision of early guidance regarding those matters and making own experiences with nursing homes. Healthcare professionals should serve as mediators during the transition process and improve the collaboration between service providers. Conclusions: Empowering families to make informed choices could be facilitated by offering advice at home about their options for formal support services, financial support, and housing solutions. Healthcare professionals should support caregivers to make a decision, coordinate the placement and to cope with the new situation.

Effect of workplace- versus home-based physical exercise on pain in healthcare workers

DEFF Research Database (Denmark)

Jakobsen, Markus Due; Sundstrup, Emil; Brandt, Mikkel

2014-01-01

BACKGROUND: The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers, allegedly due to high physical work demands of healthcare work. Previous investigations have shown promising results of physical exercise for relieving pain among different occupational......, physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend. Thus, it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain. This study is intended to investigate the effect of workplace...... to increase adherence and avoid contamination between interventions. Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1) workplace based physical exercise performed during working hours (using kettlebells, elastic bands and exercise balls...

Reducing electricity demand peaks by scheduling home appliances usage

Energy Technology Data Exchange (ETDEWEB)

Rossello-Busquet, A.; Kardaras, G.; Baek Iversen, V.; Soler, J.; Dittmann, L.

2011-05-15

Nowadays there is a tendency to consume electricity during the same period of the day leading to demand peaks. Regular energy consumption habits lead to demand peaks at specific temporal intervals, because users consume power at the same time. In order to avoid demand peaks, users' appliances should consume electricity in a more temporarily distributed way. A new methodology to schedule the usage of home appliances is proposed and analyzed in this paper. The main concept behind this approach is the aggregation of home appliances into priority classes and the definition of a maximum power consumption limit, which is not allowed to be exceeded during peak hours. The scenario simulated describes a modern household, where the electrical devices are classified in low and high priority groups. The high priority devices are always granted power in order to operate without temporal restrictions. On the contrary, the low priority devices have to pause their operation, when the algorithm dictates it, and resume it in the future. This can become beneficial for both energy companies and users. The electricity suppliers companies will be capable of regulating power generation during demand peaks periods. Moreover, users can be granted lower electricity bill rates for accepting delaying the operation of some of their appliances. In order to analyze this scenario, teletraffic engineering theory, which is used in evaluating the performance of telecommunication networks, is used. A reversible fair scheduling (RFS) algorithm, which was originally developed for telecommunication networks, is applied. The purpose is to analyze how a power consumption limit and priorities for home appliances will affect the demand peak and the users' everyday life. Verification of the effectiveness of the RFS algorithm is done by means of simulation and by using real data for power consumption and operation hours. The defined maximum power limit of 750 and 1000 Watt was not exceeded during

An assisted-living home architecture with integrated healthcare services for elderly people.

Science.gov (United States)

Marsh, Andy; Biniaris, Christos; Vergados, Dimitrios; Eppler, Arnold; Kavvadias, Christoforos; Bigalke, Olaf; Robert, Eric; Jerabek, Boro; Alevizos, Alevizos; Caragiozidis, Michael

2008-01-01

Since the population of elderly people grows absolutely and in relation to the overall population in the world, the improvement of the quality of life of elderly people at home is of a great importance. This can be achieved through the development of generic technologies for managing their domestic ambient environment consisting of medical sensors, entertainment equipment, home automation systems and white goods, increasing their autonomy and safety. In this context, the provision intelligent interactive healthcare services will improve their daily life and allowing at the same time the continuous monitoring of their health and their effective treatment. This work is supported by the INHOME Project EU IST-045061-STP, http://www.ist-inhome.eu.

A home healthcare and school of pharmacy partnership to reduce falls.

Science.gov (United States)

Withey, Mary Boss; Breault, Allison

2013-06-01

Much emphasis has been placed on the impact of falls among older adults, and the relationship between polypharmacy and falls in community-dwelling elders. As home healthcare agencies' critical role in the continuum of care is recognized, so is the responsibility for ensuring that quality patient outcomes are achieved resulting in reduced hospitalizations. As we examined the factors involved in falls and hospitalizations with our home care population, it became evident that the pharmacist plays a critical role in helping to ensure that risk factors associated with falls are minimized through a thorough medication therapy review, completed in collaboration with the case manager and the physician. This project was initiated to positively impact patient outcomes by identifying potential medication issues in those patients who were also identified as high fall risk.

Ethical issues experienced by healthcare workers in nursing homes: Literature review.

Science.gov (United States)

Preshaw, Deborah Hl; Brazil, Kevin; McLaughlin, Dorry; Frolic, Andrea

2016-08-01

Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress. The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs' experiences of ethical issues. Using a systematic approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home. The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work. The review highlighted a need for improved ethics education for care-providers. © The Author(s) 2015.

‘Connected ka pa ba?’: A study on how social media usage affects face-to-face interactions within the home.

OpenAIRE

dela Vega, Marie Grace A.; B. Flores, Rodelyn; M. Magusib, Avon Joyce

2017-01-01

This study looked at the influence of social media usage on the face-to-face family interactions within the home. Its specific purpose was to determine the teenager’s perception of the quality of family interactions in relation to the duration and frequency of the teenager’s social media usage. An online survey to 100 students was conducted to extract the target population. Ten in-depth interviews were conducted to individuals aged 16 to19 who were identified as heavy users of Facebook and/or...

Effects of the per diem prospective payment system with DRG-like grouping system (DPC/PDPS) on resource usage and healthcare quality in Japan.

Science.gov (United States)

Hamada, Hironori; Sekimoto, Miho; Imanaka, Yuichi

2012-10-01

In 2003, Japan introduced the prospective payment system (PPS) with diagnosis-related groups (DRG) rearranged grouping system called the diagnostic procedure combination/per-diem payment system (DPC/PDPS). Even after eight years, little is known about the effects of DPC/PDPS. The purpose of this study was to examine the effects of DPC/PDPS on resource usage and healthcare quality. Using 2001-2009 (fiscal year) administrative data of acute myocardial infarction patients, four indices, including inpatient total accumulated medical charges, length of stay (LOS), mortality rate, and readmission rate, were compared between patients reimbursed by DPC/PDPS or by fee-for-service. DPC/PDPS significantly reduced total accumulated medical charges by $1061 (95% confidence interval [CI], -2007, -116) and LOS by 2.29 days (95% CI, -3.71, -0.88) after risk adjustment. However, mortality rate (Odds ratio [OR], 0.94; 95% CI, 0.73, 1.21) was unchanged. Furthermore, DPC/PDPS increased the readmission rate (OR, 1.37; 95% CI, 1.03, 1.82). This study showed that DPC/PDPS was associated with reduced resource usage, but not improved healthcare quality, as with DRG/PPSs in other countries. To achieve successful healthcare reform, further discussion on additional motives will be required. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Effect of workplace- versus home-based physical exercise on muscle response to sudden trunk perturbation among healthcare workers

DEFF Research Database (Denmark)

Jakobsen, Markus D.; Sundstrup, Emil; Brandt, Mikkel

2015-01-01

.2] on a scale of 0-10) from 18 departments at three hospitals were randomized at the cluster level to 10 weeks of (1) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise...... perturbation. Furthermore, EMG preactivation of the erector spinae and fear avoidance were reduced more following WORK than HOME (95% CI -2.7--0.7 (P WORK and HOME performed 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions per week, respectively......Objectives. The present study investigates the effect of workplace- versus home-based physical exercise on muscle reflex response to sudden trunk perturbation among healthcare workers. Methods. Two hundred female healthcare workers (age: 42 [SD 11], BMI: 24 [SD 4], and pain intensity: 3.1 [SD 2...

The Future of Home Health project: developing the framework for health care at home.

Science.gov (United States)

Lee, Teresa; Schiller, Jennifer

2015-02-01

In addition to providing high-quality care to vulnerable patient populations, home healthcare offers the least costly option for patients and the healthcare system, particularly in postacute care. As the baby boom generation ages, policymakers are expressing concerns about rising costs, variation in home healthcare service use, and program integrity. The Alliance for Home Health Quality and Innovation seeks to develop a research-based strategic framework for the future of home healthcare for older Americans and those with disabilities. This article describes the initiative and invites readers to provide comments and suggestions.

Implementing Home Health Standards in Clinical Practice.

Science.gov (United States)

Gorski, Lisa A

2016-02-01

In 1986, the American Nurses Association (ANA) published the first Standards of Home Health Practice. Revised in 1992 and expanded in 1999 to become Home Health Nursing: Scope and Standards of Practice, it was revised in 2008 and again in 2014. In the 2014 edition, there are 6 standards of home healthcare nursing practice and 10 standards of professional performance for home healthcare nursing. The focus of this article is to describe the home healthcare standards and to provide guidance for implementation in clinical practice. It is strongly encouraged that home healthcare administrators, educators, and staff obtain a copy of the standards and fully read this essential home healthcare resource.

Secondary analysis of a national health survey on factors influencing women in the Philippines to deliver at home and unattended by a healthcare professional.

Science.gov (United States)

Sobel, Howard L; Oliveros, Yolanda E; Nyunt-U, Soe

2010-11-01

To elucidate factors that influence Philippine women to deliver at home and not be attended by a healthcare professional. Analysis of hospital data that were collected through Global Positioning System technology uploaded into the WHO HealthMapper and data on 7380 women from the Philippines Demographic and Health Survey, 2003. Most of the home deliveries that were not attended by healthcare professionals occurred within 15 km of a hospital. Women who had home deliveries and were not attended by a healthcare professional were more likely to be of low educational and economic status and to reside in rural houses without basic amenities (PFinancial barriers will need to be addressed to increase the number of deliveries in a healthcare facility. The apparent failure of hospitals to reduce newborn mortality may be related to suboptimal newborn care practices. Copyright © 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Doing more with Less : A client-centred approach to healthcare logistics in a nursing home setting

NARCIS (Netherlands)

Lineke Verkooijen; Dennis Moeke

2013-01-01

Dutch nursing homes are currently confronted with two seemingly incompatible goals: a more client-centred approach and the necessity to reduce costs at the same time. It is becoming increasingly apparent that healthcare logistics can contribute to providing high-quality care and support at a

RFID in the healthcare supply chain: usage and application.

Science.gov (United States)

Kumar, Sameer; Swanson, Eric; Tran, Thuy

2009-01-01

The purposes of this study are to first, determine the most efficient and cost effective portions of the healthcare supply chain in which radio frequency identification devices (RFID) can be implemented. Second, provide specific examples of RFID implementation and show how these business applications will add to the effectiveness of the healthcare supply chain. And third, to describe the current state of RFID technology and to give practical information for managers in the healthcare sector to make sound decisions about the possible implementation of RFID technology within their organizations. Healthcare industry literature was reviewed and examples of specific instances of RFID implementation were examined using an integrated simulation model developed with Excel, @Risk and Visio software tools. Analysis showed that the cost of implementing current RFID technology is too expensive for broad and sweeping implementation within the healthcare sector at this time. However, several example applications have been identified in which this technology can be effectively leveraged in a cost-effective way. This study shows that RFID technology has come a long way in the recent past and has potential to improve healthcare sector productivity and efficiency. Implementation by large companies such as Wal-mart has helped to make the technology become much more economical in its per unit cost as well as its supporting equipment and training costs. The originality of this study lies in the idea that few practical and pragmatic approaches have been taken within the academic field of study for the implementation of RFID into the healthcare supply chain. Much of the research has focused on specific companies or portions of the supply chain and not the entire supply chain. Also, many of the papers have discussed the future of the supply chain that is heavily dependent on advances in RFID technology. A few viable applications of how RFID technology can be implemented in the healthcare

The linkage between employee and patient satisfaction in home healthcare.

Science.gov (United States)

Rosati, Robert J; Marren, Joan M; Davin, Denise M; Morgan, Cynthia J

2009-01-01

Greater accountability for patient outcomes, reduced reimbursement, and a protracted nursing shortage have made employee and patient satisfaction results central performance metrics and strategic imperatives in healthcare. Key questions are whether the two interact and if so, how can that relationship be leveraged to obtain maximum gains in both employee and patient satisfaction. This article examines the experience of a large, nonprofit home care agency in exploring these issues. The agency found that organizational commitment to patient care and customer service are fundamental to patient satisfaction. The more employees perceived that the organization is focused on quality and customers, the more patient satisfaction increased. Among nurses, work-life balance, fair compensation, and regard for employees all influenced patient satisfaction.

Analysis of commode grab bar usage for the monitoring of older adults in the smart home environment.

Science.gov (United States)

Arcelus, Amaya; Holtzman, Megan; Goubran, Rafik; Sveistrup, Heidi; Guitard, Paulette; Knoefel, Frank

2009-01-01

The occurrence of falls inside the home is a common yet potentially hazardous issue for adults as they age. Even with the installation of physical aids such as grab bars, weight transfers on and off a toilet or bathtub can become increasingly difficult as a person's level of physical mobility and sense of balance deteriorate. Detecting this deterioration becomes an important goal in fall prevention within a smart home. This paper develops an unobtrusive method of analyzing the usage of toilet grab bars using pressure sensors embedded into the arm rests of a commode. Clinical parameters are successfully extracted automatically from a series of stand-to-sit (StSi) and sit-to-stand (SiSt) transfers performed by a trial group of young and older adults. A preliminary comparison of the parameters indicates differences between the two groups, and aligns well with published characteristics obtained using accelerometers worn on the body. The unobtrusive nature of this method provides a useful tool to be incorporated into a system of continuous monitoring of older adults within the smart home environment.

Effect of Workplace- versus Home-Based Physical Exercise on Muscle Response to Sudden Trunk Perturbation among Healthcare Workers

DEFF Research Database (Denmark)

Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel

2015-01-01

Objectives. The present study investigates the effect of workplace- versus home-based physical exercise on muscle reflex response to sudden trunk perturbation among healthcare workers. Methods. Two hundred female healthcare workers (age: 42 [SD 11], BMI: 24 [SD 4], and pain intensity: 3.1 [SD 2.......2] on a scale of 0-10) from 18 departments at three hospitals were randomized at the cluster level to 10 weeks of (1) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise...... perturbation. Furthermore, EMG preactivation of the erector spinae and fear avoidance were reduced more following WORK than HOME (95% CI -2.7--0.7 (P training sessions per week, respectively...

Using comprehensive geriatric assessment for quality improvements in healthcare of older people in UK care homes: protocol for realist review within Proactive Healthcare of Older People in Care Homes (PEACH) study.

Science.gov (United States)

Zubair, Maria; Chadborn, Neil H; Gladman, John R F; Dening, Tom; Gordon, Adam L; Goodman, Claire

2017-10-10

Care home residents are relatively high users of healthcare resources and may have complex needs. Comprehensive geriatric assessment (CGA) may benefit care home residents and improve efficiency of care delivery. This is an approach to care in which there is a thorough multidisciplinary assessment (physical and mental health, functioning and physical and social environments) and a care plan based on this assessment, usually delivered by a multidisciplinary team. The CGA process is known to improve outcomes for community-dwelling older people and those in receipt of hospital care, but less is known about its efficacy in care home residents. Realist review was selected as the most appropriate method to explore the complex nature of the care home setting and multidisciplinary delivery of care. The aim of the realist review is to identify and characterise a programme theory that underpins the CGA intervention. The realist review will extract data from research articles which describe the causal mechanisms through which the practice of CGA generates outcomes. The focus of the intervention is care homes, and the outcomes of interest are health-related quality of life and satisfaction with services; for both residents and staff. Further outcomes may include appropriate use of National Health Service services and resources of older care home residents. The review will proceed through three stages: (1) identifying the candidate programme theories that underpin CGA through interviews with key stakeholders, systematic search of the peer-reviewed and non-peer-reviewed evidence, (2) identifying the evidence relevant to CGA in UK care homes and refining the programme theories through refining and iterating the systematic search, lateral searches and seeking further information from study authors and (3) analysis and synthesis of evidence, involving the testing of the programme theories. The PEACH project was identified as service development following submission to the UK Health

Representing in-home and out-of-home energy consumption behavior in Beijing

International Nuclear Information System (INIS)

Yu Biying; Zhang Junyi; Fujiwara, Akimasa

2011-01-01

It is expected that in-home and out-of-home energy consumption behavior in a household might be correlated with each other, probably due to the existence of household budget constraints. Ownership and usage of energy-saving technologies for in-home appliances (or vehicles) might lead to the increase in out-of-home (or in-home) energy consumption. It is therefore necessary to jointly represent in-home and out-of-home energy consumption in the same modeling framework. With this consideration, we first build a new type of energy consumption model based on the Multiple Discrete-Continuous Extreme Value (MDCEV) modeling framework. Next, we conducted a questionnaire survey in Beijing in 2009 and successfully collected the information about households' energy consumption, ownership/usage of in-home appliances and vehicles, and households' and their members' attributes from 1014 households. Throughout an empirical analysis, it is confirmed that the MDCEV model is effective to simultaneously describe the in-home and out-of-home energy consumption behavior. In addition, it is revealed that a set of household and personal attributes affect the ownership and usage of in-home appliances and vehicles. Furthermore, it is shown that the unobserved factors play a much more important role in explaining energy consumption behavior than the observed attributes of households and their members. - Highlights: → Representing in-home and out-of-home energy consumption behavior jointly. → MDCEV model is built to describe household energy consumption behavior. → Log-linear competitive relationships are found among expenditures of end-uses. → Model results provide some insights about the influence of varied observed factors. → Unobserved factors are more important in explaining energy consumption behavior.

Improving Maternal Healthcare Access and Neonatal Survival through a Birthing Home Model in Rural Haiti

Directory of Open Access Journals (Sweden)

Elizabeth Wickstrom

2007-10-01

Full Text Available High neonatal mortality in Haiti is sustained by limited access to essential maternity services, particularly for Haiti’s rural population. We investigated the feasibility of a rural birthing home model to provide basic prenatal, delivery, and neonatal services for women with uncomplicated pregnancies while simultaneously providing triage and transport of women with pregnancy related complications. The model included consideration of the local context, including women’s perceptions of barriers to healthcare access and available resources to implement change. Evaluation methods included the performance of a baseline community census and collection of pregnancy histories from 791 women living in a defined area of rural Haiti. These retrospective data were compared with pregnancy outcome for 668 women subsequently receiving services at the birthing home. Of 764 reported most recent pregnancies in the baseline survey, 663(87% occurred at home with no assistance from skilled health staff. Of 668 women followed after opening of the birthing home, 514 (77% subsequently gave birth at the birthing home, 94 (14% were referred to a regional hospital for delivery, and only 60 (9% delivered at home or on the way to the birthing home. Other measures of clinical volume and patient satisfaction also indicated positive changes in health care seeking. After introduction of the birthing home, fewer neonates died than predicted by historical information or national statistics. The present experience points out the feasibility of a rural birthing home model to increase access to essential maternity services.

Changes in working conditions for home healthcare workers and impacts on their work activity and on their emotions

Directory of Open Access Journals (Sweden)

Corinne Van De Weerdt

2015-06-01

Full Text Available Home healthcare is steadily growing in many countries. Nevertheless, it is known that home healthcare workers are frequently exposed to a variety of potentially serious occupational hazards. Working conditions have changed to become more emotionally and physically demanding on workers. Emotional labor is increasingly high in this profession. Time pressure is increasingly common. This paper describes an ergonomic study analyzing the working conditions of nursing assistants and nurses, as well as the impacts of their work in terms of job satisfaction, emotions at work, relationships with the others, and occupational stress. The study shows that changing working conditions are making it increasingly difficult for home healthcare workers to do their work properly. We can confirm that such workers use strategies to try to cope. They use individual strategies to preserve the relational dimension of their work activity. These strategies are specifically centered around preserving the relationships with patients, and coping with the demands of the job. The study also shows that workers use strategies to express emotions and to conceal them from others. Finally, the paper presents the recommendations that were discussed with the manager and workers for improving working conditions and that led to practical proposals: e.g. implementing certain items of equipment better suited to difficult care, encouraging assistance between workers when operations so require through appropriate organizational measures, extending emotion-focused work discussion groups with management involvement.

A Collaborative Evaluation Framework for Biometric Connected Devices in Healthcare.

Science.gov (United States)

Farnia, Troskah; Jaulent, Marie Christine; Marchand, Guillaume; Yasini, Mobin

2017-01-01

A large number of biometric connected devices are currently available with a variety of designs. Healthcare users cannot easily choose the reliable ones that correspond the best to their healthcare problems. The existing evaluation methods do not consider at the same time aspects of connectivity and healthcare usage. In this study, a collaborative evaluation framework for biometric connected devices in healthcare usage is proposed. This framework contains six dimensions: medical validity, technical reliability, usability, ergonomy, legal compliance, and accuracy of measurements. In a first step, these dimensions were assessed by designing a self administered questionnaire answered by the stakeholders (patients, health professionals, payers, and manufacturers). A case study was then carried out in a second step to test this framework in a project of telemonitoring for heart failure patients. The results are in favor of the efficiency of the proposed framework as a decision making tool in healthcare usage.

Development of the International Guidelines for Home Health Nursing.

Science.gov (United States)

Narayan, Mary; Farris, Cindy; Harris, Marilyn D; Hiong, Fong Yoke

2017-10-01

Throughout the world, healthcare is increasingly being provided in home and community-based settings. There is a growing awareness that the most effective, least costly, patient-preferred setting is patients' home. Thus, home healthcare nursing is a growing nursing specialty, requiring a unique set of nursing knowledge and skills. Unlike many other nursing specialties, home healthcare nursing has few professional organizations to develop or support its practice. This article describes how an international network of home healthcare nurses developed international guidelines for home healthcare nurses throughout the world. It outlines how the guidelines for home healthcare nursing practice were developed, how an international panel of reviewers was recruited, and the process they used for reaching a consensus. It also describes the plan for nurses to contribute to future updates to the guidelines.

Home healthcare nurse retention and patient outcome model: discussion and model development.

Science.gov (United States)

Ellenbecker, Carol Hall; Cushman, Margaret

2012-08-01

This paper discusses additions to an empirically tested model of home healthcare nurse retention. An argument is made that the variables of shared decision-making and organizational commitment be added to the model based on the authors' previous research and additional evidence from the literature. Previous research testing the home healthcare nurse retention model established empirical relationships between nurse, agency, and area characteristics to nurse job satisfaction, intent to stay, and retention. Unexplained model variance prompted a new literature search to augment understanding of nurse retention and patient and agency outcomes. Data come from the authors' previous research, and a literature search from 1990 to 2011 on the topics organizational commitment, shared decision-making, nurse retention, patient outcomes and agency performance. The literature provides a rationale for the additional variables of shared decision-making and affective and continuous organizational commitment, linking these variables to nurse job satisfaction, nurse intent to stay, nurse retention and patient outcomes and agency performance. Implications for nursing.  The new variables in the model suggest that all agencies, even those not struggling to retain nurses, should develop interventions to enhance nurse job satisfaction to assure quality patient outcomes. The new nurse retention and patient outcome model increases our understanding of nurse retention. An understanding of the relationship among these variables will guide future research and the development of interventions to create and maintain nursing work environments that contribute to nurse affective agency commitment, nurse retention and quality of patient outcomes. © 2011 Blackwell Publishing Ltd.

A cloud-based home health care information sharing system to connect patients with home healthcare staff -A case report of a study in a mountainous region.

Science.gov (United States)

Nomoto, Shinichi; Utsumi, Momoe; Sasayama, Satoshi; Dekigai, Hiroshi

2017-01-01

We have developed a cloud system, the e-Renraku Notebook (e-RN) for sharing of home care information based on the concept of "patient-centricity". In order to assess the likelihood that our system will enhance the communication and sharing of information between home healthcare staff members and home-care patients, we selected patients who were residing in mountainous regions for inclusion in our study. We herein report the findings.Eighteen staff members from 7 medical facilities and 9 patients participated in the present study.The e-RN was developed for two reasons: to allow patients to independently report their health status and to have staff members view and respond to the information received. The patients and staff members were given iPads with the pre-installed applications and the information being exchanged was reviewed over a 54-day period.Information was mainly input by the patients (61.6%), followed by the nurses who performed home visits (19.9%). The amount of information input by patients requiring high-level nursing care and their corresponding staff member was significantly greater than that input by patients who required low-level of nursing care.This patient-centric system in which patients can independently report and share information with a member of the healthcare staff provides a sense of security. It also allows staff members to understand the patient's health status before making a home visit, thereby giving them a sense of security and confidence. It was also noteworthy that elderly patients requiring high-level nursing care and their staff counterpart input information in the system significantly more frequently than patients who required low-level care.

The Effectiveness of Hands-on Health Informatics Skills Exercises in the Multidisciplinary Smart Home Healthcare and Health Informatics Training Laboratories.

Science.gov (United States)

Sapci, A H; Sapci, H A

2017-10-01

This article aimed to evaluate the effectiveness of newly established innovative smart home healthcare and health informatics laboratories, and a novel laboratory course that focuses on experiential health informatics training, and determine students' self-confidence to operate wireless home health monitoring devices before and after the hands-on laboratory course. Two web-based pretraining and posttraining questionnaires were sent to 64 students who received hands-on training with wireless remote patient monitoring devices in smart home healthcare and health informatics laboratories. All 64 students completed the pretraining survey (100% response rate), and 49 students completed the posttraining survey (76% response rate). The quantitative data analysis showed that 95% of students had an interest in taking more hands-on laboratory courses. Sixty-seven percent of students had no prior experience with medical image, physiological data acquisition, storage, and transmission protocols. After the hands-on training session, 75.51% of students expressed improved confidence about training patients to measure blood pressure monitor using wireless devices. Ninety percent of students preferred to use a similar experiential approach in their future learning experience. Additionally, the qualitative data analysis demonstrated that students were expecting to have more courses with hands-on exercises and integration of technology-enabled delivery and patient monitoring concepts into the curriculum. This study demonstrated that the multidisciplinary smart home healthcare and health informatics training laboratories and the hands-on exercises improved students' technology adoption rates and their self-confidence in using wireless patient monitoring devices. Schattauer GmbH Stuttgart.

Home Care

Science.gov (United States)

... are part of home healthcare agencies. You may benefit from home care if you are dealing with ... it will trigger an emergency response or checkup phone call. Newer technologies ... or mobile testing technology (home diagnostics), including x-rays and ...

Home care services for sick children

DEFF Research Database (Denmark)

Castor, Charlotte; Hallström, Inger; Hansson, Eva Helena

2017-01-01

as challenging for healthcare professionals in home care services used to providing care predominately for adults. DESIGN: An inductive qualitative design. METHOD: Seven focus group interviews were performed with 36 healthcare professionals from multidisciplinary home care services. Data were analysed stepwise......AIMS AND OBJECTIVES: To explore healthcare professionals' conceptions of caring for sick children in home care services. BACKGROUND: Families often prefer home care to hospital care, and the number of home care services for children is increasing. Caring for children at home has been recognised...... using a phenomenographic analysis. RESULTS: Three description categories emerged: "A challenging opportunity", "A child perspective", and "Re-organise in accordance with new prerequisites." Providing home care services for children was conceived to evoke both professional and personal challenges...

Appearance-Based Multimodal Human Tracking and Identification for Healthcare in the Digital Home

Directory of Open Access Journals (Sweden)

Mau-Tsuen Yang

2014-08-01

Full Text Available There is an urgent need for intelligent home surveillance systems to provide home security, monitor health conditions, and detect emergencies of family members. One of the fundamental problems to realize the power of these intelligent services is how to detect, track, and identify people at home. Compared to RFID tags that need to be worn all the time, vision-based sensors provide a natural and nonintrusive solution. Observing that body appearance and body build, as well as face, provide valuable cues for human identification, we model and record multi-view faces, full-body colors and shapes of family members in an appearance database by using two Kinects located at a home’s entrance. Then the Kinects and another set of color cameras installed in other parts of the house are used to detect, track, and identify people by matching the captured color images with the registered templates in the appearance database. People are detected and tracked by multisensor fusion (Kinects and color cameras using a Kalman filter that can handle duplicate or partial measurements. People are identified by multimodal fusion (face, body appearance, and silhouette using a track-based majority voting. Moreover, the appearance-based human detection, tracking, and identification modules can cooperate seamlessly and benefit from each other. Experimental results show the effectiveness of the human tracking across multiple sensors and human identification considering the information of multi-view faces, full-body clothes, and silhouettes. The proposed home surveillance system can be applied to domestic applications in digital home security and intelligent healthcare.

Laughter, Leininger, and home healthcare.

Science.gov (United States)

Schwartz, Kathleen D; Saunders, Jana C

2010-10-01

Home health clinicians provide care for a culturally diverse patient population. According to Leininger's Theory of Culture Care Diversity and Universality (2010), caring is a universal phenomenon that varies based on a patient's cultural beliefs, values, and practices. Humor therapy promotes spontaneous therapeutic patient laughter. Assisting patients and families to maintain or regain their health or well-being and to deal with disabilities, dying, or other human conditions in culturally congruent and humorous ways may be beneficial. The purpose of this article is to discuss how Leininger's Theory of Culture Care Diversity and Universality (Leininger & McFarland, 2006) and humor therapy can be combined to achieve better outcomes for home health patients. A case study of how this was applied to a first-generation Irish-American home health patient is included.

Effect of workplace- versus home-based physical exercise on pain in healthcare workers: study protocol for a single blinded cluster randomized controlled trial.

Science.gov (United States)

Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel; Kristensen, Anne Zoëga; Jay, Kenneth; Stelter, Reinhard; Lavendt, Ebbe; Aagaard, Per; Andersen, Lars L

2014-04-07

The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers, allegedly due to high physical work demands of healthcare work. Previous investigations have shown promising results of physical exercise for relieving pain among different occupational groups, but the question remains whether such physical exercise should be performed at the workplace or conducted as home-based exercise. Performing physical exercise at the workplace together with colleagues may be more motivating for some employees and thus increase adherence. On the other hand, physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend. Thus, it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain. This study is intended to investigate the effect of workplace-based versus home-based physical exercise on musculoskeletal pain among healthcare workers. This study was designed as a cluster randomized controlled trial performed at 3 hospitals in Copenhagen, Denmark. Clusters are hospital departments and hospital units. Cluster randomization was chosen to increase adherence and avoid contamination between interventions. Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1) workplace based physical exercise performed during working hours (using kettlebells, elastic bands and exercise balls) for 5 × 10 minutes per week and up to 5 group-based coaching sessions, or 2) home based physical exercise performed during leisure time (using elastic bands and body weight exercises) for 5 × 10 minutes per week. Both intervention groups will also receive ergonomic instructions on patient handling and use of lifting aides etc. Inclusion criteria are female healthcare workers working at a hospital. Average pain intensity (VAS scale 0-10) of the back, neck and shoulder (primary outcome) and physical

Where the Rubber Hits the Road: What Home Healthcare Professionals Need to Know About Driving Safety for Persons With Dementia.

Science.gov (United States)

Pastor, Diane K; Jones, Andrea; Arms, Tamatha

2017-01-01

Driving cessation for people with dementia is a significant personal safety and public health issue. Home healthcare professionals frequently encounter situations where patients/clients should not continue to drive, and family members are unaware of how to approach the issue. This article will inform readers of the current state of the healthcare driving assessment process, measures and instruments used to assess, and effective strategies and resources when working with families facing the dilemma of how and when to proceed with a driving cessation plan.

Effect of workplace- versus home-based physical exercise on pain in healthcare workers: study protocol for a single blinded cluster randomized controlled trial

Science.gov (United States)

2014-01-01

Background The prevalence and consequences of musculoskeletal pain is considerable among healthcare workers, allegedly due to high physical work demands of healthcare work. Previous investigations have shown promising results of physical exercise for relieving pain among different occupational groups, but the question remains whether such physical exercise should be performed at the workplace or conducted as home-based exercise. Performing physical exercise at the workplace together with colleagues may be more motivating for some employees and thus increase adherence. On the other hand, physical exercise performed during working hours at the workplace may be costly for the employers in terms of time spend. Thus, it seems relevant to compare the efficacy of workplace- versus home-based training on musculoskeletal pain. This study is intended to investigate the effect of workplace-based versus home-based physical exercise on musculoskeletal pain among healthcare workers. Methods/Design This study was designed as a cluster randomized controlled trial performed at 3 hospitals in Copenhagen, Denmark. Clusters are hospital departments and hospital units. Cluster randomization was chosen to increase adherence and avoid contamination between interventions. Two hundred healthcare workers from 18 departments located at three different hospitals is allocated to 10 weeks of 1) workplace based physical exercise performed during working hours (using kettlebells, elastic bands and exercise balls) for 5 × 10 minutes per week and up to 5 group-based coaching sessions, or 2) home based physical exercise performed during leisure time (using elastic bands and body weight exercises) for 5 × 10 minutes per week. Both intervention groups will also receive ergonomic instructions on patient handling and use of lifting aides etc. Inclusion criteria are female healthcare workers working at a hospital. Average pain intensity (VAS scale 0-10) of the back, neck and shoulder

Safety, efficacy, and usage compliance of home-use device utilizing RF and light energies for treating periorbital wrinkles.

Science.gov (United States)

Gold, Michael H; Biron, Julie; Levi, Liora; Sensing, Whitney

2017-03-01

The aging process is often associated with undesirable effects on facial skin such as skin redundancy, reduction of elasticity, and increased wrinkling. Radiofrequency (RF) and light-emitting diodes (LEDs) are widely used, clinically proven technologies for skin rejuvenation. This study aimed to evaluate the safety, efficacy, and usage compliance of the home-use device, utilizing RF and LED energies, for self-treatment of periorbital wrinkles and improvement of skin appearance. Thirty-three subjects performed 21 treatment sessions every other day, over 6 weeks on the periorbital areas. In addition, two maintenance treatments were conducted 1 and 2 months following treatment end. Each subject served as his/her own control, comparing results before treatment, and 3 months following treatment end. Thirty subjects completed the study. A blinded, independent photographs assessment of three dermatologists demonstrated an average reduction of 1.49 Fitzpatrick scores (P Skin Tightening (HST) device offers a safe and effective in-home noninvasive technique to improve the appearance of age-related periorbital wrinkles. © 2016 Wiley Periodicals, Inc.

Preventing Rehospitalization through effective home health nursing care.

Science.gov (United States)

Vasquez, Monica S

2009-01-01

To identify strategies to improve patient outcomes and prevent rehospitalizations in home healthcare. PRIMARY PRACTICE SETTINGS(S): Primarily for home healthcare but can also be a tool for all other fields in nursing. Through team collaboration and the proper resources, patient outcomes can improve and be cost-effective for home healthcare agencies despite the changes implemented after the Medicare change in payment for services, the prospective payment system. The main goal for home healthcare is to improve patient outcomes. Nurses experienced in case management can devise creative strategies to ensure patient outcomes are met in a cost-effective manner. With continuous changes in reimbursement and payment incentives, case managers in every level of care must know about, and be responsible for, fiscal initiatives.

Review Clostridium difficile: A healthcare-associated infection of ...

African Journals Online (AJOL)

CDI is a healthcare-associated infection for which the primary risk factor is antibiotic usage, and it is the leading ... Three (of three) studies found an association with antibiotic usage. One (of four) ... prevalence and virulence of C. difficile in recent years.8-10 This ..... Changing trends in bacterial infections: Staphylococcus.

Healthcare providers' perceptions of barriers in implementing of home telecare in Taiwan: a qualitative study.

Science.gov (United States)

Chiang, Kuei-Feng; Wang, Hsiu-Hung; Chien, I-Kuang; Liou, Jhao-Kun; Hung, Chung-Lieh; Huang, Chien-Min; Yang, Feng-Yueh

2015-04-01

Telecare has not only brought down medical expenses, but has also become an important tool to address healthcare needs. In recent years, the Taiwanese government has been concerned about this healthcare issue. However, only a few hospitals provide telecare. This study aims at investigating the barriers that healthcare providers face while implementing home telecare in Taiwan. A qualitative research design was employed in this study, with semi-structured in-depth interviews. The sample was obtained from five hospitals, including three medical centers and two regional hospitals. A total of 31 healthcare providers were interviewed, including case managers (n=11), administrators (n=7), physicians (n=7), and nurses (n=6). The results were summarized into five themes, including: (1) unsuitable laws and vague policies, (2) the policy implementation fails to meet public needs, (3) lack of organizational support, (4) lack of quality and convenience of the system, and (5) inadequate public perception and attitudes. Obstacles in policy and regulations are the most fundamental difficulties for telecare implementation, therefore the government should provide a clear direction by planning policies, legislate appropriate regulations, and incorporate telecare into the scope of medical insurance, in order to improve the environment and stimulate the telecare service market. In order to improve the success rate of telecare, administrators should be able to identify an appropriate cost-benefit model to build a humane system to satisfy public needs and to provide staff with resources and support. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Healthcare workers mobile phone usage: A potential risk for viral contamination. Surveillance pilot study.

Science.gov (United States)

Cavari, Yuval; Kaplan, Or; Zander, Aviva; Hazan, Guy; Shemer-Avni, Yonat; Borer, Abraham

2016-01-01

Mobile phones are commonly used by healthcare workers (HCW) in the working environment, as they allow instant communication and endless resource utilisation. Studies suggest that mobile phones have been implicated as reservoirs of bacterial pathogens, with the potential to cause nosocomial infection. This study aimed to investigate the presence of Respiratory Syncytial Virus, Adenovirus and Influenza Virus on HCWs mobile phones and to identify risk factors implied by HCWs practice of mobile phones in a clinical paediatric environment. Fifty HCWs' mobile phones were swabbed over both sides of the mobile phone, for testing of viral contamination during 8 days in January 2015. During the same period, a questionnaire investigating usage of mobile phones was given to 101 HCWs. Ten per cent of sampled phones were contaminated with viral pathogens tested for. A total of 91% of sampled individuals by questionnaire used their mobile phone within the workplace, where 37% used their phone at least every hour. Eighty-nine (88%) responders were aware that mobile phones could be a source of contamination, yet only 13 (13%) disinfect their cell phone regularly. Mobile phones in clinical practice may be contaminated with viral pathogenic viruses. HCWs use their mobile phone regularly while working and, although the majority are aware of contamination, they do not disinfect their phones.

Healthcare seeking behaviour of students living on their own compared to those living in the parental home: a cross-sectional study

NARCIS (Netherlands)

Hof, Samuel N.; Messoussi, Ilyes; Schuijt, Michiel T. U.; de Goeij, Moniek C. M.; Kunst, Anton E.

2017-01-01

Objective This study aimed to investigate differences in healthcare seeking behaviour and barriers between students living in the parental home and those living on their own. Participants Five hundred and six second year students of the University of Amsterdam (UvA), interviewed in March and April

An investigation of factors influencing healthcare workers' use and acceptance of e-learning in post-school healthcare education.

Science.gov (United States)

Mikalsen, Marius; Walderhaug, Ståle

2009-01-01

The objective of the study presented here was to perform an empirical investigation on factors affecting healthcare workers acceptance and utilisation of e-learning in post-school healthcare education. E-learning benefits are realised when key features of e-learning are not only applied, but deemed useful, compatible with the learning process and supportive in order to reach the overall goals of the learning process. We conducted a survey of 14 state-enrolled nurses and skilled-workers within the field of healthcare in Norway. The results show that perceived compatibility and subjective norm explain system usage of the e-learning tool amongst the students. We found that the fact that the students considered the e-learning to be compatible with the course in question had a positive effect on e-learning tool usage. We also found support for factors such as facilitating conditions and ease of use leads to the e-learning tool being considered useful.

On participatory design of home-based healthcare

DEFF Research Database (Denmark)

Grönvall, Erik; Kyng, Morten

2013-01-01

Participatory design (PD) activities in private homes challenge how we relate to the PD process, compared to PD in professional settings. Grounded in a project related to chronic dizziness among older people, we identified four challenges when performing PD with ill, weak users in their private...... homes. The challenges are (1) designing for, and negotiating knowledge about, the home, (2) ill, weak users and their participation in PD, (3) divergent interests of participants and (4) usable and sustainable post-project solutions. These challenges have to be carefully addressed, and we use them...... to reflect upon differences between a home-based PD process with non-workers, such as ours, and work-place projects, such as Utopia. Through this reflection, the paper contributes to a more general discussion on PD in non-work settings with weak users. Indeed, differences do exist between traditional PD...

Impact of Healthcare Information Technology on Nursing Practice.

Science.gov (United States)

Piscotty, Ronald J; Kalisch, Beatrice; Gracey-Thomas, Angel

2015-07-01

To report additional mediation findings from a descriptive cross sectional study to examine if nurses' perceptions of the impact of healthcare information technology on their practice mediates the relationship between electronic nursing care reminder use and missed nursing care. The study used a descriptive design. The sample (N = 165) was composed of registered nurses working on acute care hospital units. The sample was obtained from a large teaching hospital in Southeast Michigan in the fall of 2012. All eligible nursing units (n = 19) were included. The MISSCARE Survey, Nursing Care Reminders Usage Survey, and the Impact of Healthcare Information Technology Scale were used to collect data to test for mediation. Mediation was tested using the method described by Baron and Kenny. Multiple regression equations were used to analyze the data to determine if mediation occurred between the variables. Missed nursing care, the outcome variable, was regressed on the predictor variable, reminder usage, and the mediator variable impact of technology on nursing practice. The impact of healthcare information technology (IHIT) on nursing practice negatively affected missed nursing care (t = -4.12, p information technology mediates the relationship between nursing care reminder use and missed nursing care. The findings are beneficial to the advancement of healthcare technology in that designers of healthcare information technology systems need to keep in mind that perceptions regarding impacts of the technology will influence usage. Many times, information technology systems are not designed to match the workflow of nurses. Systems built with redundant or impertinent reminders may be ignored. System designers must study which reminders nurses find most useful and which reminders result in the best quality outcomes. © 2015 Sigma Theta Tau International.

Smart homes, private homes? An empirical study of technology researchers? perceptions of ethical issues in developing smart-home health technologies

OpenAIRE

Birchley, Giles; Huxtable, Richard; Murtagh, Madeleine; ter Meulen, Ruud; Flach, Peter; Gooberman-Hill, Rachael

2017-01-01

Background Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology?s potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engine...

A comparison of the home-care and healthcare service use and costs of older Australians randomised to receive a restorative or a conventional home-care service.

Science.gov (United States)

Lewin, Gill; Allan, Janine; Patterson, Candice; Knuiman, Matthew; Boldy, Duncan; Hendrie, Delia

2014-05-01

Restorative home-care services, or re-ablement home-care services as they are now known in the UK, aim to assist older individuals who are experiencing difficulties in everyday living to optimise their functioning and reduce their need for ongoing home care. Until recently, the effectiveness of restorative home-care services had only been investigated in terms of singular outcomes such as length of home-care episode, admission to hospital and quality of life. This paper reports on a more complex and perhaps more significant measure--the use and cost of the home-care and healthcare services received over the 2-year period following service commencement. Seven hundred and fifty older individuals referred for government-funded home care were randomly assigned to a restorative or standard service between June 2005 and August 2007. Health and aged care service data were sourced and linked via the Western Australian Data Linkage System. Restorative clients used fewer home-care hours (mean [SD], 117.3 [129.4] vs. 191.2 [230.4]), had lower total home-care costs (AU$5570 vs. AU$8541) and were less likely to be approved for a higher level of aged care (N [%], 171 [55.2] vs. 249 [63.0]) during follow-up. They were also less likely to have presented at an emergency department (OR = 0.69, 95% CI = 0.50-0.94) or have had an unplanned hospital admission [OR (95% CI), 0.69 (0.50-0.95)]. Additionally, the aggregated health and home-care costs of the restorative clients were lower by a factor of 0.83 (95% CI 0.72-0.96) over the 2-year follow-up (AU$19,090 vs. AU$23,428). These results indicate that at a time when Australia is facing the challenges of population ageing and an expected increase in demand for health and aged care services, the provision of a restorative service when an older person is referred for home care is potentially a more cost-effective option than providing conventional home care. © 2014 The Authors. Health and Social Care in the Community published by John

XML technologies for the Omaha System: a data model, a Java tool and several case studies supporting home healthcare.

Science.gov (United States)

Vittorini, Pierpaolo; Tarquinio, Antonietta; di Orio, Ferdinando

2009-03-01

The eXtensible markup language (XML) is a metalanguage which is useful to represent and exchange data between heterogeneous systems. XML may enable healthcare practitioners to document, monitor, evaluate, and archive medical information and services into distributed computer environments. Therefore, the most recent proposals on electronic health records (EHRs) are usually based on XML documents. Since none of the existing nomenclatures were specifically developed for use in automated clinical information systems, but were adapted to such use, numerous current EHRs are organized as a sequence of events, each represented through codes taken from international classification systems. In nursing, a hierarchically organized problem-solving approach is followed, which hardly couples with the sequential organization of such EHRs. Therefore, the paper presents an XML data model for the Omaha System taxonomy, which is one of the most important international nomenclatures used in the home healthcare nursing context. Such a data model represents the formal definition of EHRs specifically developed for nursing practice. Furthermore, the paper delineates a Java application prototype which is able to manage such documents, shows the possibility to transform such documents into readable web pages, and reports several case studies, one currently managed by the home care service of a Health Center in Central Italy.

Impact of ICT on Home Healthcare

NARCIS (Netherlands)

Vavilis, S.; Petkovic, M.; Zannone, N.; Hercheui, M.D.; Whitehouse, D.; McIver, W.J.; Phahlamohlaka, J.

2012-01-01

Innovation in information and communication technology has a great potential to create large impact on modern healthcare. However, for the new technologies to be adopted, the innovations have to be meaningful and timely, taking into account user needs and addressing societal and ethical concerns. In

A natural fit: home healthcare and biomedical engineering.

Science.gov (United States)

Damasco, Nestor; Abe, Chris

2010-01-01

The involvement of Biomed in management of home care equipment has become a natural fit for Rady Children's Hospital. Managing all aspects of home care equipment through an in-house biomedical engineering department is cost-effective, efficient, provides excellent customer service, and enhances the relationship with the clinical staff and patients. It develops a sense of security for patients and staff that home care equipment is tested and maintained in a stringent manner that promotes safety.

Home health nursing care services in Greece during an economic crisis.

Science.gov (United States)

Adamakidou, T; Kalokerinou-Anagnostopoulou, A

2017-03-01

The purpose of this review was to describe public home healthcare nursing services in Greece. The effectiveness and the efficiency of home healthcare nursing are well documented in the international literature. In Greece, during the current financial crisis, the development of home healthcare nursing services is the focus and interest of policymakers and academics because of its contribution to the viability of the healthcare system. A review was conducted of the existing legislation, the printed and electronic bibliography related to the legal framework, the structures that provide home health care, the funding of the services, the human resources and the services provided. The review of the literature revealed the strengths and weaknesses of the existing system of home health care and its opportunities and threats, which are summarized in a SWOT analysis. There is no Greek nursing literature on this topic. The development of home health nursing care requires multidimensional concurrent and combined changes and adjustments that would support and strengthen healthcare professionals in their practices. Academic and nursing professionals should provide guidelines and regulations and develop special competencies for the best nursing practice in home health care. At present, in Greece, which is in an economic crisis and undergoing reforms in public administration, there is an undeniable effort being made to give primary health care the position it deserves within the health system. There is an urgent need at central and academic levels to develop home healthcare services to improve the quality and efficiency of the services provided. © 2016 International Council of Nurses.

Effect of Workplace- versus Home-Based Physical Exercise on Muscle Response to Sudden Trunk Perturbation among Healthcare Workers: A Cluster Randomized Controlled Trial

Science.gov (United States)

Jakobsen, Markus D.; Jay, Kenneth

2015-01-01

Objectives. The present study investigates the effect of workplace- versus home-based physical exercise on muscle reflex response to sudden trunk perturbation among healthcare workers. Methods. Two hundred female healthcare workers (age: 42 [SD 11], BMI: 24 [SD 4], and pain intensity: 3.1 [SD 2.2] on a scale of 0–10) from 18 departments at three hospitals were randomized at the cluster level to 10 weeks of (1) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or (2) home-based physical exercise (HOME) performed during leisure time for 5 × 10 minutes per week. Mechanical and neuromuscular (EMG) response to randomly assigned unloading and loading trunk perturbations and questions of fear avoidance were assessed at baseline and 10-week follow-up. Results. No group by time interaction for the mechanical trunk response and EMG latency time was seen following the ten weeks (P = 0.17–0.75). However, both groups demonstrated within-group changes (P < 0.05) in stopping time during the loading and unloading perturbation and in stopping distance during the loading perturbation. Furthermore, EMG preactivation of the erector spinae and fear avoidance were reduced more following WORK than HOME (95% CI −2.7–−0.7 (P < 0.05) and −0.14 (−0.30 to 0.02) (P = 0.09)), respectively. WORK and HOME performed 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions per week, respectively. Conclusions. Although training adherence was higher following WORK compared to HOME this additional training volume did not lead to significant between-group differences in the responses to sudden trunk perturbations. However, WORK led to reduced fear avoidance and reduced muscle preactivity prior to the perturbation onset, compared with HOME. This trial is registered with Clinicaltrials.gov (NCT01921764). PMID:26583145

Effect of Workplace- versus Home-Based Physical Exercise on Muscle Response to Sudden Trunk Perturbation among Healthcare Workers: A Cluster Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Markus D. Jakobsen

2015-01-01

Full Text Available Objectives. The present study investigates the effect of workplace- versus home-based physical exercise on muscle reflex response to sudden trunk perturbation among healthcare workers. Methods. Two hundred female healthcare workers (age: 42 [SD 11], BMI: 24 [SD 4], and pain intensity: 3.1 [SD 2.2] on a scale of 0–10 from 18 departments at three hospitals were randomized at the cluster level to 10 weeks of (1 workplace physical exercise (WORK performed in groups during working hours for 5 × 10 minutes per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or (2 home-based physical exercise (HOME performed during leisure time for 5 × 10 minutes per week. Mechanical and neuromuscular (EMG response to randomly assigned unloading and loading trunk perturbations and questions of fear avoidance were assessed at baseline and 10-week follow-up. Results. No group by time interaction for the mechanical trunk response and EMG latency time was seen following the ten weeks (P = 0.17–0.75. However, both groups demonstrated within-group changes (P<0.05 in stopping time during the loading and unloading perturbation and in stopping distance during the loading perturbation. Furthermore, EMG preactivation of the erector spinae and fear avoidance were reduced more following WORK than HOME (95% CI −2.7–−0.7 (P<0.05 and −0.14 (−0.30 to 0.02 (P=0.09, respectively. WORK and HOME performed 2.2 (SD: 1.1 and 1.0 (SD: 1.2 training sessions per week, respectively. Conclusions. Although training adherence was higher following WORK compared to HOME this additional training volume did not lead to significant between-group differences in the responses to sudden trunk perturbations. However, WORK led to reduced fear avoidance and reduced muscle preactivity prior to the perturbation onset, compared with HOME. This trial is registered with Clinicaltrials.gov (NCT01921764.

Predictors of low back pain in nursing home workers after implementation of a safe resident handling programme.

Science.gov (United States)

Gold, Judith E; Punnett, Laura; Gore, Rebecca J

2017-06-01

Healthcare workers have high rates of low back pain (LBP) related to handling patients. A large chain of nursing homes experienced reduced biomechanical load, compensation claims and costs following implementation of a safe resident handling programme (SRHP). The aim of this study was to examine whether LBP similarly declined and whether it was associated with relevant self-reported occupational exposures or personal health factors. Worker surveys were conducted on multiple occasions beginning with the week of first SRHP introduction (baseline). In each survey, the outcome was LBP during the prior 3 months with at least mild severity during the past week. Robust Poisson multivariable regression models were constructed to examine correlates of LBP cross-sectionally at 2 years (F3) and longitudinally at 5-6 years (F5) post-SRHP implementation among workers also in at least one prior survey. LBP prevalence declined minimally between baseline and F3. The prevalence was 37% at F3 and cumulative incidence to F5 was 22%. LBP prevalence at F3 was positively associated with combined physical exposures, psychological job demands and prior back injury, while frequent lift device usage and 'intense' aerobic exercise frequency were protective. At F5, the multivariable model included frequent lift usage at F3 (relative risk (RR) 0.39 (0.18 to 0.84)) and F5 work-family imbalance (RR=1.82 (1.12 to 2.98)). In this observational study, resident lifting device usage predicted reduced LBP in nursing home workers. Other physical and psychosocial demands of nursing home work also contributed, while frequent intense aerobic exercise appeared to reduce LBP risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Enabling active and healthy ageing decision support systems with the smart collection of TV usage patterns.

Science.gov (United States)

Billis, Antonis S; Batziakas, Asterios; Bratsas, Charalampos; Tsatali, Marianna S; Karagianni, Maria; Bamidis, Panagiotis D

2016-03-01

Smart monitoring of seniors behavioural patterns and more specifically activities of daily living have attracted immense research interest in recent years. Development of smart decision support systems to support the promotion of health smart homes has also emerged taking advantage of the plethora of smart, inexpensive and unobtrusive monitoring sensors, devices and software tools. To this end, a smart monitoring system has been used in order to extract meaningful information about television (TV) usage patterns and subsequently associate them with clinical findings of experts. The smart TV operating state remote monitoring system was installed in four elderly women homes and gathered data for more than 11 months. Results suggest that TV daily usage (time the TV is turned on) can predict mental health change. Conclusively, the authors suggest that collection of smart device usage patterns could strengthen the inference capabilities of existing health DSSs applied in uncontrolled settings such as real senior homes.

Smart Homes for Elderly Healthcare—Recent Advances and Research Challenges

Science.gov (United States)

Aghayi, Emad; Noferesti, Moein; Memarzadeh-Tehran, Hamidreza; Mondal, Tapas; Deen, M. Jamal

2017-01-01

Advancements in medical science and technology, medicine and public health coupled with increased consciousness about nutrition and environmental and personal hygiene have paved the way for the dramatic increase in life expectancy globally in the past several decades. However, increased life expectancy has given rise to an increasing aging population, thus jeopardizing the socio-economic structure of many countries in terms of costs associated with elderly healthcare and wellbeing. In order to cope with the growing need for elderly healthcare services, it is essential to develop affordable, unobtrusive and easy-to-use healthcare solutions. Smart homes, which incorporate environmental and wearable medical sensors, actuators, and modern communication and information technologies, can enable continuous and remote monitoring of elderly health and wellbeing at a low cost. Smart homes may allow the elderly to stay in their comfortable home environments instead of expensive and limited healthcare facilities. Healthcare personnel can also keep track of the overall health condition of the elderly in real-time and provide feedback and support from distant facilities. In this paper, we have presented a comprehensive review on the state-of-the-art research and development in smart home based remote healthcare technologies. PMID:29088123

Smart Homes for Elderly Healthcare—Recent Advances and Research Challenges

Directory of Open Access Journals (Sweden)

Sumit Majumder

2017-10-01

Full Text Available Advancements in medical science and technology, medicine and public health coupled with increased consciousness about nutrition and environmental and personal hygiene have paved the way for the dramatic increase in life expectancy globally in the past several decades. However, increased life expectancy has given rise to an increasing aging population, thus jeopardizing the socio-economic structure of many countries in terms of costs associated with elderly healthcare and wellbeing. In order to cope with the growing need for elderly healthcare services, it is essential to develop affordable, unobtrusive and easy-to-use healthcare solutions. Smart homes, which incorporate environmental and wearable medical sensors, actuators, and modern communication and information technologies, can enable continuous and remote monitoring of elderly health and wellbeing at a low cost. Smart homes may allow the elderly to stay in their comfortable home environments instead of expensive and limited healthcare facilities. Healthcare personnel can also keep track of the overall health condition of the elderly in real-time and provide feedback and support from distant facilities. In this paper, we have presented a comprehensive review on the state-of-the-art research and development in smart home based remote healthcare technologies.

An Exploration of Intent to Use Telehealth at Home for Patients with Chronic Diseases

Directory of Open Access Journals (Sweden)

Shu-Lin Uei

2017-12-01

Full Text Available Telecare is defined as care practiced at a distance. It is an effective strategy for improving the self-health care management of home-patients with chronic diseases. The purpose of this study was to explore the intent to use of telehealth patients. The correlation between the self-care behaviors, the intent to use of telehealth, and the effects on physiological indicators of patients with chronic disease at home were studied. A cross-sectional study design employing purposive sampling was selected. The structured questionnaire ‘Telecare Usage Intention Scale and Self-Care Behavior Scale’ were used, ‘HbA1c, glucose levels and monthly blood pressure measurements’ were analyzed in this thirteen month study. The self-care behaviors of the participants were positively correlated with their intent to use telehealth (p < 0.01. The results also indicated that HbA1c, glucose levels and frequency BP measurement of the participants improved significantly after using telecare (p < 0.005. The results indicated a strong intent to use telehealth and positive perception of telecare services by in-home patients with a chronic disease. Telehealth improves the self-care behavior of in-home chronic disease patients and enhances medical professionals’ ability to deliver quality and effective healthcare.

Technology-dependent Children and Home Care

Directory of Open Access Journals (Sweden)

Nurdan Akçay Didişen

2017-12-01

Full Text Available Today, with the rapid development in the field of healthcare technology which is reflected in medicine and patient care, the number of children who are dependent on technological tools and in need of special care, and sustain life in the home environment is rapidly increasing. These children require a multidisciplinary, multifunctional care at home. In the provision of care, healthcare workers, such as physicians, nurses, physiotherapists, social workers and psychologists, work in coordination. The aim of this review was to draw attention to the care of the technology-dependent children at home. In order to achieve the goals of the care given to the technology-dependent child, inclusion of the family in the provision of care is of importance. In order to improve the care given to these children at home, home care services must be well planned and their families should be trained on the issue because delaying the discharge of these children may increase their risk of developing a hospital-acquired infection and can extend the length of their stay in the hospital. This not only increases hospital costs but also leads to the occupation of a bed in the pediatric intensive care unit. Therefore, home healthcare is an alternative for technology-dependent children with chronic diseases and for their families. Therefore, more efforts should be made to plan and evaluate home care services, to set up support and training systems, and to make legal arrangements.

Transmission of MRSA to Healthcare Personnel Gowns and Gloves during Care of Nursing Home Residents

Science.gov (United States)

Roghmann, Mary-Claire; Johnson, J. Kristie; Sorkin, John D.; Langenberg, Patricia; Lydecker, Alison; Sorace, Brian; Levy, Lauren; Mody, Lona

2016-01-01

Objective To estimate the frequency of MRSA transmission to gowns and gloves worn by healthcare personnel (HCP) interacting with nursing home residents in order to inform infection prevention policies in this setting Design Observational study Setting and Participants Residents and HCP from 13 community-based nursing homes in Maryland and Michigan Methods Residents were cultured for MRSA at the anterior nares and perianal or perineal skin. HCP wore gowns and gloves during usual care activities. At the end of each activity, a research coordinator swabbed the HCP’s gown and gloves. Results 403 residents were enrolled; 113 were MRSA colonized. Glove contamination was higher than gown contamination (24% vs. 14% of 954 interactions, pgloves. We identified high risk activities (OR >1.0, pglove contamination. Conclusions MRSA transmission from MRSA positive residents to HCP gown and gloves is substantial with high contact activities of daily living conferring the highest risk. These activities do not involve overt contact with body fluids, skin breakdown or mucous membranes suggesting the need to modify current standards of care involving the use of gowns and gloves in this setting. PMID:26008727

Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

Science.gov (United States)

Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

2018-01-01

Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.

Saving our backs: safe patient handling and mobility for home care.

Science.gov (United States)

Beauvais, Audrey; Frost, Lenore

2014-01-01

Predicted work-related injuries for nurses and home healthcare workers are on the rise given the many risk factors in the home environment and the escalating demands for home healthcare workers in the United States. Fortunately, safe patient handling and mobility programs can dramatically decrease injuries. Despite strides being made to promote safe patient handling and mobility programs in acute care, more can be done to establish such initiatives in the home care setting.

Challenge Students to Design an Energy-Efficient Home

Science.gov (United States)

Griffith, Jack

2008-01-01

This article presents an activity that gives students a practical understanding of how much energy the average home consumes and wastes, and shows how the construction technologies used in home design affect overall energy usage. In this activity, students will outline the cost of a home's electrical system, give a breakdown of how much power the…

Leveraging Digital Innovation in Healthcare

DEFF Research Database (Denmark)

Brown, Carol V.; Jensen, Tina Blegind; Aanestad, Margun

2014-01-01

Harnessing digital innovations for healthcare delivery has raised high expectations as well as major concerns. Several countries across the globe have made progress in achieving three common goals of lower costs, higher quality, and increased patient access to healthcare services through...... investments in digital infrastructures. New technologies are leveraged to achieve widespread 24x7 disease management, patients’ wellbeing, home-based healthcare and other patient-centric service innovations. Yet, digital innovations in healthcare face barriers in terms of standardization, data privacy...... landscapes in selected countries. Then panelists with expertise in digital data streams, cloud, and mobile computing will present concrete examples of healthcare service innovations that have the potential to address one or more of the global goals. ECIS attendees are invited to join a debate about...

A qualitative study of in-home robotic telepresence for home care of community-living elderly subjects.

Science.gov (United States)

Boissy, Patrick; Corriveau, Hélène; Michaud, François; Labonté, Daniel; Royer, Marie-Pier

2007-01-01

We examined the requirements for robots in home telecare using two focus groups. The first comprised six healthcare professionals involved in geriatric care and the second comprised six elderly people with disabilities living in the community. The concept of an in-home telepresence robot was illustrated using a photograph of a mobile robot, and participants were then asked to suggest potential health care applications. Interview data derived from the transcript of each group discussion were analyzed using qualitative induction based on content analysis. The analyses yielded statements that were categorized under three themes: potential applications, usability issues and user requirements. Teleoperated mobile robotic systems in the home were thought to be useful in assisting multidisciplinary patient care through improved communication between patients and healthcare professionals, and offering respite and support to caregivers under certain conditions. The shift from a traditional hospital-centred model of care in geriatrics to a home-based model creates opportunities for using telepresence with mobile robotic systems in home telecare.

Which need characteristics influence healthcare service utilization in home care arrangements in Germany?

Science.gov (United States)

Dorin, Lena; Turner, Suzi C; Beckmann, Lea; große Schlarmann, Jörg; Faatz, Andreas; Metzing, Sabine; Büscher, Andreas

2014-05-22

We see a growing number of older adults receiving long-term care in industrialized countries. The Healthcare Utilization Model by Andersen suggests that individual need characteristics influence utilization. The purpose of this study is to analyze correlations between need characteristics and service utilization in home care arrangements. 1,152 respondents answered the questionnaire regarding their integration of services in their current and future care arrangements. Care recipients with high long-term care needs answered the questionnaire on their own, the family caregiver assisted the care recipient in answering the questions, or the family caregiver responded to the questionnaire on behalf of the care recipient. They were asked to rank specific needs according to their situation. We used descriptive statistics and regression analysis. Respondents are widely informed about services. Nursing services and counseling are the most used services. Short-term care and guidance and training have a high potential for future use. Day care, self-help groups, and mobile services were the most frequently rejected services in our survey. Women use more services than men and with rising age utilization increases. Long waiting times and bad health of the primary caregiver increases the chance of integrating services into the home care arrangements. The primary family caregiver has a high impact on service utilization. This indicates that the whole family should be approached when offering services. Professionals should react upon the specific needs of care dependents and their families.

Allocation of home care services by municipalities in Norway: a document analysis.

Science.gov (United States)

Holm, Solrun G; Mathisen, Terje A; Sæterstrand, Torill M; Brinchmann, Berit S

2017-09-22

In Norway, elder care is primarily a municipal responsibility. Municipal health services strive to offer the 'lowest level of effective care,' and home healthcare services are defined as the lowest level of care in Norway. Municipalities determine the type(s) of service and the amount of care applicants require. The services granted are outlined in an individual decision letter, which serves as a contract between the municipality and the home healthcare recipient. The purpose of this study was to gain insight into the scope and duration of home healthcare services allocated by municipalities and to determine where home care recipients live in relation to home healthcare service offices. A document analysis was performed on data derived from 833 letters to individuals allocated home care services in two municipalities in Northern Norway (Municipality A = 500 recipients, Municipality B = 333 recipients). In Municipality A, 74% of service hours were allotted to home health nursing, 12% to practical assistance, and 14% to support contact; in Municipality B, the distribution was 73%, 19%, and 8%, respectively. Both municipalities allocated home health services with no service end date (41% and 85% of the total services, respectively). Among recipients of "expired" services, 25% in Municipality A and 7% in Municipality B continued to receive assistance. Our findings reveal that the municipalities adhered to the goal for home care recipients to remain at home as long as possible before moving into a nursing home. The findings also indicate that the system for allocating home healthcare services may not be fair, as the municipalities lacked procedures for revising individual decisions. Our findings indicate that local authorities should closely examine how they design individual decisions and increase their awareness of how long a service should be provided.

Home Network Security

NARCIS (Netherlands)

Scholten, Hans; van Dijk, Hylke

2008-01-01

Service discovery and secure and safe service usage are essential elements in the deployment of home and personal networks. Because no system administrator is present, setup and daily operation of such a network has to be automated as much as possible with a high degree of user friendliness. To

Security And Privacy Issues in Health Monitoring Systems: eCare@Home Case Study

DEFF Research Database (Denmark)

Wearing, Thomas; Dragoni, Nicola

2016-01-01

Automated systems for monitoring elderly people in their home are becoming more and more common. Indeed, an increasing number of home sensor networks for healthcare can be found in the recent literature, indicating a clear research direction in smart homes for health-care. Although the huge amount...... of sensitive data these systems deal with and expose to the external world, security and privacy issues are surpris-ingly not taken into consideration. The aim of this paper is to raise some key security and privacy issues that home health monitor systems should face with. The analysis is based on a real world...... monitoring sensor network for healthcare built in the context of the eCare@Home project....

Medication errors in home care: a qualitative focus group study.

Science.gov (United States)

Berland, Astrid; Bentsen, Signe Berit

2017-11-01

To explore registered nurses' experiences of medication errors and patient safety in home care. The focus of care for older patients has shifted from institutional care towards a model of home care. Medication errors are common in this situation and can result in patient morbidity and mortality. An exploratory qualitative design with focus group interviews was used. Four focus group interviews were conducted with 20 registered nurses in home care. The data were analysed using content analysis. Five categories were identified as follows: lack of information, lack of competence, reporting medication errors, trade name products vs. generic name products, and improving routines. Medication errors occur frequently in home care and can threaten the safety of patients. Insufficient exchange of information and poor communication between the specialist and home-care health services, and between general practitioners and healthcare workers can lead to medication errors. A lack of competence in healthcare workers can also lead to medication errors. To prevent these, it is important that there should be up-to-date information and communication between healthcare workers during the transfer of patients from specialist to home care. Ensuring competence among healthcare workers with regard to medication is also important. In addition, there should be openness and accurate reporting of medication errors, as well as in setting routines for the preparation, alteration and administration of medicines. To prevent medication errors in home care, up-to-date information and communication between healthcare workers is important when patients are transferred from specialist to home care. It is also important to ensure adequate competence with regard to medication, and that there should be openness when medication errors occur, as well as in setting routines for the preparation, alteration and administration of medications. © 2017 John Wiley & Sons Ltd.

Home parenteral nutrition in children

International Nuclear Information System (INIS)

Kalousova, J.; Rouskova, B.; Styblova, J.

2011-01-01

Parenteral nutrition delivered at home presents a major improvement in the quality of life of children dependent on long term parenteral nutrition. Indications, technical conditions, logistics, complications, prognosis of home parenteral nutrition as well as some health-care issues to be addressed by pediatric practitioner are summarized. (author)

Handbook of Home Health Standards - Fifth edition Marrelli Tina M Handbook of Home Health Standards - Fifth edition 688pp Elsevier 9780323052245 032305224X [Formula: see text].

Science.gov (United States)

2009-06-03

Home care is different from other forms of health care. Clinicians are guests in patients' homes and may be the only healthcare providers patients see on a particular day or week, so they should feel comfortable working independently, but recognise they are part of a larger healthcare team.

Future Home Network Requirements

DEFF Research Database (Denmark)

Charbonnier, Benoit; Wessing, Henrik; Lannoo, Bart

This paper presents the requirements for future Home Area Networks (HAN). Firstly, we discuss the applications and services as well as their requirements. Then, usage scenarios are devised to establish a first specification for the HAN. The main requirements are an increased bandwidth (towards 1...

Prevalence and Predictors of Use of Home Sphygmomanometers Among Hypertensive Patients.

Science.gov (United States)

Zahid, Hira; Amin, Aisha; Amin, Emaan; Waheed, Summaiya; Asad, Ameema; Faheem, Ariba; Jawaid, Samreen; Afzal, Adila; Misbah, Sarah; Majid, Kanza

2017-04-11

Few studies have looked at the predictors of use of home sphygmomanometers among hypertensive patients in low-income countries such as Pakistan. Considering the importance of home blood pressure monitoring (HBPM), cross-sectional study was conducted to evaluate the prevalence and predictors of the usage of all kinds of HBPM devices. This study was conducted in Karachi during the time period of January-February 2017. Adult patients previously diagnosed with hypertension visiting tertiary care hospitals were selected for the study. Interviews from the individuals were conducted after verbal consent using a pre-coded questionnaire. The data was analyzed using Statistical Package for the Social Sciences v. 23.0 (SPSS, IBM Corporation, NY, USA). Chi-squared test was applied as the primary statistical test. More than half of the participants used a home sphygmomanometer (n=250, 61.7%). The age, level of education, family history of hypertension, compliance to drugs and blood pressure (BP) monitoring, few times a month at clinics were significant determinants of HBPM (P values manual type (n=122, 48.8%). Moreover, avoiding BP measurement in a noisy environment was the most common precaution taken (n=117, 46.8%). The study showed that around 40% of the hypertensive individuals did not own a sphygmomanometer and less than 25% performed HBPM regularly. General awareness by healthcare professionals can be a possible factor which can increase HBPM.

Architecting for connected healthcare - a case of telehomecare and hypertension

DEFF Research Database (Denmark)

Tambo, Torben; Hoffmann-Petersen, Nikolai; Bejder, Karsten

2012-01-01

of the citizen, the healthcare system, the information infrastructure and the citizen-oriented technology. A case of telemonitoring and selfcare is presented using mobile hypertension measurement on a large scale population cohort. Evaluation of the acceptance and success of the solutions is done within......The healthcare system is in many countries operated by the governments, and interaction with the healthcare system is one of the most frequent interactions between citizen and government. Demographic, medical and technological changes are likely to bring new aspects of connectedness...... into the everyday life of people and place healthcare and homecare professionals in new roles. A transformation is taking place where hospital best practices are constantly reducing patient’s in-hospital stays to alternative, less-costly care – notably at home. Telemedicine, telehealth, home-monitoring and self...

LEAN thinking in Finnish healthcare.

Science.gov (United States)

Jorma, Tapani; Tiirinki, Hanna; Bloigu, Risto; Turkki, Leena

2016-01-01

Purpose - The purpose of this study is to evaluate how LEAN thinking is used as a management and development tool in the Finnish public healthcare system and what kind of outcomes have been achieved or expected by using it. The main focus is in managing and developing patient and treatment processes. Design/methodology/approach - A mixed-method approach incorporating the Webropol survey was used. Findings - LEAN is quite a new concept in Finnish public healthcare. It is mainly used as a development tool to seek financial savings and to improve the efficiency of patient processes, but has not yet been deeply implemented. However, the experiences from LEAN initiatives have been positive, and the methodology is already quite well-known. It can be concluded that, because of positive experiences from LEAN, the environment in Finnish healthcare is ready for the deeper implementation of LEAN. Originality/value - This paper evaluates the usage of LEAN thinking for the first time in the public healthcare system of Finland as a development tool and a management system. It highlights the implementation and achieved results of LEAN thinking when used in the healthcare environment. It also highlights the expectations for LEAN thinking in Finnish public healthcare.

Interactive Healthcare Systems in the Home: Vestibular Rehabilitation

DEFF Research Database (Denmark)

Aarhus, Rikke; Grönvall, Erik; Larsen, Simon Bo

2010-01-01

Vestibular dysfunction is a balance disorder, causing dizziness that provokes discomfort and fall situations. This paper discusses early results from a project that aims to develop assistive technologies to support home-based rehabilitation for elderly affected by Vestibular dysfunction.......Vestibular dysfunction is a balance disorder, causing dizziness that provokes discomfort and fall situations. This paper discusses early results from a project that aims to develop assistive technologies to support home-based rehabilitation for elderly affected by Vestibular dysfunction....

Resources for Middle Eastern patients: online resources for culturally and linguistically appropriate services in home healthcare and hospice, part 3.

Science.gov (United States)

Young, Judith S

2013-01-01

As the population of patients for whom English is not their primary language grows, home care and hospice clinicians are challenged to provide culturally respectful and acceptable patient-centered care for cultures and languages unfamiliar to them. This article identifies resources for understanding the culture of Middle Eastern-born patients and appropriate patient education materials in most of the languages spoken by this population. The resources have been made available for free on the Web by healthcare professionals, government agencies, and support organizations from around the world.

The @Home project

DEFF Research Database (Denmark)

Coxon, Ian Robert

2014-01-01

of being overshadowed by what is increasingly seen as new (and substantial) pharmacological and health equipment business market opportunities in what is now viewed as a health 'industry'. The Centre for Innovation at Mayo Clinic (CFI) in Rochester USA, has conducted many projects which border on and have...... investigated various aspects of care provision and patient experience within a patient's home environment. Considerable work by other researchers inside and outside the health field has also contributed insights and platforms for moving healthcare in this direction. In most areas of the western world......, the healthcare sector is struggling to cope with the scale of strain that shifting demographics, rising costs and increasing chronic/complex care is placing on the health system. The shift towards home based care and personal health self-management is seen as offering some possibilities to alleviate...

Your Heart Failure Healthcare Team

Science.gov (United States)

... Artery Disease Venous Thromboembolism Aortic Aneurysm More Your Heart Failure Healthcare Team Updated:May 9,2017 Patients with ... to the Terms and Conditions and Privacy Policy Heart Failure • Home • About Heart Failure • Causes and Risks for ...

Semantic Labeling of User Location Context Based on Phone Usage Features

Directory of Open Access Journals (Sweden)

Helena Leppäkoski

2017-01-01

Full Text Available In mobile phones, the awareness of the user’s context allows services better tailored to the user’s needs. We propose a machine learning based method for semantic labeling that utilizes phone usage features to detect the user’s home, work, and other visited places. For place detection, we compare seven different classification methods. We organize the phone usage data based on periods of uninterrupted time that the user has been in a certain place. We consider three approaches to represent this data: visits, places, and cumulative samples. Our main contribution is semantic place labeling using a small set of privacy-preserving features and novel data representations suitable for resource constrained mobile devices. The contributions include (1 introduction of novel data representations including accumulation and averaging of the usage, (2 analysis of the effect of the data accumulation time on the accuracy of the place classification, (3 analysis of the confidence on the classification outcome, and (4 identification of the most relevant features obtained through feature selection methods. With a small set of privacy-preserving features and our data representations, we detect the user’s home and work with probability of 90% or better, and in 3-class problem the overall classification accuracy was 89% or better.

Expectations and attitudes in eHealth: a survey among patients of Dutch private healthcare organizations.

NARCIS (Netherlands)

Hendrikx, H.C.A.A.; Pippel, S.; Wetering, R. van de; Batenburg, R.S.

2013-01-01

Internet usage has been steadily increasing over recent years, and people have become used to manage the medical aspects of their lives using the Internet. Meanwhile, many organizational changes are influencing the provision of healthcare. This raises the question whether the demands of healthcare

PLANNED HOME BIRTH: A REVIEW

OpenAIRE

Tamara Serdinšek; Iztok Takač

2016-01-01

Background: Home birth is as old as humanity, but still most middle- and high-income countries consider hospitals as the safest birth settings, as complications regarding birth are highly unpredictable. Despite this there are a few countries in which home birth in integrated into official healthcare system (the Netherlands, United Kingdom, Canada etc.). Home births can be divided into unplanned and planned, and the latter can be further categorized by the presence of the birth attendants. Thi...

Intelligent Multi-Agent Middleware for Ubiquitous Home Networking Environments

OpenAIRE

Minwoo Son; Seung-Hun Lee; Dongkyoo Shin; Dongil Shin

2008-01-01

The next stage of the home networking environment is supposed to be ubiquitous, where each piece of material is equipped with an RFID (Radio Frequency Identification) tag. To fully support the ubiquitous environment, home networking middleware should be able to recommend home services based on a user-s interests and efficiently manage information on service usage profiles for the users. Therefore, USN (Ubiquitous Sensor Network) technology, which recognizes and manages a ...

Technology and medication errors: impact in nursing homes.

Science.gov (United States)

Baril, Chantal; Gascon, Viviane; St-Pierre, Liette; Lagacé, Denis

2014-01-01

The purpose of this paper is to study a medication distribution technology's (MDT) impact on medication errors reported in public nursing homes in Québec Province. The work was carried out in six nursing homes (800 patients). Medication error data were collected from nursing staff through a voluntary reporting process before and after MDT was implemented. The errors were analysed using: totals errors; medication error type; severity and patient consequences. A statistical analysis verified whether there was a significant difference between the variables before and after introducing MDT. The results show that the MDT detected medication errors. The authors' analysis also indicates that errors are detected more rapidly resulting in less severe consequences for patients. MDT is a step towards safer and more efficient medication processes. Our findings should convince healthcare administrators to implement technology such as electronic prescriber or bar code medication administration systems to improve medication processes and to provide better healthcare to patients. Few studies have been carried out in long-term healthcare facilities such as nursing homes. The authors' study extends what is known about MDT's impact on medication errors in nursing homes.

Process-driven selection of information systems for healthcare

Science.gov (United States)

Mills, Stephen F.; Yeh, Raymond T.; Giroir, Brett P.; Tanik, Murat M.

1995-05-01

Integration of networking and data management technologies such as PACS, RIS and HIS into a healthcare enterprise in a clinically acceptable manner is a difficult problem. Data within such a facility are generally managed via a combination of manual hardcopy systems and proprietary, special-purpose data processing systems. Process modeling techniques have been successfully applied to engineering and manufacturing enterprises, but have not generally been applied to service-based enterprises such as healthcare facilities. The use of process modeling techniques can provide guidance for the placement, configuration and usage of PACS and other informatics technologies within the healthcare enterprise, and thus improve the quality of healthcare. Initial process modeling activities conducted within the Pediatric ICU at Children's Medical Center in Dallas, Texas are described. The ongoing development of a full enterprise- level model for the Pediatric ICU is also described.

Home-based care for people living with AIDS in Zimbabwe ...

African Journals Online (AJOL)

Similar to the healthcare systems of other resource-constrained countries with a high prevalence of HIV and AIDS, Zimbabwe's healthcare system encourages communities and non-governmental organisations (NGOs) to support the public healthcare sector by initiating home-based care activities and training volunteers to ...

Role of environmental cleanliness and decontamination in care homes.

Science.gov (United States)

Cousins, Gary

2016-01-06

While it is widely accepted that the environment has an important role in transmission of healthcare-associated infections, there has been a paucity of empirical investigation in this area to date, and the majority of published literature relates to acute settings. People living in care homes come into contact with a communally used environment and communally used equipment daily. Equipment may include hoists, hoist slings, clinical monitoring equipment, commodes and shower chairs. In care homes, primary responsibility for decontamination lies with the healthcare team, most of whom are not nurses. The challenge for nurses working in care homes is their accountability for the provision of safe and effective care.

On-the-job training makes the difference: healthcare assistants' perceived competence and responsibility in the care of patients with home mechanical ventilation.

Science.gov (United States)

Swedberg, Lena; Michélsen, Hans; Chiriac, Eva Hammar; Hylander, Ingrid

2015-06-01

To describe and analyse perceived competence and perceived responsibility among healthcare assistants (HC assistants), caring for patients with home mechanical ventilation (HMV) and other advanced caring needs, adjusted for socio-demographic and workplace background factors. A cross-sectional study was conducted including 128 HC assistants employed in Stockholm County, Sweden. The HC assistants responded to a study-specific questionnaire on perceived competence and perceived responsibility, provided socio-demographic and workplace background data, as well as information on the patient characteristics for the understanding of their work situations. Descriptive statistics and logistic regression analyses were performed. Eighty per cent of the HC assistants rated their perceived competence as high, and fifty-nine per cent rated their perceived responsibility as high. Fifty-five per cent lacked formal healthcare training, and only one in five of the HC assistants had a formal training equivalent with a licensed practical nurse (LPN) examination. Males lacked formal training to a greater extent than females and rated their competence accordingly. On-the-job training was significantly associated with high ratings on both perceived competence and perceived responsibility, and clinical supervision was associated with high rating on perceived responsibility. HC assistants with limited formal training self-reported their competence as high, and on-the-job training was found to be important. Also, clinical supervision was found important for their perception of high responsibility. In Sweden, HC assistants have a 24-hour responsibility for the care and safety of their patient with HMV and other advanced caring needs. The study results point out important issues for further research regarding formal training requirements as well as the needs for standardised workplace training and supervision of HC assistants. The consequences of transfer of responsibility by delegation from

Client Involvement in Home Care Practice

DEFF Research Database (Denmark)

Glasdam, Stinne; Henriksen, Nina; Kjær, Lone

2013-01-01

Client involvement’ has been a mantra within health policies, education curricula and healthcare institutions over many years, yet very little is known about how ‘client involvement’ is practised in home-care services. The aim of this article is to analyse ‘client involvement’ in practise seen fr...... in public home-care practice remains limited...

Habits of cell phone usage and sperm quality - does it warrant attention?

Science.gov (United States)

Zilberlicht, Ariel; Wiener-Megnazi, Zofnat; Sheinfeld, Yulia; Grach, Bronislava; Lahav-Baratz, Shirly; Dirnfeld, Martha

2015-09-01

Male infertility constitutes 30-40% of all infertility cases. Some studies have shown a continuous decline in semen quality since the beginning of the 20th century. One postulated contributing factor is radio frequency electromagnetic radiation emitted from cell phones. This study investigates an association between characteristics of cell phone usage and semen quality. Questionnaires accessing demographic data and characteristics of cell phone usage were completed by 106 men referred for semen analysis. Results were analysed according to WHO 2010 criteria. Talking for ≥1 h/day and during device charging were associated with higher rates of abnormal semen concentration (60.9% versus 35.7%, P cell phone usage may bear adverse effects on sperm concentration. Investigation using large-scale studies is thus needed. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

A remote data access architecture for home-monitoring health-care applications.

Science.gov (United States)

Lin, Chao-Hung; Young, Shuenn-Tsong; Kuo, Te-Son

2007-03-01

With the aging of the population and the increasing patient preference for receiving care in their own homes, remote home care is one of the fastest growing areas of health care in Taiwan and many other countries. Many remote home-monitoring applications have been developed and implemented to enable both formal and informal caregivers to have remote access to patient data so that they can respond instantly to any abnormalities of in-home patients. The aim of this technology is to give both patients and relatives better control of the health care, reduce the burden on informal caregivers and reduce visits to hospitals and thus result in a better quality of life for both the patient and his/her family. To facilitate their widespread adoption, remote home-monitoring systems take advantage of the low-cost features and popularity of the Internet and PCs, but are inherently exposed to several security risks, such as virus and denial-of-service (DoS) attacks. These security threats exist as long as the in-home PC is directly accessible by remote-monitoring users over the Internet. The purpose of the study reported in this paper was to improve the security of such systems, with the proposed architecture aimed at increasing the system availability and confidentiality of patient information. A broker server is introduced between the remote-monitoring devices and the in-home PCs. This topology removes direct access to the in-home PC, and a firewall can be configured to deny all inbound connections while the remote home-monitoring application is operating. This architecture helps to transfer the security risks from the in-home PC to the managed broker server, on which more advanced security measures can be implemented. The pros and cons of this novel architecture design are also discussed and summarized.

Ethical issues in palliative care for nursing homes: Development and testing of a survey instrument.

Science.gov (United States)

Preshaw, Deborah Hl; McLaughlin, Dorry; Brazil, Kevin

2018-02-01

To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes. Registered nurses and healthcare assistants have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers. Cross-sectional survey of Registered nurses and healthcare assistants in nursing homes in one region of the UK. A survey instrument, "Ethical issues in Palliative Care for Nursing homes", was developed through the findings of qualitative interviews with Registered nurses and healthcare assistants in nursing homes and a literature review. It was reviewed by an expert panel and piloted prior to implementation in a survey in 2015 with a convenience sample of 596 Registered nurses and healthcare assistants. Descriptive and exploratory factor analyses were used to assess the underlying structure of the Frequency and Distress Scales within the instrument. Analysis of 201 responses (response rate = 33.7%) revealed four factors for the Frequency Scale and five factors for the Distress Scale that comprise the Ethical issues in Palliative Care for Nursing homes. Factors common to both scales included "Processes of care," "Resident autonomy" and "Burdensome treatment." Additionally, the Frequency Scale included "Competency," and the Distress Scale included "Quality of care" and "Communication." The Ethical issues in Palliative Care for Nursing homes instrument has added to the palliative care knowledge base by considering the ethical issues experienced specifically by Registered nurses and healthcare assistants within the nursing home. This research offers preliminary evidence of the psychometric properties of the Ethical issues in Palliative Care for Nursing homes survey instrument. The two largest factors highlight the need to address the organisational aspects of caring and provide training in negotiating conflicting

Smart home technologies for health and social care support.

Science.gov (United States)

Martin, Suzanne; Kelly, Greg; Kernohan, W George; McCreight, Bernadette; Nugent, Christopher

2008-10-08

The integration of smart home technology to support health and social care is acquiring an increasing global significance. Provision is framed within the context of a rapidly changing population profile, which is impacting on the number of people requiring health and social care, workforce availability and the funding of healthcare systems. To explore the effectiveness of smart home technologies as an intervention for people with physical disability, cognitive impairment or learning disability, who are living at home, and to consider the impact on the individual's health status and on the financial resources of health care. We searched the following databases for primary studies: (a) the Cochrane Effective Practice and Organisation of Care (EPOC) Group Register, (b) the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library, issue 1, 2007), and (c) bibliographic databases, including MEDLINE (1966 to March 2007), EMBASE (1980 to March 2007) and CINAHL (1982 to March 2007). We also searched the Database of Abstracts of Reviews of Effectiveness (DARE). We searched the electronic databases using a strategy developed by the EPOC Trials Search Co-ordinator. We included randomised controlled trials (RCTs), quasi-experimental studies, controlled before and after studies (CBAs) and interrupted time series analyses (ITS). Participants included adults over the age of 18, living in their home in a community setting. Participants with a physical disability, dementia or a learning disability were included. The included interventions were social alarms, electronic assistive devices, telecare social alert platforms, environmental control systems, automated home environments and 'ubiquitous homes'. Outcome measures included any objective measure that records an impact on a participant's quality of life, healthcare professional workload, economic outcomes, costs to healthcare provider or costs to participant. We included measures of service satisfaction

Online resources for culturally and linguistically appropriate services in home healthcare and hospice, part 2: resources for Asian patients.

Science.gov (United States)

Young, Judith S

2012-04-01

Home care and hospice clinicians are increasingly working with patients for whom English is not their primary language. Provision of culturally respectful and acceptable patient-centered care includes both an awareness of cultural beliefs that influence the patient's health and also the ability to provide the patient with health information in the language with which he or she is most comfortable. This article identifies resources for understanding the cultural norms of Asian-born patients and appropriate patient education materials in the many languages spoken by this population. The resources have been made available free on the Web by healthcare professionals and government agencies from around the world.

Self-reported hand hygiene practices, and feasibility and acceptability of alcohol-based hand rubs among village healthcare workers in Inner Mongolia, China.

Science.gov (United States)

Li, Y; Wang, Y; Yan, D; Rao, C Y

2015-08-01

Good hand hygiene is critical to reduce the risk of healthcare-associated infections. Limited data are available on hand hygiene practices from rural healthcare systems in China. To assess the feasibility and acceptability of sanitizing hands with alcohol-based hand rubs (ABHRs) among Chinese village healthcare workers, and to assess their hand hygiene practice. Five hundred bottles of ABHR were given to village healthcare workers in Inner Mongolia, China. Standardized questionnaires collected information on their work load, availability, and usage of hand hygiene facilities, and knowledge, attitudes, and practices of hand hygiene. In all, 369 (64.2%) participants completed the questionnaire. Although 84.5% of the ABHR recipients believed that receiving the ABHR improved their hand hygiene practice, 78.8% of recipients would pay no more than US$1.5 out of their own pocket (actual cost US$4). The majority (77.2%) who provided medical care at patients' homes never carried hand rubs with them outside their clinics. In general, self-reported hand hygiene compliance was suboptimal, and the lowest compliance was 'before touching a patient'. Reported top three complaints with using ABHR were skin irritation, splashing, and unpleasant residual. Village doctors with less experience practised less hand hygiene. The overall acceptance of ABHR among the village healthcare workers is high as long as it is provided to them for free/low cost, but their overall hand hygiene practice is suboptimal. Hand hygiene education and training is needed in settings outside of traditional healthcare facilities. Published by Elsevier Ltd.

Factors influencing home care nurse intention to remain employed.

Science.gov (United States)

Tourangeau, Ann; Patterson, Erin; Rowe, Alissa; Saari, Margaret; Thomson, Heather; MacDonald, Geraldine; Cranley, Lisa; Squires, Mae

2014-11-01

To identify factors affecting Canadian home care nurse intention to remain employed (ITR). In developed nations, healthcare continues to shift into community settings. Although considerable research exists on examining nurse ITR in hospitals, similar research related to nurses employed in home care is limited. In the face of a global nursing shortage, it is important to understand the factors influencing nurse ITR across healthcare sectors. A qualitative exploratory descriptive design was used. Focus groups were conducted with home care nurses. Data were analysed using qualitative content analysis. Six categories of influencing factors were identified by home care nurses as affecting ITR: job characteristics; work structures; relationships/communication; work environment; nurse responses to work; and employment conditions. Findings suggest the following factors influence home care nurse ITR: having autonomy; flexible scheduling; reasonable and varied workloads; supportive work relationships; and receiving adequate pay and benefits. Home care nurses did not identify job satisfaction as a single concept influencing ITR. Home care nursing management should support nurse autonomy, allow flexible scheduling, promote reasonable workloads and create opportunities for team building that strengthen supportive relationships among home care nurses and other health team members. © 2013 John Wiley & Sons Ltd.

Rethinking Healthcare Transitions and Policies: Changing and Expanding Roles in Transitional Care

Science.gov (United States)

Moreño, Patricienn K.

2014-01-01

The breakdown of care transitions between various healthcare facilities, providers, and services is a major issue in healthcare, and accounts for over US$15 billion in healthcare expenditures annually. The transition between inpatient care and home care is a very delicate period where, too often, chronically ill patients get worse and wind up back…

Challenges for Infants’ Home Care: a Qualitative Study

Directory of Open Access Journals (Sweden)

Zeinab Hemati

2016-06-01

Full Text Available Background Home care is an acceptable strategy for the relationship between family and healthcare team and implementation of healthcare interventions, and infants’ nurses could play an important role in enhancing the capability of families and promoting child health in this area. This study examined challenges facing infants’ home care from nurses’ viewpoints in Iranian culture.Materials and MethodsA qualitative design was used to explain challenges facing infants’ home care from nurses’ viewpoints. Participants included 20 nurses’ working in the neonatal units of University hospitals in Isfahan, Iran in 2015. Data collection was done by interviewing nurses working in neonatal units of Shahid Beheshti and Alzahra hospitals. All the data were analyzed by qualitative content analysis.ResultsFour main categories of “The need to warn the community ", “culture",” need for security " and ” legal support" were extracted from the participants' explanations, indicating the dimensions of Challenges for Infants’ Home Care.Conclusion Nursing policy makers and managers are able to help to facilitate home care and improve the infants’ health through correcting the infrastructure and eliminating current obstacles.

Establishing Relationships and Navigating Boundaries When Caring for Children With Medical Complexity at Home.

Science.gov (United States)

Nageswaran, Savithri; Golden, Shannon L

Children with medical complexity receive care from many healthcare providers including home healthcare nurses. The objective of our study, based on a conceptual framework, was to describe the relationships between parents/caregivers of children with medical complexity and home healthcare nurses caring for these children. We collected qualitative data in 20 semistructured in-depth interviews (15 English, 5 Spanish) with 26 primary caregivers of children with medical complexity, and 4 focus groups of 18 home healthcare nurses inquiring about their experiences about home healthcare nursing services for children with medical complexity. During an iterative analysis process, we identified recurrent themes related to caregiver-nurse relationships. Our study showed that: (1) caregiver-nurse relationships evolved over time and were determined by multiple factors; (2) communication and trust were essential to the establishment of caregiver-nurse relationships; (3) both caregivers and nurses described difficulties of navigating physical, professional, personal, and emotional boundaries, and identified strategies to maintain these boundaries; and (4) good caregiver-nurse relationships helped in the care of children with medical complexity, reduced caregiver burden, resulted in less stress for nurses, and was a factor in nurse retention. We conclude that trusted relationships between caregivers and nurses are important to the home care of children with medical complexity. Interventions to develop and maintain good caregiver-nurse relationships are necessary.

Quality dementia care - Prerequisites and relational ethics among multicultural healthcare providers

OpenAIRE

Sellevold, Gerd Sylvi

2017-01-01

Background: Many nursing homes are multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Further, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. Purpose: The aim of this study is to illuminate multi-ethnic healthcare providers´ lived experiences of their own workin...

Predictors of Home Care Expenditures and Death at Home for Cancer Patients in an Integrated Comprehensive Palliative Home Care Pilot Program

Science.gov (United States)

Howell, Doris M.; Abernathy, Tom; Cockerill, Rhonda; Brazil, Kevin; Wagner, Frank; Librach, Larry

2011-01-01

Purpose: Empirical understanding of predictors for home care service use and death at home is important for healthcare planning. Few studies have examined these predictors in the context of the publicly funded Canadian home care system. This study examined predictors for home care use and home death in the context of a “gold standard” comprehensive palliative home care program pilot in Ontario where patients had equal access to home care services. Methods: Secondary clinical and administrative data sources were linked using a unique identifier to examine multivariate factors (predisposing, enabling, need) on total home care expenditures and home death for a cohort of cancer patients enrolled in the HPCNet pilot. Results: Subjects with gastrointestinal symptoms (OR: 1.64; p=0.03) and those with higher income had increased odds of dying at home (OR: 1.14; phome care expenditures. Conclusions: Predictors of home death found in earlier studies appeared less important in this comprehensive palliative home care pilot. An income effect for home death observed in this study requires examination in future controlled studies. Relevance: Access to palliative home care that is adequately resourced and organized to address the multiple domains of issues that patients/families experience at the end of life has the potential to enable home death and shift care appropriately from limited acute care resources. PMID:22294993

Encounters With Health-Care Providers and Advance Directive Completion by Older Adults.

Science.gov (United States)

Koss, Catheryn

2018-01-01

The Patient Self-Determination Act (PSDA) requires hospitals, home health agencies, nursing homes, and hospice providers to offer new patients information about advance directives. There is little evidence regarding whether encounters with these health-care providers prompt advance directive completion by patients. To examine whether encounters with various types of health-care providers were associated with higher odds of completing advance directives by older patients. Logistic regression using longitudinal data from the 2012 and 2014 waves of the Health and Retirement Study. Participants were 3752 US adults aged 65 and older who reported not possessing advance directives in 2012. Advance directive was defined as a living will and/or durable power of attorney for health care. Four binary variables measured whether participants had spent at least 1 night in a hospital, underwent outpatient surgery, received home health or hospice care, or spent at least one night in a nursing home between 2012 and 2014. Older adults who received hospital, nursing home, or home health/hospice care were more likely to complete advance directives. Outpatient surgery was not associated with advance directive completion. Older adults with no advance directive in 2012 who encountered health-care providers covered by the PSDA were more likely to have advance directives by 2014. The exception was outpatient surgery which is frequently provided in freestanding surgery centers not subject to PSDA mandates. It may be time to consider amending the PSDA to cover freestanding surgery centers.

WSN- and IOT-Based Smart Homes and Their Extension to Smart Buildings

OpenAIRE

Ghayvat, Hemant; Mukhopadhyay, Subhas; Gui, Xiang; Suryadevara, Nagender

2015-01-01

Our research approach is to design and develop reliable, efficient, flexible, economical, real-time and realistic wellness sensor networks for smart home systems. The heterogeneous sensor and actuator nodes based on wireless networking technologies are deployed into the home environment. These nodes generate real-time data related to the object usage and movement inside the home, to forecast the wellness of an individual. Here, wellness stands for how efficiently someone stays fit in the home...

Flexible home care automation adapting to the personal and evolving needs and situations of the patient

NARCIS (Netherlands)

Zarifi Eslami, Mohammed; van Sinderen, Marten J.

Health monitoring and healthcare provisioning at home (i.e., outside the hospital) have received increasingly attention as a possible and partial solution for addressing the problems of an aging population. There are still many technological issues that need to be solved before home healthcare

Impact of Home Health Care on Health Care Resource Utilization Following Hospital Discharge: A Cohort Study.

Science.gov (United States)

Xiao, Roy; Miller, Jacob A; Zafirau, William J; Gorodeski, Eiran Z; Young, James B

2018-04-01

As healthcare costs rise, home health care represents an opportunity to reduce preventable adverse events and costs following hospital discharge. No studies have investigated the utility of home health care within the context of a large and diverse patient population. A retrospective cohort study was conducted between 1/1/2013 and 6/30/2015 at a single tertiary care institution to assess healthcare utilization after discharge with home health care. Control patients discharged with "self-care" were matched by propensity score to home health care patients. The primary outcome was total healthcare costs in the 365-day post-discharge period. Secondary outcomes included follow-up readmission and death. Multivariable linear and Cox proportional hazards regression were used to adjust for covariates. Among 64,541 total patients, 11,266 controls were matched to 6,363 home health care patients across 11 disease-based Institutes. During the 365-day post-discharge period, home health care was associated with a mean unadjusted savings of $15,233 per patient, or $6,433 after adjusting for covariates (p Home health care independently decreased the hazard of follow-up readmission (HR 0.82, p home health care most benefited patients discharged from the Digestive Disease (death HR 0.72, p home health care was associated with significant reduction in healthcare utilization and decreased hazard of readmission and death. These data inform development of value-based care plans. Copyright © 2018 Elsevier Inc. All rights reserved.

Move to Solar-DC at Home Premises

Indian Academy of Sciences (India)

48V DC line as an additional power line at home. Highly power-efficient usage of Solar; Low-power from grid alone converted from AC-DC. Designed to have minimal loss. Battery can be added with higher efficiency (no convertors), if required.

Maternity waiting homes in Southern Lao PDR: the unique 'silk home'.

Science.gov (United States)

Eckermann, Elizabeth; Deodato, Giovanni

2008-10-01

The concept of maternity waiting homes (MWH) has a long history spanning over 100 years. The research reported here was conducted in the Thateng District of Sekong Province in southern Lao People's Democratic Republic (PDR) to establish whether the MWH concept would be affordable, accessible, and most importantly acceptable, as a strategy to improve maternal outcomes in the remote communities of Thateng with a high proportion of the population from ethnic minority groups. The research suggested that there were major barriers to minority ethnic groups using existing maternal health services (reflected in very low usage of trained birth attendants and hospitals and clinics) in Thateng. Unless MWH are adapted to overcome these potential barriers, such initiatives will suffer the same fate as existing maternal facilities. Consequently, the Lao iteration of the concept, as operationalized in the Silk Homes project in southern Lao PDR is unique in combining maternal and infant health services with opportunities for micro credit and income generating activities and allowing non-harmful traditional practices to co-exist alongside modern medical protocols. These innovative approaches to the MWH concept address the major economic, social and cultural barriers to usage of safe birthing options in remote communities of southern Lao PDR.

Universal standard for the smart energy home

International Nuclear Information System (INIS)

Hatler, M.

2009-01-01

Smart metering systems are now being installed in countries throughout the world. This article discussed technologies designed to connect in-home electrical devices such as thermostats, energy displays, and computers to the electricity grid. The smart-grid connected devices will form part of the home area network (HAN) designed to provide consumers with real time control of their energy use. Many governments are now mandating the use of HAN interfaces, and members of the energy industry are developing global standards for HANs. Within 5 years, it is estimated that over 126 million smart meters will be installed in households worldwide. Using HANs, consumers will be able to shift their usage away from peak energy usage times that are more expensive. Studies have demonstrated that the use of dynamic pricing options can result in a 50 per cent load reduction during critical peak periods. A universal standard and certification process is currently underway to prevent HAN market fragmentation and to ensure plug-and-play interoperability among HAN devices. It was concluded that the smart energy home will present large market opportunities for software developers, investors, and manufacturers. 1 fig

Infrastructuring Multicultural Healthcare Information Systems.

Science.gov (United States)

Dreessen, Katrien; Huybrechts, Liesbeth; Grönvall, Erik; Hendriks, Niels

2017-01-01

This paper stresses the need for more research in the field of Participatory Design (PD) and in particular into how to design Health Information Technology (HIT) together with care providers and -receivers in multicultural settings. We contribute to this research by describing a case study, the 'Health-Cultures' project, in which we designed HIT for the context of home care of older people with a migration background. The Health-Cultures project is located in the city of Genk, Belgium, which is known for its multicultural population, formed by three historical migration waves of people coming to work in the nowadays closed coal mines. Via a PD approach, we studied existing means of dialogue and designed HIT that both care receivers and care providers in Genk can use in their daily exchanges between cultures in home care contexts. In discussing relevant literature as well as the results of this study, we point to the need and the ways of taking spatio-historical aspects of a specific healthcare situation into account in the PD of HIT to support multicultural perspectives on healthcare.

Refugee women face daunting healthcare needs | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

Refugee women face daunting healthcare needs ... Women faced long waits to get care, sometimes resorting to offering bribes for services. ... Equally important, it brought home “that the women I spoke with in this study are people, just like you ...

Meaning creation and employee engagement in home health caregivers.

Science.gov (United States)

Nielsen, Mette Strange; Jørgensen, Frances

2016-03-01

The purpose of this study is to contribute to an understanding on how home health caregivers experience engagement in their work, and specifically, how aspects of home healthcare work create meaning associated with employee engagement. Although much research on engagement has been conducted, little has addressed how individual differences such as worker orientation influence engagement, or how engagement is experienced within a caregiving context. The study is based on a qualitative study in two home homecare organisations in Denmark using a think-aloud data technique, interviews and observations. The analysis suggests caregivers experience meaning in three relatively distinct ways, depending on their work orientation. Specifically, the nature of engagement varies across caregivers oriented towards being 'nurturers', 'professionals', or 'workers', and the sources of engagement differ for each of these types of caregivers. The article contributes by (i) advancing our theoretical understanding of employee engagement by emphasising meaning creation and (ii) identifying factors that influence meaning creation and engagement of home health caregivers, which should consequently affect the quality of services provided home healthcare patients. © 2015 Nordic College of Caring Science.

Usage evaluation of the Physiotherapy Evidence Database (PEDro) among Brazilian physical therapists.

Science.gov (United States)

Elkins, Mark R; Moseley, Anne M; Pinto, Rafael Z

2015-01-01

It is unclear whether the Physiotherapy Evidence Database (PEDro) is widely and equally used by physical therapists in Brazil. As PEDro is considered a key resource to support evidence-based physical therapy, analyses of PEDro usage could reflect the extent of dissemination of evidence-based practice. To describe the usage of PEDro among the five regions of the World Confederation for Physical Therapy (WCPT) and, in more detail, in the South American region and Brazil over a 5-year period. PEDro home-page sessions and the number of searches performed were logged for a 5-year period (2010-2014). Absolute usage and relative usage were calculated for each region of the WCPT, each country in the South American region of WCPT, and each Regional Council (CREFITO) in Brazil. Europe had the highest absolute and relative usage among the five regions of the WCPT (971 searches per million-population per year), with the South American region ranked 4th in absolute terms and 3rd in relative terms (486). Within the South American region, Brazil accounted for nearly 60% of searches (755). Analysis at a national level revealed that usage per physical therapist in Brazil is very low across all CREFITOs. The highest usage occurred in CREFITO 6 with 1.3 searches per physical therapist per year. PEDro is not widely and equally used throughout Brazil. Strategies to promote PEDro and to make PEDro more accessible to physical therapists speaking Portuguese are needed.

[Organising a successful return home].

Science.gov (United States)

Mézière, Anthony

Discharge from hospital is a major component of the quality and efficiency of the healthcare system. The failures of the return home of elderly people testify to the difficulties of applying guidelines in the area of hospital discharge. The action plan decided in the hospital for a successful return home can be jeopardised for personal, relational, functional and structural reasons originating from the different players involved in the hospital discharge. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Drug usage patterns and treatment costs in newly-diagnosed type 2 diabetes mellitus cases, 2007 vs 2012: findings from a large US healthcare claims database analysis.

Science.gov (United States)

Weng, W; Liang, Y; Kimball, E S; Hobbs, T; Kong, S; Sakurada, B; Bouchard, J

2016-07-01

Objective To explore trends in demographics, comorbidities, anti-diabetic drug usage, and healthcare utilization costs in patients with newly-diagnosed type 2 diabetes mellitus (T2DM) using a large US claims database. Methods For the years 2007 and 2012, Truven Health Marketscan Research Databases were used to identify adults with newly-diagnosed T2DM and continuous 12-month enrollment with prescription benefits. Variables examined included patient demographics, comorbidities, inpatient utilization patterns, healthcare costs (inpatient and outpatient), drug costs, and diabetes drug claim patterns. Results Despite an increase in the overall database population between 2007-2012, the incidence of newly-diagnosed T2DM decreased from 1.1% (2007) to 0.65% (2012). Hyperlipidemia and hypertension were the most common comorbidities and increased in prevalence from 2007 to 2012. In 2007, 48.3% of newly-diagnosed T2DM patients had no claims for diabetes medications, compared with 36.2% of patients in 2012. The use of a single oral anti-diabetic drug (OAD) was the most common diabetes medication-related claim (46.2% of patients in 2007; 56.7% of patients in 2012). Among OAD monotherapy users, metformin was the most commonly used and increased from 2007 (74.7% of OAD monotherapy users) to 2012 (90.8%). Decreases were observed for sulfonylureas (14.1% to 6.2%) and thiazolidinediones (7.3% to 0.6%). Insulin, predominantly basal insulin, was used by 3.9% of patients in 2007 and 5.3% of patients in 2012. Mean total annual healthcare costs increased from $13,744 in 2007 to $15,175 in 2012, driven largely by outpatient services, although costs in all individual categories of healthcare services (inpatient and outpatient) increased. Conversely, total drug costs per patient were lower in 2012 compared with 2007. Conclusions Despite a drop in the rate of newly-diagnosed T2DM from 2007 to 2012 in the US, increased total medical costs and comorbidities per individual patient suggest that

Task-role-based Access Control Model in Smart Health-care System

OpenAIRE

Wang Peng; Jiang Lingyun

2015-01-01

As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for...

The feasibility of employing a home healthcare model for education and treatment of opioid overdose using a naloxone auto-injector in a private practice pain medicine clinic.

Science.gov (United States)

Dragovich, Anthony; Brason, Fred; Beltran, Thomas; McCoart, Amy; Plunkett, Anthony R

2018-04-18

The purpose of this study was to determine if employing a home healthcare model for education and treatment of opioid overdose using Evzio® (Naloxone)* auto-injector in a private practice pain clinic. A prospective survey was used to determine the feasibility of integrating a naloxone auto-injector within the patient's home with a home care training model. Twenty moderate or high-risk patients were enrolled from our chronic pain clinic. Patients who were moderate or high risk completed an evaluation survey. The naloxone auto-injector was dispensed to all patients meeting criteria. The treating provider after prescribing the naloxone auto-injector then consulted home health per standard clinical practice. All patients had home health consulted to perform overdose identification and rescue training. A Cochran's Q test was conducted to examine differences in patient knowledge pre and post training. The post training test was done 2-4 weeks later. Forty subjects enrolled after meeting inclusion/exclusion criteria. Twenty withdrew because their insurance declined coverage for the naloxone auto-injector. Those completing home health showed a statistically significant difference in their ability to correctly identify the steps needed to effectively respond to an overdose p = 0.03 Discussion: Preliminary evidence would suggest training on overdose symptom recognition and proper use of prescription naloxone for treatment in the home setting by home health staff would prove more beneficial than the clinic setting, but feasibility was hindered by unaffordable costs related to insurance coverage limitations.

Care pathways as boundary objects between primary and secondary care: Experiences from Norwegian home care services.

Science.gov (United States)

Håland, Erna; Røsstad, Tove; Osmundsen, Tonje C

2015-11-01

The need for integration of healthcare services and collaboration across organisational boundaries is highlighted as a major challenge within healthcare in many countries. Care pathways are often presented as a solution to this challenge. In this article, we study a project of developing, introducing and using a care pathway across healthcare levels focusing on older home-dwelling patients in need of home care services after hospital discharge. In so doing, we use the concept of boundary object, as described by Star and Griesemer, to explore how care pathways can act as tools for translation between specialist healthcare services and home care services. Based on interviews with participants in the project, we find that response to existing needs, local tailoring, involvement and commitment are all crucial for the care pathway to function as a boundary object in this setting. Furthermore, the care pathway, as we argue, can be used to push boundaries just as much as it can be used as a tool for bridging across them, thus potentially contributing to a more equal relationship between specialist healthcare services and home care services. © The Author(s) 2015.

Risk factors for work-related stress and subjective hardship in health-care staff in nursing homes for the elderly: A cross-sectional study.

Science.gov (United States)

Pélissier, Carole; Vohito, Michel; Fort, Emmanuel; Sellier, Brigitte; Agard, Jean Pierre; Fontana, Luc; Charbotel, Barbara

2015-01-01

This study aimed to explore potential risk factors for work-related stress by, detailing working conditions and subjective hardship according to occupational category in health-care staff working with elderly patients. A cross-sectional descriptive survey was conducted in 105 nursing homes for the elderly in France. Data on nursing home working conditions were collected by occupational physicians. The study population was limited to those in direct contact with the elderly, who were divided into 3 occupational groups defined by qualifications and tasks: housekeepers (HKs), nursing assistants (NAs) and nurses (Ns). Employees answered a questionnaire on their perceived working conditions and vocational training courses. Psychosocial stress was assessed with the Siegrist questionnaire. The subjects included 706 HKs, 1,565 NAs and 378 Ns, and the findings showed confusion of tasks and responsibilities in the study population. Verbal abuse by residents was reported by 60.9% of HKs (versus 76.2% of NAs and 76.7% of Ns, pstress related to insufficient ability, nursing home workers should be encouraged to attend job training courses, which should cover knowledge of the specific care needs of elderly patients and of the authority/responsibility required to do their job.

Home care for children with multiple complex chronic conditions at the end of life: The choice of hospice versus home health.

Science.gov (United States)

Lindley, Lisa C; Mixer, Sandra J; Mack, Jennifer W

2016-01-01

Families desire to bring their children home at end of life, and this creates a variety of unique care needs at home. This study analyzed the child and family factors associated with hospice versus home health care use in the last year of life among children with multiple complex chronic conditions. Using the Andersen Behavioral Healthcare Utilization Model, the predisposing, enabling, and need factors of the child and family were shown to be significant predictors of hospice and home health care use. Hospice and home health care have advantages, and families may wish to use the service that best fits their needs.

Model medication management process in Australian nursing homes using business process modeling.

Science.gov (United States)

Qian, Siyu; Yu, Ping

2013-01-01

One of the reasons for end user avoidance or rejection to use health information systems is poor alignment of the system with healthcare workflow, likely causing by system designers' lack of thorough understanding about healthcare process. Therefore, understanding the healthcare workflow is the essential first step for the design of optimal technologies that will enable care staff to complete the intended tasks faster and better. The often use of multiple or "high risk" medicines by older people in nursing homes has the potential to increase medication error rate. To facilitate the design of information systems with most potential to improve patient safety, this study aims to understand medication management process in nursing homes using business process modeling method. The paper presents study design and preliminary findings from interviewing two registered nurses, who were team leaders in two nursing homes. Although there were subtle differences in medication management between the two homes, major medication management activities were similar. Further field observation will be conducted. Based on the data collected from observations, an as-is process model for medication management will be developed.

The determinants of home and nursing home death: a systematic review and meta-analysis.

Science.gov (United States)

Costa, Vania; Earle, Craig C; Esplen, Mary Jane; Fowler, Robert; Goldman, Russell; Grossman, Daphna; Levin, Leslie; Manuel, Douglas G; Sharkey, Shirlee; Tanuseputro, Peter; You, John J

2016-01-20

Most Canadians die in hospital, and yet, many express a preference to die at home. Place of death is the result of the interaction among sociodemographic, illness- and healthcare-related factors. Although home death is sometimes considered a potential indicator of end-of-life/palliative care quality, some determinants of place of death are more modifiable than others. The objective of this systematic review was to evaluate the determinants of home and nursing home death in adult patients diagnosed with an advanced, life-limiting illness. A systematic literature search was performed for studies in English published from January 1, 2004 to September 24, 2013 that evaluated the determinants of home or nursing home death compared to hospital death in adult patients with an advanced, life-limiting condition. The adjusted odds ratios, relative risks, and 95% confidence intervals of each determinant were extracted from the studies. Meta-analyses were performed if appropriate. The quality of individual studies was assessed using the Newcastle-Ottawa scale and the body of evidence was assessed according to the GRADE Working Group criteria. Of the 5,900 citations identified, 26 retrospective cohort studies were eligible. The risk of bias in the studies identified was considered low. Factors associated with an increased likelihood of home versus hospital death included multidisciplinary home palliative care, preference for home death, cancer as opposed to other diagnoses, early referral to palliative care, not living alone, having a caregiver, and the caregiver's coping skills. Knowledge about the determinants of place of death can be used to inform care planning between healthcare providers, patients and family members regarding the feasibility of dying in the preferred location and may help explain the incongruence between preferred and actual place of death. Modifiable factors such as early referral to palliative care, presence of a multidisciplinary home palliative care

Outsourcing in private healthcare organisations: a Greek perspective.

Science.gov (United States)

Moschuris, Socrates J; Kondylis, Michael N

2007-01-01

The purpose of this paper is to present a study carried out to investigate the extent of outsourcing, the decision-making process, the impact of outsourcing, and the future trend of outsourcing in private healthcare organisations in Greece. A survey instrument was designed and mailed to a random sample of 100 private healthcare organisations in Greece. A total of 25 usable questionnaires were received, representing a response rate of 25 percent. The survey instrument focused on the extent to which private healthcare organisations outsource services, the decision-making process for choosing an external service provider, the impact of outsourcing, and the future trend of outsourcing. Private healthcare organisations in Greece outsource a variety of activities. Cost savings, customisation, and customer satisfaction are the main factors affecting the outsourcing decision. The cooperation with a contract service provider has led to an improvement in customer satisfaction and to a cost reduction. Most users are highly satisfied with the performance of these companies and believe that there will be a future increase in the usage of these services. The paper provides a framework regarding outsourcing in private healthcare organisations. This research fills the gap in the area of outsourcing in private healthcare organisations in Greece.

Telemonitoring and home hospitalization in patients with chronic obstructive pulmonary disease: study TELEPOC.

Science.gov (United States)

Mirón Rubio, Manuel; Ceballos Fernández, Rocío; Parras Pastor, Inmaculada; Palomo Iloro, Amaya; Fernández Félix, Borja Manuel; Medina Miralles, Jenifer; Zamudio López, Esther; González Pastor, Javier; Amador Lorente, Caridad; Mena Hortelano, Nazaret; Domínguez Sánchez, Alejandro; Alonso-Viteri, Soledad

2018-04-01

Chronic obstructive pulmonary disease (COPD) is a major consumer of healthcare resources, with most costs related to disease exacerbations. Telemonitoring of patients with COPD may help to reduce the number of exacerbations and/or the related costs. On the other hand, home hospitalization is a cost-saving alternative to inpatient hospitalization associated with increased comfort for patients. The results are reported regarding using telemonitoring and home hospitalization for the management of patients with COPD. Twenty-eight patients monitored their health parameters at home for six months. A nurse remotely revised the collected parameters and followed the patients as programmed. A home care unit was dispatched to the patients' home if an alarm signal was detected. The outcomes were compared to historical data from the same patients. The number of COPD exacerbations during the study period did not reduce but the number of hospital admissions decreased by 60% and the number of emergency room visits by 38%. On average, costs related to utilization of healthcare resources were reduced by €1,860.80 per patient per year. Telemonitoring of patients with COPD combined with home hospitalization may allow for a reduction in healthcare costs, although its usefulness in preventing exacerbations is still unclear.

Home Features and Assistive Technology for the Home-Bound Elderly in a Thai Suburban Community by Applying the International Classification of Functioning, Disability, and Health

Directory of Open Access Journals (Sweden)

Supawadee Putthinoi

2017-01-01

Full Text Available The ageing population is having an impact worldwide and has created a serious challenge in Thailand’s healthcare systems, whereby healthcare practitioners play a major role in promoting independent interaction of their client’s abilities, as well as environmental factors. The purpose of this study was to survey features of the home and assistive technology (AT for the home-bound elderly in the community of Chiang Mai, Thailand. Home evaluation included features inside and outside the home, and AT was based on the International Classification of Functioning, Disability, and Health (ICF concept. Methods included observation and an interview that were used by the researcher for evaluation. The study found that every home had at least one hazardous home feature such as inappropriate width of the door, high door threshold, tall stair steps, no bedside rail, and inappropriate height of the toilet pan. AT was found in houses as general products and technology for personal use in daily living and for personal indoor and outdoor mobility as well as transportation. Therefore, home features and AT can afford the home-bound elderly independent living within the community. Perspective AT according to the ICF concept could provide a common language for ageing in place benefits.

PRagmatic trial Of Video Education in Nursing homes: The design and rationale for a pragmatic cluster randomized trial in the nursing home setting.

Science.gov (United States)

Mor, Vincent; Volandes, Angelo E; Gutman, Roee; Gatsonis, Constantine; Mitchell, Susan L

2017-04-01

Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the "real world" application of an Advance Care Planning Video Program in two large US nursing home healthcare systems. Methods PRagmatic trial Of Video Education in Nursing homes was conducted in 360 nursing homes (N = 119 intervention/N = 241 control) owned by two healthcare systems. Over an 18-month implementation period, intervention facilities were instructed to offer the Advance Care Planning Video Program to all patients. Control facilities employed usual advance care planning practices. Patient characteristics and outcomes were ascertained from Medicare Claims, Minimum Data Set assessments, and facility electronic medical record data. Intervention adherence was measured using a Video Status Report embedded into electronic medical record systems. The primary outcome was the number of hospitalizations/person-day alive among long-stay patients with advanced dementia or cardiopulmonary disease. The rationale for the approaches to facility randomization and recruitment, intervention implementation, population selection, data acquisition, regulatory issues, and statistical analyses are discussed. Results The large number of well-characterized candidate facilities enabled several unique design features including stratification on historical hospitalization rates, randomization prior to recruitment, and 2:1 control to intervention facilities ratio. Strong endorsement from corporate leadership made randomization

Fostering dignity in the care of nursing home residents through slow caring

DEFF Research Database (Denmark)

Lohne, Vibeke; Høy, Bente; Lillestø, Britt

2017-01-01

Background: Physical impairment and dependency on others may be a threat to dignity. Research questions: The purpose of this study was to explore dignity as a core concept in caring, and how healthcare personnel focus on and foster dignity in nursing home residents. Research design: This study has...... personnel, maintaining human dignity requires slow caring in nursing homes, as an essential approach....... a hermeneutic design. Participants and research context: In all, 40 healthcare personnel from six nursing homes in Scandinavia participated in focus group interviews in this study. Ethical considerations: This study has been evaluated and approved by the Regional Ethical Committees and the Social Science Data...

Care on demand in nursing homes: a queueing theoretic approach

NARCIS (Netherlands)

Van Eeden, K.; Moeke, D.; Bekker, R.

2014-01-01

Nursing homes face ever-tightening healthcare budgets and are searching for ways to increase the efficiency of their healthcare processes without losing sight of the needs of their residents. Optimizing the allocation of care workers plays a key role in this search as care workers are responsible

The impact of work culture on quality of care in nursing homes--a review study.

Science.gov (United States)

André, Beate; Sjøvold, Endre; Rannestad, Toril; Ringdal, Gerd I

2014-09-01

The main aim of this review study was to identify which factors that characterise the relationship between work culture and quality of care in nursing homes. This review study was structured through systematic search methods to identify articles that describe the relationship between work culture and quality of care in nursing homes. The database search yielded 14510 hits. Closer examination showed that 10401 of these hits were duplicates. Of the remaining 4109 articles, only 10 were related to our aim for the study. A qualitative method were used to explain and understand phenomena of work culture and quality if care in nursing homes. Nine out of 10 articles in this review study emphasise the importance of leadership style and supportive management to increase quality of care in nursing homes. Increased empowerment, participation and influence were important factors for improving quality of care. Significant associations between work culture and quality of care and between empowerment and quality of care were reported. Nursing management and leaders must take in consideration that work culture is crucial for improving quality of care in nursing homes, and this study can be used to increase the focus on the work culture among healthcare personnel in nursing homes. Changes are necessary to increase healthcare personnel's job satisfaction, empowerment, autonomy and influence in nursing homes. Giving empowerment to the healthcare personnel working in nursing homes is both an organisational and an interpersonal issue. Being given empowerment and influence over their own work situation, the healthcare workers can be more committed and involved in the goal of obtaining best possible care to the residents. © 2013 Nordic College of Caring Science.

The Science of Home Automation

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Thomas, Brian Louis

Smart home technologies and the concept of home automation have become more popular in recent years. This popularity has been accompanied by social acceptance of passive sensors installed throughout the home. The subsequent increase in smart homes facilitates the creation of home automation strategies. We believe that home automation strategies can be generated intelligently by utilizing smart home sensors and activity learning. In this dissertation, we hypothesize that home automation can benefit from activity awareness. To test this, we develop our activity-aware smart automation system, CARL (CASAS Activity-aware Resource Learning). CARL learns the associations between activities and device usage from historical data and utilizes the activity-aware capabilities to control the devices. To help validate CARL we deploy and test three different versions of the automation system in a real-world smart environment. To provide a foundation of activity learning, we integrate existing activity recognition and activity forecasting into CARL home automation. We also explore two alternatives to using human-labeled data to train the activity learning models. The first unsupervised method is Activity Detection, and the second is a modified DBSCAN algorithm that utilizes Dynamic Time Warping (DTW) as a distance metric. We compare the performance of activity learning with human-defined labels and with automatically-discovered activity categories. To provide evidence in support of our hypothesis, we evaluate CARL automation in a smart home testbed. Our results indicate that home automation can be boosted through activity awareness. We also find that the resulting automation has a high degree of usability and comfort for the smart home resident.

The influence of a mental health home visit service partnership intervention on the caregivers' home visit service satisfaction and care burden.

Science.gov (United States)

Cheng, Jui-Fen; Huang, Xuan-Yi; Lin, Mei-Jue; Wang, Ya-Hui; Yeh, Tzu-Pei

2018-02-01

To investigate a community-based and hospital-based home visit partnership intervention in improving caregivers' satisfaction with home service and reducing caregiver burden. The community-oriented mental healthcare model prevails internationally. After patients return to the community, family caregivers are the patients' main support system and they also take the most of the burden of caring for patients. It is important to assist these caregivers by building good community healthcare models. A longitudinal quasi-experimental quantitative design. The experimental group (n = 109) involved "partnership" intervention, and the control group (n = 101) maintained routine home visits. The results were measured before the intervention, 6 and 12 months after the partnership intervention. Six months after the partnership intervention, the satisfaction of the experimental group was higher than the control group for several aspects of care. Although the care burden was reduced in the experimental group, there was no significant difference between the two groups. This study confirms that the partnership intervention can significantly improve caregiver satisfaction with home services, without reducing the care burden. The community-based and hospital-based mental health home visit service partnership programme could improve the main caregiver's satisfaction with the mental health home visit services, while the reduction in care burden may need government policies for the provision of more individual and comprehensive assistance. © 2017 John Wiley & Sons Ltd.

MRI usage in a pediatric emergency department: an analysis of usage and usage trends over 5 years

Energy Technology Data Exchange (ETDEWEB)

Scheinfeld, Meir H. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiology, Division of Emergency Radiology, Bronx, NY (United States); Moon, Jee-Young; Wang, Dan [Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY (United States); Fagan, Michele J. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Pediatrics, Division of Emergency Medicine, Bronx, NY (United States); Davoudzadeh, Reubin [Montefiore Medical Center, Department of Radiology, Bronx, NY (United States); Taragin, Benjamin H. [Montefiore Medical Center, Albert Einstein College of Medicine, Department of Radiology, Division of Pediatric Radiology, Bronx, NY (United States)

2017-03-15

Magnetic resonance imaging (MRI) usage has anecdotally increased due to the principles of ALARA and the desire to Image Gently. Aside from a single abstract in the emergency medicine literature, pediatric emergency department MRI usage has not been described. Our objective was to determine whether MRI use is indeed increasing at a high-volume urban pediatric emergency department with 24/7 MRI availability. Also, we sought to determine which exams, time periods and demographics influenced the trend. Institutional Review Board exemption was obtained. Emergency department patient visit and exam data were obtained from the hospital database for the 2011-2015 time period. MRI usage data were normalized using emergency department patient visit data to determine usage rates. The z-test was used to compare MRI use by gender. The chi-square test was used to test for trends in MRI usage during the study period and in patient age. MRI usage for each hour and each weekday were tabulated to determine peak and trough usage times. MRI usage rate per emergency department patient visit was 0.36%. Headache, pain and rule-out appendicitis were the most common indications for neuroradiology, musculoskeletal and trunk exams, respectively. Usage in female patients was significantly greater than in males (0.42% vs. 0.29%, respectively, P<0.001). Usage significantly increased during the 5-year period (P<0.001). Use significantly increased from age 3 to 17 (0.011% to 1.1%, respectively, P<0.001). Sixty percent of exams were performed after-hours, the highest volume during the 10 p.m. hour and lowest between 4 a.m. and 9 a.m. MRI use was highest on Thursdays and lowest on Sundays (MRI on 0.45% and 0.22% of patients, respectively). MRI use in children increased during the study period, most notably in females, on weekdays and after-hours. (orig.)

Influenza vaccination coverage of healthcare workers and residents and their determinants in nursing homes for elderly people in France: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Guthmann Jean-Paul

2010-03-01

Full Text Available Abstract Background Nursing home residents bear a substantial burden of influenza morbidity and mortality. Vaccination of residents and healthcare workers (HCWs is the main strategy for prevention. Despite recommendations, influenza vaccination coverage among HCWs remains generally low. Methods During the 2007-2008 influenza season, we conducted a nationwide survey to estimate influenza vaccination coverage of HCWs and residents in nursing homes for elderly people in France and to identify determinants of vaccination rates. Multivariate analysis were performed with a negative binomial regression. Results Influenza vaccination coverage rates were 33.6% (95% CI: 31.9-35.4 for HCWs and 91% (95% CI: 90-92 for residents. Influenza vaccination uptake of HCWs varied by occupational category. Higher vaccination coverage was found in private elderly care residences, when free vaccination was offered (RR: 1.89, 1.35-2.64, in small nursing homes (RR: 1.54, 1.31-1.81 and when training sessions and staff meetings on influenza were organized (RR: 1.20, 1.11-1.29. The analysis by occupational category showed that some determinants were shared by all categories of professionals (type of nursing homes, organization of training and staff meetings on influenza. Higher influenza vaccination coverage was found when free vaccination was offered to recreational, cleaning, administrative staff, nurses and nurse assistants, but not for physicians. Conclusions This nationwide study assessed for the first time the rate of influenza vaccination among residents and HCWs in nursing homes for elderly in France. Better communication on the current recommendations regarding influenza vaccination is needed to increase compliance of HCWs. Vaccination programmes should include free vaccination and education campaigns targeting in priority nurses and nurse assistants.

Home Area Networks and the Smart Grid

Energy Technology Data Exchange (ETDEWEB)

Clements, Samuel L.; Carroll, Thomas E.; Hadley, Mark D.

2011-04-01

With the wide array of home area network (HAN) options being presented as solutions to smart grid challenges for the home, it is time to compare and contrast their strengths and weaknesses. This white paper examines leading and emerging HAN technologies. The emergence of the smart grid is bringing more networking players into the field. The need for low consistent bandwidth usage differs enough from the traditional information technology world to open the door to new technologies. The predominant players currently consist of a blend of the old and new. Within the wired world Ethernet and HomePlug Green PHY are leading the way with an advantage to HomePlug because it doesn't require installing new wires. In the wireless the realm there are many more competitors but WiFi and ZigBee seem to have the most momentum.

Creutzfeldt-Jakob Disease Fact Sheet for Healthcare Workers and Morticians

Science.gov (United States)

... here Home » Disorders » Patient & Caregiver Education » Fact Sheets Creutzfeldt-Jakob Disease Fact Sheet for Healthcare Workers and Morticians Creutzfeldt-Jakob disease (CJD) is a rare, fatal brain disorder that ...

A New Remote Health-Care System Based on Moving Robot Intended for the Elderly at Home

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Bing Zhou

2018-01-01

Full Text Available Nowadays, due to the growing need for remote care and the constantly increasing popularity of mobile devices, a large amount of mobile applications for remote care support has been developed. Although mobile phones are very suitable for young people, there are still many problems related to remote health care of the elderly. Due to hearing loss or limited movements, it is difficult for the elderly to contact their families or doctors via real-time video call. In this paper, we introduce a new remote health-care system based on moving robots intended for the elderly at home. Since the proposed system is an online system, the elderly can contact their families and doctors quickly anytime and anywhere. Besides call, our system involves the accurate indoor object detection algorithms and automatic health data collection, which are not included in existing remote care systems. Therefore, the proposed system solves some challenging problems related to the elderly care. The experiment has shown that the proposed care system achieves excellent performance and provides good user experience.

Improving Smart Home Concept with the Internet of Things Concept Using RaspberryPi and NodeMCU

Science.gov (United States)

Amri, Yasirli; Andri Setiawan, Mukhammad

2018-03-01

The Internet of things (IoT) is getting more tractions in recent years. One of the usage scenario of IoT is smart home. Smart home basically provides home automation for installed devices at home such as thermostat, lighting, air conditioning, etc and allows devices connected to the Internet to be monitored and controlled remotely by user. However many studies on smart home concept focusing only on few main features. They still lack of important usage of IoT i.e. providing energy efficiency, energy monitoring, dealing with security, and managing privacy. This paper proposes a smart home system with RaspberryPi and NodeMCU as the backend that not only serves as home automation and merely a switch replacement, but to also record and report important things to the owner of the house e.g. when someone trespasses the house (security perimeter), or to report the calculation of how much money has been spent in consuming the electrical appliances. We successfully examine our proposed system in a real life working scenario. The communication between user and the system is done using Telegram Bot.

Patient safety culture in Norwegian nursing homes.

Science.gov (United States)

Bondevik, Gunnar Tschudi; Hofoss, Dag; Husebø, Bettina Sandgathe; Deilkås, Ellen Catharina Tveter

2017-06-20

Patient safety culture concerns leader and staff interaction, attitudes, routines, awareness and practices that impinge on the risk of patient-adverse events. Due to their complex multiple diseases, nursing home patients are at particularly high risk of adverse events. Studies have found an association between patient safety culture and the risk of adverse events. This study aimed to investigate safety attitudes among healthcare providers in Norwegian nursing homes, using the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). We studied whether variations in safety attitudes were related to professional background, age, work experience and mother tongue. In February 2016, 463 healthcare providers working in five nursing homes in Tønsberg, Norway, were invited to answer the SAQ-AV, translated and adapted to the Norwegian nursing home setting. Previous validation of the Norwegian SAQ-AV for nursing homes identified five patient safety factors: teamwork climate, safety climate, job satisfaction, working conditions and stress recognition. SPSS v.22 was used for statistical analysis, which included estimations of mean values, standard deviations and multiple linear regressions. P-values safety factors teamwork climate, safety climate, job satisfaction and working conditions. Not being a Norwegian native speaker was associated with a significantly higher mean score for job satisfaction and a significantly lower mean score for stress recognition. Neither professional background nor work experience were significantly associated with mean scores for any patient safety factor. Patient safety factor scores in nursing homes were poorer than previously found in Norwegian general practices, but similar to findings in out-of-hours primary care clinics. Patient safety culture assessment may help nursing home leaders to initiate targeted quality improvement interventions. Further research should investigate associations between patient safety culture and the occurrence

Self-reported healthcare provider utilization across United States Midwestern households

Directory of Open Access Journals (Sweden)

S.R. Dominick

2018-06-01

Full Text Available Understanding the relationships between health care provider usage and demographics of patients is necessary for the development of educational materials, outreach information, and programs targeting individuals who may benefit from services. This analysis identified relationships between health care provider usage and individual's demographics. A sample of Midwestern U.S. respondents (n = 1265 was obtained through the use of an online survey distributed February 12–26, 2016 and was targeted to be representative of the population of the Midwestern states sampled in terms of sex, age, income, and state of residence. Specific factors identified as significant in contributing to provider usage (in the past five years differed across the eleven provider types studied. In the most commonly used practitioners (the general or primary physician, relationships between provider usage and age, income, health insurance coverage status, and having children in the household were identified. Furthermore, significant (and positive correlations were identified between the usage of various practitioners; reporting the use of one type of practitioner studied was correlated positively with reporting the use of another type of health care provider studied in this analysis. This analysis provides insight into the relationships between health care provider usage and demographics of individuals, which can aid in the development of educational materials, outreach programs, and policy development. Keywords: Healthcare, Provider use, Clinician use, Primary physician

Comparing Catheter-associated Urinary Tract Infection Prevention Programs Between VA and Non-VA Nursing Homes

Science.gov (United States)

Mody, Lona; Greene, M. Todd; Saint, Sanjay; Meddings, Jennifer; Trautner, Barbara W.; Wald, Heidi L.; Crnich, Christopher; Banaszak-Holl, Jane; McNamara, Sara E.; King, Beth J.; Hogikyan, Robert; Edson, Barbara; Krein, Sarah L.

2018-01-01

OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that U.S. Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the “AHRQ Safety Program for Long-term Care” collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention. RESULTS A total of 353 (71%; 47 VA, 306 non-VA) of 494 nursing homes from 41 states responded. VA nursing homes reported more hours/week devoted to infection prevention-related activities (31 vs. 12 hours, P<.001), and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs. 66%, P<.001), sharing CAUTI data with leadership (94% vs. 70%, P=.014) and nursing personnel (85% vs. 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs. 81%, P=.004) and catheter insertion (83% vs. 94%, P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. PMID:27917728

Factors affecting pain relief in response to physical exercise interventions among healthcare workers.

Science.gov (United States)

Jakobsen, M D; Sundstrup, E; Brandt, M; Andersen, L L

2017-12-01

The aim of this study is to identify factors associated with musculo-skeletal pain reduction during workplace-based or home-based physical exercise interventions among healthcare workers. Two hundred female healthcare workers (age: 42.0, BMI: 24.1, average pain intensity: 3.1 on a scale of 0-10) from three hospitals participated. Participants were randomly allocated at the cluster level (18 departments) to 10 weeks of (i) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to five group-based coaching sessions on motivation for regular physical exercise, or (ii) home-based physical exercise (HOME) performed alone during leisure-time for 5 × 10 minutes per week. Linear mixed models accounting for cluster identified factors affecting pain reduction. On average 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions were performed per week in WORK and HOME, respectively. The multi-adjusted analysis showed a significant effect on pain reduction of both training adherence (P=.04) and intervention group (P=.04) with participants in WORK experiencing greater reductions compared with HOME. Obesity at baseline was associated with better outcome. Leisure-time exercise, daily patient transfer, age, and chronic pain did not affect the changes in pain. In conclusion, even when adjusted for training adherence, performing physical exercise at the workplace is more effective than home-based exercise in reducing musculo-skeletal pain in healthcare workers. Noteworthy, obese individuals may especially benefit from physical exercise interventions targeting musculo-skeletal pain. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

One Family's Journey: Medical Home and the Network of Supports It Offers Children and Youth with Special Health Care Needs--Parent Partners

Science.gov (United States)

Townsend, Sabra; Pola-Money, Gina; Gatto, Molly

2007-01-01

In this 12 installment Medical Home series, "EP" will present a case study about the American Academy of Pediatrics' Medical Home Initiative. A "Medical Home" is not a building. It is an approach to providing healthcare services to children with special healthcare needs. This article presents Part 3 in the series as readers learn more about Amita…

Study of Cloud Computing in HealthCare Industry

OpenAIRE

Reddy, G. Nikhita; Reddy, G. J. Ugander

2014-01-01

In Todays real world technology has become a domiant crucial component in every industry including healthcare industry. The benefits of storing electronically the records of patients have increased the productivity of patient care and easy accessibility and usage. The recent technological innovations in the health care is the invention of cloud based Technology. But many fears and security measures regarding patient records storing remotely is a concern for many in health care industry. One n...

Planned home birth in the United States and professionalism: a critical assessment.

Science.gov (United States)

Chervenak, Frank A; McCullough, Laurence B; Grünebaum, Amos; Arabin, Birgit; Levene, Malcolm I; Brent, Robert L

2013-01-01

Planned home birth has been considered by some to be consistent with professional responsibility in patient care. This article critically assesses the ethical and scientific justification for this view and shows it to be unjustified. We critically assess recent statements by professional associations of obstetricians, one that sanctions and one that endorses planned home birth. We base our critical appraisal on the professional responsibility model of obstetric ethics, which is based on the ethical concept of medicine from the Scottish and English Enlightenments of the 18th century. Our critical assessment supports the following conclusions. Because of its significantly increased, preventable perinatal risks, planned home birth in the United States is not clinically or ethically benign. Attending planned home birth, no matter one's training or experience, is not acting in a professional capacity, because this role preventably results in clinically unnecessary and therefore clinically unacceptable perinatal risk. It is therefore not consistent with the ethical concept of medicine as a profession for any attendant to planned home birth to represent himself or herself as a "professional." Obstetric healthcare associations should neither sanction nor endorse planned home birth. Instead, these associations should recommend against planned home birth. Obstetric healthcare professionals should respond to expressions of interest in planned home birth by pregnant women by informing them that it incurs significantly increased, preventable perinatal risks, by recommending strongly against planned home birth, and by recommending strongly for planned hospital birth. Obstetric healthcare professionals should routinely provide excellent obstetric care to all women transferred to the hospital from a planned home birth.The professional responsibility model of obstetric ethics requires obstetricians to address and remedy legitimate dissatisfaction with some hospital settings and

Parent's use of the Internet in the search for healthcare information and subsequent impact on the doctor-patient relationship.

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Harvey, S; Memon, A; Khan, R; Yasin, F

2017-11-01

The Internet is an unavoidable source of healthcare information. This information, both reliable and unreliable, has previously been shown to influence carer's decisions. Our aim was to evaluate this information seeking behavior among parents and its subsequent potential impact on the doctor-patient relationship. We undertook a cross-sectional questionnaire-based survey of paediatric outpatients. Enrollment took place over 4 weeks in March 2015. There were no inclusion or exclusion criteria and enrollment was voluntary. In total 100 questionnaires were completed. General Practitioners were the most common source of healthcare information. The Internet ranked third as a reliable source of healthcare information. The Internet was commonly used as an educational resource to learn about causes, treatment, and medications. A significant percentage of our population expressed concern regarding Internet information reliability. A small percentage of parents were concerned that disclosing Internet usage may worsen the relationship with their doctor. Parents showed a willingness to learn about diseases and treatments, and felt that the Internet was a good resource to do so. This study shows that open discussion about Internet usage between parents and doctors is not common and carers feel at risk of judgment should they admit to Internet usage. The Internet should be seen as a positive adjunct to patient education which can improve understanding, thus strengthening the doctor-patient relationship. The Internet will never replace the role of healthcare professionals but must be seen as an integral part of a multi-disciplinary approach.

Examinations of Home Economics Textbooks for Sex Bias.

Science.gov (United States)

Weis, Susan F.

1979-01-01

Four analyses were conducted on a sample of 100 randomly selected, secondary home economics textbooks published between 1964 and 1974. Results indicated that the contents presented sex bias in language usage, in pictures portraying male and female role environments, and in role behaviors and expectations emphasized. (Author/JH)

[eLearning service for home palliative care].

Science.gov (United States)

Sakuyama, Toshikazu; Komatsu, Kazuhiro; Inoue, Daisuke; Fukushima, Osamu

2008-12-01

In order to support the home palliative care learning, we made the eLearning service for home palliative care (beta version) and tried to teach the palliative care to the medical staffs in the community. The various learners (such as nurses, pharmacists and the like) accessed to the online learning and used this eLearning service. After the learners finished eLearning for home palliative care, some questionnaires were distributed to the learners and analyzed by us. The analysis of questionnaires revealed that almost all were satisfied with our eLearning services. Especially the learners were not only interested in using the skills of opioids and the management of pain control, but they had a good cognition for the usage of opioids.

Perceptions of risk and risk management among 735 women who opted for a home birth.

Science.gov (United States)

Lindgren, Helena E; Rådestad, Ingela J; Christensson, Kyllike; Wally-Bystrom, Kristina; Hildingsson, Ingegerd M

2010-04-01

home birth is not included in the Swedish health-care system and the rate for planned home births is less than one in a thousand. The aim of this study was to describe women's perceptions of risk related to childbirth and the strategies for managing these perceived risks. a nationwide study including all women who had given birth at home in Sweden was conducted between 1 January 1992 and 31 July 2005. a total of 735 women had given birth to 1038 children. Of the 1038 questionnaires sent to the women, 1025 (99%) were returned. two open questions regarding risk related to childbirth and two questions answered using a scale were investigated by content analysis. regarding perceived risks about hospital birth, three categories, all related to loss of autonomy, were identified: (1) being in the hands of strangers; (2) being in the hands of routines and unnecessary interventions; and (3) being in the hands of structural conditions. Perceived risks related to a home birth were associated with a sense of being beyond help: (1) worst-case scenario; and (2) distance to the hospital. The perceived risks were managed by using extrovert activities and introvert behaviour, and by avoiding discussions concerning risks with health-care professionals. women who plan for a home birth in Sweden do consider risks related to childbirth but they avoid talking about the risks with health-care professionals. to understand why women choose to give birth at home, health-care professionals must learn about the perceived beneficial effect of doing so. Copyright 2008 Elsevier Ltd. All rights reserved.

The care unit in nursing home research: evidence in support of a definition.

Science.gov (United States)

Estabrooks, Carole A; Morgan, Debra G; Squires, Janet E; Boström, Anne-Marie; Slaughter, Susan E; Cummings, Greta G; Norton, Peter G

2011-04-14

Defining what constitutes a resident care unit in nursing home research is both a conceptual and practical challenge. The aim of this paper is to provide evidence in support of a definition of care unit in nursing homes by demonstrating: (1) its feasibility for use in data collection, (2) the acceptability of aggregating individual responses to the unit level, and (3) the benefit of including unit level data in explanatory models. An observational study design was used. Research (project) managers, healthcare aides, care managers, nursing home administrators and directors of care from thirty-six nursing homes in the Canadian prairie provinces of Alberta, Saskatchewan and Manitoba provided data for the study. A definition of care unit was developed and applied in data collection and analyses. A debriefing session was held with research managers to investigate their experiences with using the care unit definition. In addition, survey responses from 1258 healthcare aides in 25 of the 36 nursing homes in the study, that had more than one care unit, were analyzed using a multi-level modeling approach. Trained field workers administered the Alberta Context Tool (ACT), a 58-item self-report survey reflecting 10 organizational context concepts, to healthcare aides using computer assisted personal interviews. To assess the appropriateness of obtaining unit level scores, we assessed aggregation statistics (ICC(1), ICC(2), η², and ω²), and to assess the value of using the definition of unit in explanatory models, we performed multi-level modeling. In 10 of the 36 nursing homes, the care unit definition developed was used to align the survey data (for analytic purposes) to specific care units as designated by our definition, from that reported by the facility administrator. The aggregation statistics supported aggregating the healthcare aide responses on the ACT to the realigned unit level. Findings from the multi-level modeling further supported unit level aggregation. A

Development of a user-friendly, low-cost home energy monitoring and recording system

International Nuclear Information System (INIS)

Fletcher, James; Malalasekera, Weeratunge

2016-01-01

This paper reports research undertaken to develop a user-friendly home energy monitoring system which is capable of collecting, processing and displaying detailed usage data. The system allows users to monitor power usage and switch their electronic appliances remotely, using any web enabled device, including computers, phones and tablets. The system aims to raise awareness of consumer energy use by gathering data about usage habits, and displaying this information to support consumers when selecting energy tariffs or new appliances. To achieve these aims, bespoke electrical hardware, or ‘nodes’, have been designed and built to monitor power usage, switch devices on and off, and communicate via a Wi-Fi connection, with bespoke software, the ‘server’. The server hosts a webpage which allows users to see a real-time overview of how power is being used in the home as well as allowing scheduled tasks and triggered tasks (which respond to events) to be programmed. The system takes advantage of well standardised networking specifications, such as Wi-Fi and TCP, allowing access from within the home, or remotely through the internet. The server runs under Debian Linux on a Raspberry Pi computer and is written in Python, HTML and JavaScript. The server includes advanced functionality, such as device recognition which allows users to individually monitor several devices that share a single node. The openPicus Flyport is used to provide Wi-Fi connectivity and programmable logic control to nodes. The Flyport is programmed with code compiled from C. - Highlights: • The system is capable of collecting, processing and displaying detailed usage data. • The system is built using commonly available components and software. • Nodes in this system can communicate via a Wi-Fi connection with a server. • The data saved in the server can be used in smart grid applications.

Gender Differences in Availability, Internet Access and Rate of Usage of Computers among Distance Education Learners.

Science.gov (United States)

Atan, Hanafi; Sulaiman, Fauziah; Rahman, Zuraidah Abd; Idrus, Rozhan Mohammed

2002-01-01

Explores the level of availability of computers, Internet accessibility, and the rate of usage of computers both at home and at the workplace between distance education learners according to gender. Results of questionnaires completed at the Universiti Sains Malaysia indicate that distance education reduces the gender gap. (Author/LRW)

Strengthening the decentralised healthcare system in rural South Africa through improved service delivery: testing mobility, information and communication technology intervention options

CSIR Research Space (South Africa)

Chakwizira, J

2010-09-01

Full Text Available their own human resources in providing healthcare services that ultimately counteract these inequalities. Presently, what could be considered the last level of decentralised healthcare is mostly represented by home and community-based healthcare...

Supporting home care for the dying: an evaluation of healthcare professionals' perspectives of an individually tailored hospice at home service.

Science.gov (United States)

Jack, Barbara A; Baldry, Catherine R; Groves, Karen E; Whelan, Alison; Sephton, Janice; Gaunt, Kathryn

2013-10-01

To explore health care professionals' perspective of hospice at home service that has different components, individually tailored to meet the needs of patients. Over 50% of adults diagnosed with a terminal illness and the majority of people who have cancer, prefer to be cared for and to die in their own home. Despite this, most deaths occur in hospital. Increasing the options available for patients, including their place of care and death is central to current UK policy initiatives. Hospice at home services aim to support patients to remain at home, yet there are wide variations in the design of services and delivery. A hospice at home service was developed to provide various components (accompanied transfer home, crisis intervention and hospice aides) that could be tailored to meet the individual needs of patients. An evaluation study. Data were collected from 75 health care professionals. District nurses participated in one focus group (13) and 31 completed an electronic survey. Palliative care specialist nurses participated in a focus group (9). One hospital discharge co-ordinator and two general practitioners participated in semi-structured interviews and a further 19 general practitioners completed the electronic survey. Health care professionals reported the impact and value of each of the components of the service, as helping to support patients to remain at home, by individually tailoring care. They also positively reported that support for family carers appeared to enable them to continue coping, rapid access to the service was suggested to contribute to faster hospital discharges and the crisis intervention service was identified as helping patients remain in their own home, where they wanted to be. Health care professionals perceived that the additional individualised support provided by this service contributed to enabling patients to continue be cared for and to die at home in their place of choice. This service offers various components of a hospice

PLANNED HOME BIRTH: A REVIEW

Directory of Open Access Journals (Sweden)

Tamara Serdinšek

2016-05-01

Full Text Available Background: Home birth is as old as humanity, but still most middle- and high-income countries consider hospitals as the safest birth settings, as complications regarding birth are highly unpredictable. Despite this there are a few countries in which home birth in integrated into official healthcare system (the Netherlands, United Kingdom, Canada etc.. Home births can be divided into unplanned and planned, and the latter can be further categorized by the presence of the birth attendants. This review focuses on planned home births, which are differently represented throughout the world. In the United States 0.6-1.0% of all children are born at home, in the United Kingdom 2-3%, in Canada 1.6% and in the Netherlands 20-30%. For Slovenia, the number of planned home births is unknown; however, in 2010 0.1% of children were born outside medical facilities.Conclusions: The safety of home birth in still under the debate. While research confirms smaller number of obstetric interventions and some complications in mothers who give birth at home, the data regarding the neonatal and perinatal mortality and morbidity is still conflicting. This confirms the need for large multicentric trials in this field. Current home birth guidelines emphasize that women should be well informed regarding the possible advantages and disadvantages of home births. In addition, the emphasis is on definition of selection criteria for home birth, indications for intrapartal transfer to the hospital and appropriate education of birth attendants. 

Patient autonomy in home care: Nurses' relational practices of responsibility.

Science.gov (United States)

Jacobs, Gaby

2018-01-01

Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A case study was conducted in a professional development course ('learning circle') for home care nurses, including participant observations and focus groups. The theoretical notion of 'relational agency' and the moral concept of 'practices of responsibility' were used to conduct a narrative analysis on the nurses' stories about autonomy. Eight nurses, two coaches and two university lecturers who participated in the learning circle. Ethical considerations: Informed consent was sought at the start of the course and again, at specific moments during the course of the learning circle. Three main themes were found that expressed the moral demands experienced and negotiated by the nurses: adapting to the person, activating patients' strengths and collaboration with patients and informal caregivers. On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on healthcare budget savings. This is manifested in the ambiguities the nurses face in fostering patient autonomy in their daily home care practice. To support nurses, critical thinking, moral sensitivity and trans-professional working should be part of their professional development. The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together.

Perception and attitude of healthcare workers towards the use of a ...

African Journals Online (AJOL)

Perception and attitude of healthcare workers towards the use of a female condom in Gaborone, Botswana. ... Journal Home > Vol 21, No 1 (2016) > ... contracting the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome ...

Field Measurements of Heating Efficiency of Electric Forced-Air Furnaces in Six Manufactured Homes.

Energy Technology Data Exchange (ETDEWEB)

Davis, Bob; Palmiter, Larry S.; Siegel, Jeff

1994-07-26

This report presents the results of field measurements of heating efficiency for six manufactured homes in the Pacific Northwest heated with electric forced-air systems. This is the first in a series of regional and national efforts to measure in detail the heating efficiency of manufactured homes. Only six homes were included in this study because of budgetary constraints; therefore this is not a representative sample. These investigations do provide some useful information on the heating efficiency of these homes. Useful comparisons can be drawn between these study homes and site-built heating efficiencies measured with a similar protocol. The protocol used to test these homes is very similar to another Ecotope protocol used in the study conducted in 1992 and 1993 for the Bonneville Power Administration to test the heating efficiency of 24 homes. This protocol combined real-time power measurements of furnace energy usage with energy usage during co-heat periods. Accessory data such as house and duct tightness measurements and tracer gas measurements were used to describe these homes and their heating system efficiency. Ensuring that manufactured housing is constructed in an energy and resource efficient manner is of increasing concern to manufactured home builders and consumers. No comparable work has been done to measure the heating system efficiency of MCS manufactured homes, although some co-heat tests have been performed on manufactured homes heated with natural gas to validate HUD thermal standards. It is expected that later in 1994 more research of this kind will be conducted, and perhaps a less costly and less time-consuming method for testing efficiencies will be develops.

Privacy versus autonomy: a tradeoff model for smart home monitoring technologies.

Science.gov (United States)

Townsend, Daphne; Knoefel, Frank; Goubran, Rafik

2011-01-01

Smart homes are proposed as a new location for the delivery of healthcare services. They provide healthcare monitoring and communication services, by using integrated sensor network technologies. We validate a hypothesis regarding older adults' adoption of home monitoring technologies by conducting a literature review of articles studying older adults' attitudes and perceptions of sensor technologies. Using current literature to support the hypothesis, this paper applies the tradeoff model to decisions about sensor acceptance. Older adults are willing to trade privacy (by accepting a monitoring technology), for autonomy. As the information captured by the sensor becomes more intrusive and the infringement on privacy increases, sensors are accepted if the loss in privacy is traded for autonomy. Even video cameras, the most intrusive sensor type were accepted in exchange for the height of autonomy which is to remain in the home.

Exploring the Barriers of Home Care Services in Iran: A Qualitative Study

Directory of Open Access Journals (Sweden)

Heshmatolah Heydari

2016-01-01

Full Text Available With increasing chronic diseases, the use of home care is rising in the world. Home care in Iran has many challenges and to improve that, we should identify the challenges and barriers of home care. The aim of this study was to identify and explore the barriers of home care in Iran. This is a qualitative study with content analysis approach that was conducted in Iran in 2015. Fourteen key informants comprising health policymakers, faculty members, nurses, and physicians as well as patients and families engaged in home care purposefully participated in this study. Data was obtained using face-to-face semistructured interviews. A focus group discussion was also used to complete the findings. Graneheim and Lundman’s approach was used for analysis of data and Lincoln and Guba’s criteria were used to confirm the trustworthiness of study’s findings. The data were divided into three main categories and eight subcategories. Main categories included treatment-based approach in the healthcare system, cultural dimensions, and the lack of adequate infrastructure. A position for home care in the healthcare system, considering cultural dimensions in Iranian society and providing an appropriate infrastructure, can be beneficial to improve the situation of home care services in Iran.

Personalized Monitoring and Assistive Systems: Case Study of Efficient Home Solutions.

Science.gov (United States)

Lhotska, Lenka; Doležal, Jaromír; Adolf, Jindřich; Potůček, Jiří; Křížek, Miroslav; Chbani, Baha

2018-01-01

The rapid emergence and proliferation of connected medical devices and their application in healthcare are already part of the Healthcare Internet of Things (IoT) - as this area started to be named. Their true impact on patient care and other aspects of healthcare remains to be seen and is highly dependent on the quality and relevancy of the data acquired. There is also the trend of application of IoT in telemedicine and home care environment. Currently many research groups focus on design and development of various solutions that can assist elderly and handicapped people in their home environment. However, many of these solutions are sophisticated and require advanced users that are able to control the device, handle error states and exceptions. They are frequently using expensive technologies that are good for laboratory environment but they are not affordable for many elderly or handicapped persons. In the paper we will analyze the current situation, present identified needs of elderly population and propose potential solutions. On a case study of efficient home solution of a personalized and assistive system we will show possibilities of technologically simple solutions using off-the-shelf devices and elements.

Needs of home care services for the bedridden patient’s problems living in their home

Directory of Open Access Journals (Sweden)

Nuran Akdemir

2011-03-01

Full Text Available The study was carry out as an semi-experimental study to identify the difficulties confronted by bedridden patients with stroke to give them necessary counseling services and to improve models of home care service.Method: The research sample is composed of 38 patients discarged from Hacettepe University İbni Sina Hospital and Health Ministry Ankara Numune Hospital Neurology services following cerebro-vascular accident. The data derived from the research is evaluated through percentage usage. Patients included in the study were visited average 5 times during the research.Result: During the home visiting, it is found out that most of the patients were in need of information concerning insufficient hygienic care, other illnesses, use of medication, discharge system problems like constipation and diarhea and dietary/nutritional; it is also observed that they are experiencing psycho-social diffuculties. The study results put forward suggestions in realizing progression and to form model of systematic home care services.

Economic impact analysis of an end-of-life programme for nursing home residents.

Science.gov (United States)

Teo, W-S Kelvin; Raj, Anusha Govinda; Tan, Woan Shin; Ng, Charis Wei Ling; Heng, Bee Hoon; Leong, Ian Yi-Onn

2014-05-01

Due to limited end-of-life discussions and the absence of palliative care, hospitalisations are frequent at the end of life among nursing home residents in Singapore, resulting in high health-care costs. Our objective was to evaluate the economic impact of Project Care at the End-of-Life for Residents in homes for the Elderly (CARE) programme on nursing home residents compared to usual end-of-life care. DESIGN AND SETTINGS/PARTICIPANTS: Project CARE was introduced in seven nursing homes to provide advance care planning and palliative care for residents identified to be at risk of dying within 1 year. The cases consisted of nursing home residents enrolled in the Project CARE programme for at least 3 months. A historical group of nursing home residents not in any end-of-life care programme was chosen as the matched controls. Cost differences between the two groups were analysed over the last 3 months and final month of life. The final sample comprised 48 Project CARE cases and 197 controls. Compared to the controls, the cases were older with more comorbidities and higher nursing needs. After risk adjustment, Project CARE cases demonstrated per-resident cost savings of SGD$7129 (confidence interval: SGD$4544-SGD$9714) over the last 3 months of life and SGD$3703 (confidence interval: SGD$1848-SGD$5557) over the last month of life (US$1 = SGD$1.3). This study demonstrated substantial savings associated with an end-of-life programme. With a significant proportion of the population in Singapore requiring nursing home care in the near future, these results could assist policymakers and health-care providers in decision-making on allocation of health-care resources.

Social relations and healthcare utilisation among middle-aged and older people

DEFF Research Database (Denmark)

Mikkelsen, Anne Sophie Bech; Lund, Rikke; Kristiansen, Maria

2017-01-01

at nursing homes in Denmark. Methods/design: A combined quantitative register-based approach and a qualitative implementation approach will be applied in this study. First, we will quantitatively analyse the relationship between social relations, health status and use of healthcare services among middle......Background: While previous research establishes an association between social relations, health and use of healthcare services among older people, how to implement this knowledge in real-life settings has received much less attention. This study will explore the relationship between social...... relations among older people at nursing homes. Trial registration: The study has been registered and approved by the Danish Data Protection Agency. Seperate approvals have been attained for the qualitative data (Approval No. SUND-2016-08), and for the quantitative data in the CAMB database which has also...

DOE Zero Energy Ready Home Case Study: Greenhill Contracting, Inc., Hickory Ridge

Energy Technology Data Exchange (ETDEWEB)

Pacific Northwest National Laboratory

2017-09-01

Greenhill Contracting built this 3,912-ft2 house in Gardiner, New York, to the high-performance criteria of the DOE Zero Energy Ready Home (ZERH) program. A highly efficient air-source heat pump heats and cools the home’s interior, while the roof-mounted photovoltaic system offsets electricity usage to cut energy bills to nearly zero. Many months the home owners see a credit on their utility bill.

The Promise of the Internet of Things in Healthcare: How Hard Is It to Keep?

Science.gov (United States)

Marques, Rita; Gregório, João; Mira Da Silva, Miguel; Lapão, Luís Velez

2016-01-01

Internet of Things is starting to be implemented in healthcare. An example is the automated monitoring systems that are currently being used to provide healthcare workers with feedback regarding their hand hygiene compliance. These solutions seem effective in promoting healthcare workers self-awareness and action regarding their hand hygiene performance, which is still far from desired. Underlying these systems, an indoor positioning component (following Internet of Things paradigm) is used to collect data from the ward regarding healthcare workers' position, which will be later used to make some assumptions about the usage of alcohol-based handrub dispensers and sinks. We found that building such a system under the scope of the healthcare field is not a trivial task and it must be subject to several considerations, which are presented, analyzed and discussed in this paper. The limitations of present Internet of Things technologies are not yet ready to address the demanding field of healthcare.

Usage Center

DEFF Research Database (Denmark)

Kleinaltenkamp, Michael; Plewa, Carolin; Gudergan, Siegfried

2017-01-01

Purpose: The purpose of this paper is to advance extant theorizing around resourceintegration by conceptualizing and delineating the notion of a usage center. Ausage center consists of a combination of interdependent actors that draw onresources across their individual usage processes to create v...

Understanding health decisions using critical realism: home-dialysis decision-making during chronic kidney disease.

Science.gov (United States)

Harwood, Lori; Clark, Alexander M

2012-03-01

Understanding health decisions using critical realism: home-dialysis decision-making during chronic kidney disease This paper examines home-dialysis decision making in people with Chronic Kidney Disease (CKD) from the perspective of critical realism. CKD programmes focus on patient education for self-management to delay the progression of kidney disease and the preparation and support for renal replacement therapy e.g.) dialysis and transplantation. Home-dialysis has clear health, societal and economic benefits yet service usage is low despite efforts to realign resources and educate individuals. Current research on the determinants of modality selection is superficial and insufficient to capture the complexities embedded in the process of dialysis modality selection. Predictors of home-dialysis selection and the effect of chronic kidney disease educational programmes provide a limited explanation of this experience. A re-conceptualization of the problem is required in order to fully understand this process. The epistemology and ontology of critical realism guides our knowledge and methodology particularly suited for examination of these complexities. This approach examines the deeper mechanisms and wider determinants associated with modality decision making, specifically who chooses home dialysis and under what circumstances. Until more is known regarding dialysis modality decision making service usage of home dialysis will remain low as interventions will be based on inadequate epistemology. © 2011 Blackwell Publishing Ltd.

"Broken covenant": healthcare aides' "experience of the ethical" in caring for dying seniors in a personal care home.

Science.gov (United States)

McClement, Susan; Lobchuk, Michelle; Chochinov, Harvey Max; Dean, Ruth

2010-01-01

Canada's population is aging, and seniors constitute the fastest growing demographic in the nation. The chronic health conditions, limited social support, functional decline, and cognitive impairment experienced by seniors may necessitate admission to a personal care home (PCH) setting up until the time of their death. The ethical problems that arise in the care of dying patients are numerous and complicated. The care of dying seniors in PCHs, however, is largely provided by frontline workers such as healthcare aides (HCAs), who usually have little training in palliative care or ethics. Research examining the identification and resolution of ethical problems in care of the dying has been conducted from the perspectives of nurses and physicians in various clinical settings, but the voice of HCAs in PCHs is virtually absent from clinical ethics. Given that the inability to satisfactorily resolve ethical issues in clinical practice is associated with feelings of guilt, powerlessness, avoiding contact with patients, failing to provide good physical care, and increased staff turnover, an empirical examination of HCAs' experiences of ethically challenging situations is warranted. We conducted a phenomenological study to access the lived experience of HCAs (N = 12) working in proprietary and nonproprietary care homes as they encountered situations they deemed ethically challenging in providing end-of-life care to dying seniors. The findings reported here explicate: (1) the types of situations that are ethically problematic for HCAs; (2) the meanings they assign to these situations, and (3) the impact such situations have on the provision of end-of-life care.

Nutrition in care homes and home care: How to implement adequate strategies

DEFF Research Database (Denmark)

Arvanitakis, M.; Beck, Anne Marie; Coppens, P.

2008-01-01

are various: medical, social, environmental, organizational and financial. Lack of alertness of individuals, their relatives and health-care professionals play an important role. Undernutrition enhances the risk of infection, hospitalization, mortality and alter the quality of life. Moreover, undernutrition...... related-disease is an economic burden in most countries. Nutritional assessment should be part of routine global management. Nutritional support combined with physical training and an improved ambiance during meats is mandatory. Awareness, information and collaboration with all the stakeholders should...... facilitate implementation of nutritional strategies. Conclusions: Undernutrition in home care and care home settings is a considerable problem and measures should be taken to prevent and treat it. (C) 2008 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved....

Legal regulation of home births

Directory of Open Access Journals (Sweden)

Baturan Luka O.

2015-01-01

Full Text Available In this paper, authors tried to find efficient legal frame for home births. The main problem is the risk of life and health of a mother and a baby. If a mother wants a home labor, there are no legal obstacles ^for her to take the risk of her own life, after consultation with health-care professionals. However, society is obligated to protect unborn child from irrational behavior of the mother, if she acts against child's best interests. Legal rules were analyzed by methods of neo-institutional economic theory, while the risks of life and health of a mother and a baby were analyzed by medical science methods.

Scheduling home appliances for energy efficient buildings

DEFF Research Database (Denmark)

Rossello Busquet, Ana; Kardaras, Georgios; Iversen, Villy Bæk

2010-01-01

The number of appliances found in users’ homes is increasing together with electricity consumption of users’ residences. In addition, there is a tendency to consume during the same period leading to demand peaks. During these periods, electricity providers are forced to develop costly methods...... to generate enough power to meet consumers’ requirements. In addition, high demand peaks can lead to electricity shortages or even blackouts in certain areas. In order to avoid demand peaks, users’ appliances should consume electricity in a more distributed way. A new methodology to schedule the usage of home...... appliances is proposed and analyzed. The main concept behind this approach is the aggregation of home appliances into priority classes and the definition of a maximum power consumption threshold, which is not allowed to be exceeded during peak hours. The scenario simulated describes a modern household, where...

Quality dementia care: Prerequisites and relational ethics among multicultural healthcare providers.

Science.gov (United States)

Sellevold, Gerd Sylvi; Egede-Nissen, Veslemøy; Jakobsen, Rita; Sørlie, Venke

2017-01-01

Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. The aim of this study is to illuminate multi-ethnic healthcare providers' lived experiences of their own working relationship, and its importance to quality care for people with dementia. The study is part of a greater participatory action research project: 'Hospice values in the care for persons with dementia'. The data material consists of extensive notes from seminars, project meetings and dialogue-based teaching. The text material was subjected to phenomenological-hermeneutical interpretation. Participants and research context: Participants in the project were healthcare providers working in a nursing home unit. The participants came from 15 different countries, had different formal qualifications, varied backgrounds and ethnic origins. Ethical considerations: The study is approved by the Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services. The results show that good working relationships, characterized by understanding each other's vulnerability and willingness to learn from each other through shared experiences, are prerequisites for quality care. The healthcare providers further described ethical challenges as uncertainty and different understandings. The results are discussed in the light of Lögstrup's relational philosophy of ethics and the concepts of vulnerability, ethic responsibility, trust and openness of speech. The prerequisite for quality care for persons with dementia in a multicultural working environment is to create arenas for open discussions between the healthcare providers. Leadership is of great importance.

Risk factors for burnout among caregivers working in nursing homes.

Science.gov (United States)

Kandelman, Nadia; Mazars, Thierry; Levy, Antonin

2018-01-01

(i) To assess the level of burnout in nursing home caregivers within a unique healthcare network in France and (ii) to evaluate potential risk factors in this population. Burnout syndrome occurs frequently among nursing home caregivers and has strong detrimental effects on the quality of health care for residents. We used an observational survey to study burnout in nursing home caregivers. The survey was used to quantify burnout level (Maslach Burnout Inventory) and potential risk factors and was implemented from October 2013-April 2014. A logistic regression was used to explore the association between burnout and its risk factors. Three hundred and sixty questionnaires were delivered to caregivers in 14 nursing homes within a unique healthcare network. The response rate was 37% (132/360), and 124/132 (94%) surveys were analysed. Caregiver burnout rate was 40% (49/124). Median age was 41 years (range, 20-70) and most caregivers were female. The most common profession (n = 54; 44%) was nurse caregiver and 90% (n = 112) had an antecedent of bullying by a resident. Risk factors identified were as follows: the presence of institutional protocols (death announcement [OR: 3.7] and pain assessment [OR: 2.8]), working in a profit-making establishment (OR: 2.6) and the antecedent of bullying by a resident (OR: 6.2). Factors most negatively associated with burnout included: practising pastimes (OR: 0.4) and working as a nurse (OR: 0.3). The only significant risk factor in the multivariate analysis was the antecedent of bullying by a resident (OR: 5.3). Several specific risk factors for burnout in nursing home caregivers were identified. In high-risk populations of healthcare professionals, screening and management of risk factors is crucial for preventing burnout. © 2017 John Wiley & Sons Ltd.

Service models for remote healthcare monitoring systems.

Science.gov (United States)

Moorman, Bridget A

2010-01-01

These scenarios reflect where the future is heading for remote health monitoring technology and service expectations. Being able to manage a "system of systems" with timely service hand-off over seams of responsibility and system interfaces will become very important for a BMET or clinical engineer. These interfaces will include patient homes, clinician homes, commercial/civilian infrastructure, public utilities, vendor infrastructure as well as internal departmental domains. Concurrently, technology is changing rapidly resulting in newer software delivery modes and hardware appliances as well as infrastructure changes. Those who are able to de-construct the complex systems and identify infrastructure assumptions and seams of servicing responsibility will be able to better understand and communicate the expectations for service of these systems. Moreover, as identified in Case 1, prodigious use of underlying system monitoring tools (managing the "meta-data") could move servicing of these remote systems from a reactive approach to a proactive approach. A prepared healthcare organization will identify their current and proposed future service combination use cases and design service philosophies and expectations for those use cases, while understanding the infrastructure assumptions and seams of responsibility. This is the future of technical service to the healthcare clinicians and patients.

Establishing a culturally specific nursing home for Finnish-speaking older persons in Sweden: A case study.

Science.gov (United States)

Hadziabdic, Emina; Hjelm, Katarina

2018-04-01

The study aims to describe the establishment of a culturally specific nursing home for Finnish-speaking older persons in Sweden. A descriptive qualitative study. A descriptive case study based on a review of 14 public documents and individual interviews with two experts in the area, analysed with qualitative content analysis. This study found that shared language, preservation of customs and habits and collaboration between the representatives of the municipality, Finnish-speaking migrant associations and staff at the nursing home influenced the development of the culturally specific nursing home for older Finnish-speaking people intended to avoid loneliness, isolation and misunderstandings among older Finnish-speaking. Collaboration between healthcare service for older persons and minority people resulted in an optimal culturally specific nursing home, simultaneously encountering the majority culture. Nursing and healthcare services need to be aware of positive effects of collaboration with stakeholders to achieve optimal culturally specific nursing homes.

Physical exercise at the workplace prevents deterioration of work ability among healthcare workers: cluster randomized controlled trial.

Science.gov (United States)

Jakobsen, Markus D; Sundstrup, Emil; Brandt, Mikkel; Jay, Kenneth; Aagaard, Per; Andersen, Lars L

2015-11-25

Imbalance between individual resources and work demands can lead to musculoskeletal disorders and reduced work ability. The purpose of this study was to investigate the effect of workplace- versus home-based physical exercise on work ability among healthcare workers. Two hundred female healthcare workers (Age: 42.0, BMI: 24.1, work ability index [WAI]: 43.1) from 18 departments at three Danish hospitals participated (Copenhagen, Denmark, Aug 2013-Jan 2014). Participants were randomly allocated at the cluster level to 10 weeks of: 1) workplace physical exercise (WORK) performed during working hours for 5x10 min per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or 2) home-based physical exercise (HOME) performed during leisure time for 5x10 min per week. Both groups received ergonomic counseling on patient handling and use of lifting aides. The main outcome measure was the change from baseline to 10-week follow-up in WAI. Significant group by time interaction was observed for WAI (p WORK compared with HOME corresponding to a small effect size (Cohens'd = 0.24). Within-group changes indicated that between-group differences were mainly caused by a reduction in WAI in HOME. Of the seven items of WAI, item 2 (work ability in relation to the demands of the job) and item 5 (sickness absence during the past year) were improved in WORK compared with HOME (P work ability among female healthcare workers. ClinicalTrials.gov NCT01921764 . Registered 10 August 2013.

Home Mechanical Ventilation: A 12-Year Population-Based Retrospective Cohort Study.

Science.gov (United States)

Povitz, Marcus; Rose, Louise; Shariff, Salimah Z; Leonard, Sean; Welk, Blayne; Jenkyn, Krista Bray; Leasa, David J; Gershon, Andrea S

2018-04-01

Increasing numbers of individuals are being initiated on home mechanical ventilation, including noninvasive (bi-level) and invasive mechanical ventilation delivered via tracheostomy due to chronic respiratory failure to enable symptom management and promote quality of life. Given the high care needs of these individuals, a better understanding of the indications for home mechanical ventilation, and health-care utilization is needed. We performed a retrospective cohort study using provincial health administrative data from Ontario, Canada (population ∼13,000,000). Home mechanical ventilation users were characterized using health administrative data to determine the indications for home mechanical ventilation, the need for acute care at the time of ventilation approval, and their health service use and mortality rates following approval. The annual incidence of home mechanical ventilation approval rose from 1.8/100,000 in 2000 to 5.0/100,000 in 2012, or an annual increase of approximately 0.3/100,000 persons/y. The leading indications were neuromuscular disease, thoracic restriction, and COPD. The indication for the remainder could not be determined due to limitations of the administrative databases. Of the 4,670 individuals, 23.0% commenced home mechanical ventilation following an acute care hospitalization. Among individuals who survived at least 1 y, fewer required hospitalization in the year that followed home mechanical ventilation approval (29.9% vs 39.8%) as compared with the year prior. Utilization of home mechanical ventilation is increasing in Ontario, Canada, and further study is needed to clarify the factors contributing to this and to further optimize utilization of health-care resources. Copyright © 2018 by Daedalus Enterprises.

Safety factors predictive of job satisfaction and job retention among home healthcare aides.

Science.gov (United States)

Sherman, Martin F; Gershon, Robyn R M; Samar, Stephanie M; Pearson, Julie M; Canton, Allison N; Damsky, Marc R

2008-12-01

Although many of the well known work characteristics associated with job satisfaction in home health care have been documented, a unique aspect of the home health care aides' (HHA) work environment that might also affect job satisfaction is the fact that their workplace is a household. To obtain a better understanding of the potential impact of the risks/exposures/hazards within the household environment on job satisfaction and job retention in home care, we recently conducted a risk assessment study. Survey data from a convenience sample of 823 New York City HHAs were obtained and analyzed. Household/job-related risks, environmental exposures, transportation issues, threats/verbal and physical abuse, and potential for violence were significantly correlated with HHA job satisfaction and job retention. Addressing the modifiable risk factors in the home health care household may improve job satisfaction and reduce job turnover in this work population.

Feature Usage Explorer: Usage Monitoring and Visualization Tool in HTML5 Based Applications

Directory of Open Access Journals (Sweden)

Sarunas Marciuska

2013-10-01

Full Text Available Feature Usage Explorer is a JavaScript library, which automatically detects features in HTML5 based applications and monitors their usage. The collected information can be visualized in a Feature Usage Diagram, which is automatically generated from an input json file. Currently, the users of Feature Usage Explorer have to design their own tool in order to generate the json file from collected usage information. This option remains viable when using the library in order not to constraint the user’s choice of preferred data storage. Feature Usage Explorer can be reused in any HTML5 based applications where an understanding of how users interact with the system is required (i.e. user experience and usability studies, human computer interaction field, or requirement prioritization area.

Determinants of RFID adoption in Malaysia's healthcare industry: occupational level as a moderator.

Science.gov (United States)

Zailani, Suhaiza; Iranmanesh, Mohammad; Nikbin, Davoud; Beng, Jameson Khoo Cheong

2015-01-01

With today's highly competitive market in the healthcare industry, Radio Frequency Identification (RFID) is a technology that can be applied by hospitals to improve operational efficiency and to gain a competitive advantage over their competitors. The purpose of this study is to investigate the factors that may effect RFID adoption in Malaysia's healthcare industry. In addition, the moderating role of occupational level was tested. Data was collected from 223 managers as well as healthcare and supporting staffs. This data was analyzed using the partial least squares technique. The results show that perceived ease of use and usefulness, government policy, top management support, and security and privacy concerns have an effect on the intent to adopt RFID in hospitals. There is a wide gap between managers and healthcare staff in terms of the factors that influence RFID adoption. The results of this study will help decision makers as well as managers in the healthcare industry to better understand the determinants of RFID adoption. Additionally, it will assist in the process of RFID adoption, and therefore, spread the usage of RFID technology in more hospitals.

Article Commentary: The interRAI Pediatric Home Care (PEDS HC Assessment: Evaluating the Long-term Community-Based Service and Support Needs of Children Facing Special Healthcare Challenges

Directory of Open Access Journals (Sweden)

Charles D. Phillips

2015-01-01

Full Text Available The vast majority of assessment instruments developed to assess children facing special healthcare challenges were constructed to assess children within a limited age range or children who face specific conditions or impairments. In contrast, the interRAI Pediatric Home Care (PEDS HC Assessment Form was specifically designed to assess the long-term community-based service and support needs of children and youth aged from four to 20 years who face a wide range of chronic physical or behavioral health challenges. Initial research indicates that PEDS HC items exhibit good predictive validity–-explaining significant proportions of the variance in parents’ perceptions of needs, case managers’ service authorizations, and Medicaid program expenditures for long-term community-based services and supports. In addition, PEDS HC items have been used to construct scales that summarize the strengths and needs of children facing special healthcare challenges. Versions of the PEDS HC are now being used in Medicaid programs in three states in the United States.

The puzzle of Fran: home healthcare in a hurricane.

Science.gov (United States)

King, D

1998-10-01

A natural disaster in the form of Hurricane Fran resulted not only in stories of ingenuity and compassion, but in a major performance improvement (PI) process for the entire agency. Through this PI process we learned about ourselves as a home health agency and discovered ways to improve our performance. More importantly we discovered ways to improve patient tracking and care during a disaster.

Home health services in primary care: What can we do?

Directory of Open Access Journals (Sweden)

Yasemin Çayır

2013-01-01

Full Text Available Home health services is to give examination, diagnosis,treatment, and rehabilitation services to the patients whobedridden, have difficulties to access health facility due toa variety of chronic or malignant disease by professionalhealth care team. Family physicians that providing healthcare in primary care is responsible for to determine whowill need home health care services, and to make homevisit on a regular basis among registered patients in theirpopulations. It is seems that the biggest shortcoming thecontent and scope of this service is not yet a standard. Inthis article, how home health services should be given willbe discussed.Key words: Primary health care, home health care, bedriddenpatient

Security And Privacy Issues in Healthcare Monitoring Systems: A Case Study

DEFF Research Database (Denmark)

Handler, Daniel Tolboe; Hauge, Lotte; Spognardi, Angelo

2017-01-01

Security and privacy issues are rarely taken into account in automated systems for monitoring elderly people in their home, exposing inhabitants to a number of threats they are usually not aware of. As a case study to expose the major vulnerabilities these systems are exposed to, this paper reviews...... a generic example of automated healthcare monitoring system. The security and privacy issues identified in this case study can be easily generalised and regarded as alarm bells for all the pervasive healthcare professionals....

Newborn well-child visits in the home setting: a pilot study in a family medicine residency.

Science.gov (United States)

Lakin, Ashley; Sutter, Mary Beth; Magee, Susanna

2015-03-01

The purpose of our study was to pilot a home visit program targeting neonates conducted by family medicine residents. While the literature shows that home visit programs are successful at preventing adverse outcomes for young children, such as improving parenting practices and promoting breastfeeding, no data exist about newborn home visits conducted by resident physicians. Residents conducted newborn home visits precepted by a family medicine faculty member from June 2012--May 2013. Subjects were recruited from the residency continuity practice and randomized to receive two home visits (which replaced two office visits) or routine office-based newborn care. All participants were surveyed using the validated WHOQOL-BREF quality of life scale and a patient satisfaction instrument. Metrics were also obtained from the electronic medical record. Mothers and resident physicians completed an open-ended questionnaire about their experience. All patients, whether receiving office-based or home-based care, rated their care highly. Significant differences were seen in usage of acute care in the first 6 months of life, and mothers in the home visit group trended toward initiating breastfeeding at a higher rate. The home visit group ranked their quality of life higher across all domains when compared to the control group, approaching statistical significance in two domains. Residents providing home visits reported increased connectedness to patients and improved confidence in anticipatory guidance delivery. Home visits are valuable for families with newborns, in terms of minimizing acute care service usage, breastfeeding promotion, and perhaps increasing maternal perceptions of well-being. A home visit program has the potential to enhance resident education and the doctor-patient relationship.

Healthcare Resource Uses and Out-of-Pocket Expenses Associated with Pulmonary TB Treatment in Thailand.

Science.gov (United States)

Tanvejsilp, Pimwara; Loeb, Mark; Dushoff, Jonathan; Xie, Feng

2017-08-22

In Thailand, pharmaceutical care has been recently introduced to a tertiary hospital as an approach to improve adherence to tuberculosis (TB) treatment in addition to home visit and modified directly observed therapy (DOT). However, the economic impact of pharmaceutical care is not known. The aim of this study was to estimate healthcare resource uses and costs associated with pharmaceutical care compared with home visit and modified DOT in pulmonary TB patients in Thailand from a healthcare sector perspective inclusive of out-of-pocket expenditures. We conducted a retrospective study using data abstracted from the hospital billing database associated with pulmonary TB patients who began treatment between 2010 and 2013 in three hospitals in Thailand. We used generalized linear models to compare the costs by accounting for baseline characteristics. All costs were converted to international dollars (Intl$) RESULTS: The mean direct healthcare costs to the public payer were $519.96 (95%confidence interval [CI] 437.31-625.58) associated with pharmaceutical care, $1020.39 (95% CI 911.13-1154.11) for home visit, and $887.79 (95% CI 824.28-955.91) for modified DOT. The mean costs to patients were $175.45 (95% CI 130.26-230.48) for those receiving pharmaceutical care, $53.77 (95% CI 33.25-79.44) for home visit, and $49.33 (95% CI 34.03-69.30) for modified DOT. After adjustment for baseline characteristics, pharmaceutical care was associated with lower total direct costs compared with home visit (-$354.95; 95% CI -285.67 to -424.23) and modified DOT (-$264.61; 95% CI -198.76 to -330.46). After adjustment for baseline characteristics, pharmaceutical care was associated with lower direct costs compared with home visit and modified DOT.

Patient Hand Hygiene at Home Predicts Their Hand Hygiene Practices in the Hospital

OpenAIRE

Barker, Anna; Sethi, Ajay; Shulkin, Emily; Caniza, Rachell; Zerbel, Sara; Safdar, Nasia

2014-01-01

We examine factors associated with hand hygiene practices of hospital patients. Hygiene decreased compared to at home, and home practices were strongly associated with hospital practices. Understanding and leveraging the intrinsic value some patients associate with hand hygiene may be important for improving overall hospital hygiene and decreasing healthcare-associated infections.

Energy Storage System Control Algorithm by Operating Target Power to Improve Energy Sustainability of Smart Home

OpenAIRE

Byeongkwan Kang; Kyuhee Jang; Sounghoan Park; Myeong-in Choi; Sehyun Park

2018-01-01

As energy issues are emerging around the world, a variety of smart home technologies aimed at realizing zero energy houses are being introduced. Energy storage system (ESS) for smart home energy independence is increasingly gaining interest. However, limitations exist in that most of them are controlled according to time schedules or used in conjunction with photovoltaic (PV) generation systems. In consideration of load usage patterns and PV generation of smart home, this study proposes an ES...

Medical data transmission system for remote healthcare centres

International Nuclear Information System (INIS)

Gonzalez, E A; Cagnolo, F J; Olmos, C E; Centeno, C A; Riva, G G; Zerbini, C A

2007-01-01

The main motivation of this project is to improve the healthcare centres equipment and human resources efficiency, enabling those centres for transmission of parameters of medical interest. This system facilitates remote consultation, in particular between specialists and remote healthcare centres. Likewise it contributes to the qualification of professionals. The electrocardiographic (ECG) and electroencephalographic (EEG) signals are acquired, processed and then sent, fulfilling the effective norms, for application in the hospital network of Cordoba Province, which has nodes interconnected by phone line. As innovative aspects we emphasized the low cost of development and maintenance, great versatility and handling simplicity with a modular design for interconnection with diverse data transmission media (Wi-Fi, GPRS, etc.). Successfully experiences were obtained during the acquisition of the signals and transmissions on wired LAN networks. As improvements, we can mention: energy consumption optimization and mobile communication systems usage, in order to offer more autonomy

Home-based Self-care: Understanding and Designing Pervasive Technology to Support Care Management Work at Home

DEFF Research Database (Denmark)

Verdezoto, Nervo

the self-care management work at home. People need to know which care activities to perform, when to perform them, how to proceed and why these are important. While at home, an active lifestyle and comorbidity not only challenge self-care activities but also the use of self-care technologies in non...... that fit into people’s everyday life. Through a design research approach applying user-centered design methods and prototyping, the main focus of this dissertation is on exploring and providing a holistic understanding of the self-care work practices in non-clinical settings. Several home-based care...... practices are investigated to (a) further understand the self-care management work in nonclinical settings, and (b) inform future design of pervasive healthcare technology that accounts for people’s perspectives on self-care and everyday life. First, we explore two selfcare practices of medication...

Electric Energy Management in the Smart Home: Perspectives on Enabling Technologies and Consumer Behavior

Energy Technology Data Exchange (ETDEWEB)

Zipperer, A. [Colorado State Univ., Fort Collins, CO (United States); Aloise-Young, P. A. [Colorado State Univ., Fort Collins, CO (United States); Suryanarayanan, S. [Colorado State Univ., Fort Collins, CO (United States); Zimmerle, D. [Colorado State Univ., Fort Collins, CO (United States); Roche, R. [Univ. of Technology, Belfort-Montebeliard (France); Earle, L. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Christensen, D. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bauleo, P. [Fort Collins Utilities, CO (United States)

2013-08-01

Smart homes hold the potential for increasing energy efficiency, decreasing costs of energy use, decreasing the carbon footprint by including renewable resources, and trans-forming the role of the occupant. At the crux of the smart home is an efficient electric energy management system that is enabled by emerging technologies in the electricity grid and consumer electronics. This article presents a discussion of the state-of-the-art in electricity management in smart homes, the various enabling technologies that will accelerate this concept, and topics around consumer behavior with respect to energy usage.

Electric Energy Management in the Smart Home: Perspectives on Enabling Technologies and Consumer Behavior

Energy Technology Data Exchange (ETDEWEB)

Zipperer, Adam; Aloise-Young, Patricia A.; Suryanarayanan, Siddharth; Roche, Robin; Earle, Lieko; Christensen, Dane; Bauleo, Pablo; Zimmerle, Daniel

2013-11-01

Smart homes hold the potential for increasing energy efficiency, decreasing costs of energy use, decreasing the carbon footprint by including renewable resources, and transforming the role of the occupant. At the crux of the smart home is an efficient electric energy management system that is enabled by emerging technologies in the electric grid and consumer electronics. This article presents a discussion of the state-of-the-art in electricity management in smart homes, the various enabling technologies that will accelerate this concept, and topics around consumer behavior with respect to energy usage.

A cross-sectional analysis of barriers to health-care seeking among medical students across training period

Directory of Open Access Journals (Sweden)

Vikas Menon

2017-01-01

Full Text Available Background and Aims: Very little information is available on how needs and perceptions to service utilization may change with duration of medical training. Our objective was to compare the self-reported barriers to health-care seeking for mental and physical health services separately between 1st year and final year medical students. Methods: In this cross-sectional study, we invited all medical students of the concerned cohorts to complete a prevalidated checklist and 28-item self-reported questionnaire about perceived barriers to health-care seeking. The questionnaire had separate items pertaining to usage of mental and physical health-care services. Results: The response rate of the 1st year and final year cohorts were 83.8% and 86.6%, respectively. Lack of time, unawareness about where to seek help, cost issues, and fear of future academic jeopardy were more common concerns among 1st year students to the usage of mental health services (odds ratio [OR] 0.27, 0.45,0.09, and 0.49, respectively whereas issues of stigma were more commonly reported by final year students for using mental health services (OR = 2.87. In contrast, the barriers in using physical health services were broadly comparable between the two cohorts. Conclusion: Differences exist between medical students in various years of training particularly with regard to self-reported barriers and perceptions particularly about using mental health-care services. This may have key implications for designing and delivery of service provisions in this group.

Enabling ICU patients to die at home.

Science.gov (United States)

Battle, Emma; Bates, Lucy; Liderth, Emma; Jones, Samantha; Sheen, Sheryl; Ginty, Andrew; Northmore, Melanie

2014-10-07

There is often an overlap between intensive care medicine and palliative medicine. When all curative treatment options have been explored, keeping the patient comfortable and free from pain is the main concern for healthcare practitioners. Patient autonomy in end of life decisions has not been encouraged in the intensive care unit (ICU), until now, because of its specialised and technical nature. Staff at the Royal Bolton Hospital have broken down the barriers to enabling ICU patients to die in their own homes, and have developed a system of collaborative working that can help to fulfil a patient's final wish to go home. This article describes how ICU staff developed a process that enabled two ventilated patients to be transferred home for end of life care.

Breastfeeding knowledge, attitudes, and practices among providers in a medical home.

Science.gov (United States)

Szucs, Kinga A; Miracle, Donna J; Rosenman, Marc B

2009-03-01

Breastfeeding offers numerous health advantages to children, mothers, and society. From obstetrics to pediatrics, breastfeeding dyads come in contact with a wide range of healthcare providers. The American Academy of Pediatrics (AAP) calls for pediatricians to support breastfeeding enthusiastically and for all children to have a medical home. We studied an inner-city healthcare system with a Dyson Community Pediatrics Training Initiative Model Medical Home clinic, to explore how a breastfeeding/baby-friendly medical home might be built upon this framework. We describe breastfeeding knowledge, attitudes, and practices among a full range of providers and healthcare system-level barriers to effective and coordinated breastfeeding services. We conducted eight focus groups using semistructured interviews: (1) pediatricians; (2) obstetricians; (3) pediatric nurses and allied health professionals; (4) obstetric nurses and allied health professionals; (5) 24-hour telephone triage answering service nurses; (6) public health nurses; (7) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) personnel; and (8) lactation consultants and peer counselors. We identified gaps in providers' breastfeeding knowledge, counseling skills, and professional education and training. Providers' cultures and attitudes affect breastfeeding promotion and support. Providers used their own breastfeeding experiences to replace evidence-based knowledge and AAP policy statement recommendations for breastfeeding dyads. There were communication disconnects between provider groups. Providers underestimated their own, and overestimated others', influence on breastfeeding. The system lacked a coordinated breastfeeding mission. This study illuminated key disconnectedness challenges (and, hence, opportunities) for a model medical home in fostering continuous, comprehensive, coordinated, culturally effective, and evidence-based breastfeeding promotion and support.

Task-role-based Access Control Model in Smart Health-care System

Directory of Open Access Journals (Sweden)

Wang Peng

2015-01-01

Full Text Available As the development of computer science and smart health-care technology, there is a trend for patients to enjoy medical care at home. Taking enormous users in the Smart Health-care System into consideration, access control is an important issue. Traditional access control models, discretionary access control, mandatory access control, and role-based access control, do not properly reflect the characteristics of Smart Health-care System. This paper proposes an advanced access control model for the medical health-care environment, task-role-based access control model, which overcomes the disadvantages of traditional access control models. The task-role-based access control (T-RBAC model introduces a task concept, dividing tasks into four categories. It also supports supervision role hierarchy. T-RBAC is a proper access control model for Smart Health-care System, and it improves the management of access rights. This paper also proposes an implementation of T-RBAC, a binary two-key-lock pair access control scheme using prime factorization.

An Integrated Patient Information and In-Home Health Monitoring System Using Smartphones and Web Services.

Science.gov (United States)

Sorwar, Golam; Ali, Mortuza; Islam, Md Kamrul; Miah, Mohammad Selim

2016-01-01

Modern healthcare systems are undergoing a paradigm shift from in-hospital care to in-home monitoring, leveraging the emerging technologies in the area of bio-sensing, wireless communication, mobile computing, and artificial intelligence. In-home monitoring promises to significantly reduce healthcare spending by preventing unnecessary hospital admissions and visits to healthcare professionals. Most of the in-home monitoring systems, proposed in the literature, focus on monitoring a set of specific vital signs. However, from the perspective of caregivers it is infeasible to maintain a collection of specialized monitoring systems. In this paper, we view the problem of in-home monitoring from the perspective of caregivers and present a framework that supports various monitoring capabilities while making the complexity transparent to the end users. The essential idea of the framework is to define a 'general purpose architecture' where the system specifies a particular protocol for communication and makes it public. Then any bio-sensing system can communicate with the system as long as it conforms to the protocol. We then argue that as the system grows in terms of number of patients and bio-sensing systems, artificial intelligence technologies need to be employed for patients' risk assessment, prioritization, and recommendation. Finally, we present an initial prototype of the system designed according to the proposed framework.

Hospital in the Home nurses' recognition and response to clinical deterioration.

Science.gov (United States)

Gray, Erika; Currey, Judy; Considine, Julie

2018-05-01

To obtain an understanding of how Hospital in the Home (HITH) nurses recognise and respond to clinical deterioration in patients receiving care at home or in their usual place of residence. Recognising and responding to clinical deterioration is an international safety priority and a key nursing responsibility. Despite an increase in care delivery in home environments, how HITH nurses recognise and respond to clinical deterioration is not yet fully understood. A prospective, descriptive exploratory design was used. A survey containing questions related to participant characteristics and 10 patient scenarios was used to collect data from 47 nurses employed in the HITH units of three major health services in Melbourne, Australia. The 10 scenarios reflected typical HITH patients and included medical history and clinical assessment findings (respiratory rate, oxygen saturation, heart rate, blood pressure, temperature, conscious state and pain score). The three major findings from this study were that: (i) nurse and patient characteristics influenced HITH nurses' assessment decisions; (ii) the cues used by HITH nurses to recognise clinical deterioration varied according to the clinical context; and (iii) although HITH nurses work in an autonomous role, they engage in collaborative practice when responding to clinical deterioration. Hospital in the Home nurses play a fundamental role in patient assessment, and the context in which they recognise and respond to deterioration is markedly different to that of hospital nurses. The assessment, measurement and interpretation of clinical data are a nursing responsibility that is crucial to early recognition and response to clinical deterioration. The capacity of HITH services to care for increasing numbers of patients in their home environment, and to promptly recognise and respond to clinical deterioration should it occur, is fundamental to safety within the healthcare system. Hospital in the Home nurses are integral to a

Realistic Scheduling Mechanism for Smart Homes

Directory of Open Access Journals (Sweden)

Danish Mahmood

2016-03-01

Full Text Available In this work, we propose a Realistic Scheduling Mechanism (RSM to reduce user frustration and enhance appliance utility by classifying appliances with respective constraints and their time of use effectively. Algorithms are proposed regarding functioning of home appliances. A 24 hour time slot is divided into four logical sub-time slots, each composed of 360 min or 6 h. In these sub-time slots, only desired appliances (with respect to appliance classification are scheduled to raise appliance utility, restricting power consumption by a dynamically modelled power usage limiter that does not only take the electricity consumer into account but also the electricity supplier. Once appliance, time and power usage limiter modelling is done, we use a nature-inspired heuristic algorithm, Binary Particle Swarm Optimization (BPSO, optimally to form schedules with given constraints representing each sub-time slot. These schedules tend to achieve an equilibrium amongst appliance utility and cost effectiveness. For validation of the proposed RSM, we provide a comparative analysis amongst unscheduled electrical load usage, scheduled directly by BPSO and RSM, reflecting user comfort, which is based upon cost effectiveness and appliance utility.

Attractiveness of people-centred and integrated Dutch Home Care: A nationwide survey among nurses.

Science.gov (United States)

Maurits, Erica E M; de Veer, Anke J E; Groenewegen, Peter P; Francke, Anneke L

2018-03-05

The World Health Organization is calling for a fundamental change in healthcare services delivery, towards people-centred and integrated health services. This includes providing integrated care around people's needs that is effectively co-ordinated across providers and co-produced by professionals, the patient, the family and the community. At the same time, healthcare policies aim to scale back hospital and residential care in favour of home care. This is one reason for the home-care nursing staff shortages in Europe. Therefore, this study aimed to examine whether people-centred, integrated home care appeals to nurses with different levels of education in home care and hospitals. A questionnaire survey was held among registered nurses in Dutch home-care organisations and hospitals in 2015. The questionnaire addressed the perceived attractiveness of different aspects of people-centred, integrated home care. In total 328 nurses filled in the questionnaire (54% response rate). The findings showed that most home-care nurses (70% to 97%) and 36% to 76% of the hospital nurses regard the different aspects of people-centred, integrated home care as attractive. Specific aspects that home-care nurses find attractive are promoting the patient's self-reliance and having a network in the community. Hospital nurses are mainly attracted to health-related prevention and taking control in complex situations. No clear differences between the educational levels were found. It is concluded that most home-care nurses and a minority of hospital nurses feel attracted to people-centred, integrated home care, irrespective of their educational level. The findings are relevant to policy makers and home-care organisations who aim to expand the home-care nursing workforce. © 2018 John Wiley & Sons Ltd.

Controlling the temperature in Canadian homes

International Nuclear Information System (INIS)

Dewis, G.

2008-01-01

Programmable thermostats can be used to optimize the operation of heating and cooling systems by reducing system usage when occupants are asleep or when dwellings are unoccupied. This paper used the results of a 2006 households and the environment survey to examine how programmable thermostats are currently being used in Canadian households. The demographic factors associated with thermostat use were discussed, as well as how their usage varied in different areas of Canada. The study showed that most Canadian households set their temperature at between 20 to 22 degrees C during times when they are home and awake. Home temperatures were reduced to between 16 and 18 degrees C when household members were away or asleep. Only 4 out of 10 households used programmable thermostats. Of those who used programmable thermostats, only 7 in 10 programmed the thermostat to lower the temperature when occupants were asleep. Senior citizens and people with lower levels of education were less likely to use programmable thermostats. It was concluded that incentive programs and the distribution of free programmable thermostats will increase their use in households. Assistance in programming during the installation process should also be provided. Factor analyses must also be conducted to examine the influence of age, education, and income and the decisions made by households in relation to temperature regulation. 7 tabs

Workplace Stress and Ethical Challenges Experienced by Nursing Staff in a Nursing Home

Science.gov (United States)

Vondras, Dean D.; Flittner, Diane; Malcore, Sylvia A.; Pouliot, Gregory

2009-01-01

This research explores the workplace stress and ethical challenges reported by healthcare staff in a nursing home. A brief self-report survey was administered to 44 members of the nursing staff in a not-for-profit nursing home. The survey included items that elicited identification of specific workplace stressors and ethical challenges and global…

Avatars@Home

Science.gov (United States)

Morandell, Martin M.; Hochgatterer, Andreas; Wöckl, Bernhard; Dittenberger, Sandra; Fagel, Sascha

Avatars are a common field of research for interfacing smart homes, especially for elderly people. The present study focuses on the usage of photo-realistic faces with different levels of movements (video, avatar and photo) as components of the graphical user interface (GUI) for Ambient Assisted Living (AAL) environments. Within a usability test, using the "Wizard of Oz" technique, these presentation modes were compared with a text and a voice only interface with users of the target groups: elderly people with (nMCI=12) and without (nMCI=12) Mild Cognitive Impairment (MCI). Results show that faces on the GUI were liked by both, elderly with and without cognitive restrictions. However, users' performance on executing tasks did not differ much between the different presentation modes.

Development and communication of written ethics policies on euthanasia in Catholic hospitals and nursing homes in Belgium (Flanders).

Science.gov (United States)

Gastmans, Chris; Lemiengre, Joke; de Casterlé, Bernadette Dierckx

2006-10-01

To describe whether and how Catholic hospitals and nursing homes in Belgium (Flanders) have developed written ethics policies on euthanasia and communicated these policies to their employees, patients, and patient's relatives. A cross-sectional mail survey of general directors of Catholic hospitals and nursing homes in Belgium (Flanders). Of the 298 targeted institutions, 81% of hospitals and 62% of nursing homes returned complete questionnaires. A high percentage of Catholic hospitals (79%) and a moderate percentage of nursing homes (30%) had written ethics policies on euthanasia. Both caregivers and healthcare administrators were involved in the development and approval of these policies. Physicians and nurses were best informed about the policies. More than half of the nursing homes (57%) took the initiative to inform both residents and relatives about the policies, while only one hospital did so. The high prevalence of written ethics policies on euthanasia in Flemish Catholic hospitals may reflect the concern of healthcare administrators to maintain the quality of care for patients requesting euthanasia. However, the true contribution of these policies to quality end-of-life care and to supporting caregivers remains unknown and needs further research. Legislation and centrally developed guidelines might influence healthcare institutions to develop ethics policies.

Evaluating in a Healthcare Setting

DEFF Research Database (Denmark)

Jensen, Janne Jul

2007-01-01

The think-aloud protocol, also known as concurrent verbalisation protocol, is widely used in the field of HCI today, but as the technology and applications have evolved the protocol has had to cope with this. Therefore new variations of the protocol have seen the light of day. One example...... is retrospective verbalisation. To compare concurrent and retrospective verbalisation an experiment was conducted. A home healthcare application was evaluated with 15 participants using both protocols. The results of the experiment show that the two protocols have each their strengths and weaknesses...

A university-sponsored home health nursing program in Karachi, Pakistan.

Science.gov (United States)

Smego, Raymond A; Khan, Mohammad Aslam; Khowaja, Khurshid; Rafique, Rozina; Datoo, Farida

2005-11-01

This article describes a university-sponsored home health nursing program in a large urban center in Pakistan and details the essential elements needed in implementing such a program in a developing country. Compared to in-hospital treatment, home healthcare reduced hospital stay from 12.8 days to 3.9 days, and resulted in a net savings of Pakistani rupees (PRs) 5,374,135 (USD 89,569). A cost-effective home treatment program in a resource-limited country can be successfully implemented by using the hospital pharmacy as the central point for the preparation and distribution of medications and specialty nursing services.

Characteristics of communication with older people in home care: A qualitative analysis of audio recordings of home care visits.

Science.gov (United States)

Kristensen, Dorte V; Sundler, Annelie J; Eide, Hilde; Hafskjold, Linda; Ruud, Iren; Holmström, Inger K

2017-12-01

To describe the characteristics of communication practice in home care visits between older people (over 65 years old) and nurse assistants and to discuss the findings from a person-centered perspective. The older population is increasing worldwide, along with the need for healthcare services in the person's home. To achieve a high-quality care, person-centered communication is crucial. A descriptive design with a qualitative inductive approach was used. Fifteen audio recordings of naturally occurring conversations between 12 nurse assistants and 13 older people in Norway were analysed by qualitative content analysis. Four categories were revealed through analysis: (i) supporting older people's connection to everyday life; (ii) supporting older people's involvement in their own care; (iii) attention to older people's bodily and existential needs; and (iv) the impact of continuity and predictability on older people's well-being. The communication between the older people and the nurse assistants during home care visits was mainly task-oriented, but also related to the person. The older people were involved in the tasks to be carried out and humour was part of the communication. Greater attention was paid to bodily than existential needs. The communication was connected with the older people's everyday life in several ways. Time frames and interruptions concern the older people; hearing and speech impairments were a challenge to communication. To enhance person-centred communication, further studies are needed, especially intervention studies for healthcare professionals and students. Being responsive to older people's subjective experiences is important in meeting their needs in home care. Communication that addresses the need for trust and predictability is important for older people. Responding to existential needs require more attention. The home care setting has an impact on communication. © 2017 John Wiley & Sons Ltd.

Carers' perceptions of the impact of home telehealth monitoring on the provision of care and sustainability of use.

Science.gov (United States)

Wade, Rachael; Cartwright, Colleen; Shaw, Kelly

2015-06-01

This paper aims to report carers' perceptions of the impact of home telehealth on the provision of care and the sustainability of home telehealth use. This paper is reporting on a sample of 15 carers who were involved in the telehealth arm of a larger controlled trial. Carers primarily believed that telehealth helped to provide better care. None of the carers had organised, or planned to organise, ongoing telehealth monitoring beyond the study. The main reason given for non-sustained usage was the belief that the person they cared for no longer required, or would benefit from, the monitoring. As the person being cared for was a frail older person with multiple chronic diseases and a history of recent hospitalisation, the non-sustained usage of home telehealth by carers raises questions about what is needed to ensure sustainability of use; this requires further investigation. © 2014 AJA Inc.

A HOME-BASED MASSED PRACTICE SYSTEM FOR PEDIATRIC NEUROREHABILITATION

Directory of Open Access Journals (Sweden)

Yi-Ning Wu

2013-11-01

Full Text Available The objective of this paper is to introduce a novel low-cost human-computer interface (HCI system for home-based massed practice for children with upper limb impairment due to brain injury. Successful massed practice, a type of neurorehabilitation, may be of value for children with brain injury because it facilitates impaired limb use. Use of automated, home-based systems could provide a practical means for massed practice. However, the optimal strategy to deliver and monitor home-based massed practice is still unclear. We integrated motion sensor, video game, and HCI software technologies to create a useful home-based massed practice at targeted joints. The system records joint angle and number of movements using a low-cost custom hand-held sensor. The sensor acts as an input device to play video games. We demonstrated the system’s functionality and provided preliminary observations on usage by children with brain injury, including joint motion and muscle activation.

A learning-based agent for home neurorehabilitation.

Science.gov (United States)

Lydakis, Andreas; Meng, Yuanliang; Munroe, Christopher; Wu, Yi-Ning; Begum, Momotaz

2017-07-01

This paper presents the iterative development of an artificially intelligent system to promote home-based neurorehabilitation. Although proper, structured practice of rehabilitation exercises at home is the key to successful recovery of motor functions, there is no home-program out there which can monitor a patient's exercise-related activities and provide corrective feedback in real time. To this end, we designed a Learning from Demonstration (LfD) based home-rehabilitation framework that combines advanced robot learning algorithms with commercially available wearable technologies. The proposed system uses exercise-related motion information and electromyography signals (EMG) of a patient to train a Markov Decision Process (MDP). The trained MDP model can enable an agent to serve as a coach for a patient. On a system level, this is the first initiative, to the best of our knowledge, to employ LfD in an health-care application to enable lay users to program an intelligent system. From a rehabilitation research perspective, this is a completely novel initiative to employ machine learning to provide interactive corrective feedback to a patient in home settings.

Effect of the delegation of GP-home visits on the development of the number of patients in an ambulatory healthcare centre in Germany

Science.gov (United States)

2012-01-01

Background The AGnES-concept (AGnES: GP-supporting, community-based, e-health-assisted, systemic intervention) was developed to support general practitioners (GPs) in undersupplied regions. The project aims to delegate GP-home visits to qualified AGnES-practice assistants, to increase the number of patients for whom medical care can be provided. This paper focuses on the effect of delegating GP-home visits on the total number of patients treated. First, the theoretical number of additional patients treated by delegating home visits to AGnES-practice assistants was calculated. Second, actual changes in the number of patients in participating GP-practices were analyzed. Methods The calculation of the theoretical increase in the number of patients was based on project data, data which were provided by the Association of Statutory Health Insurance Physicians, or which came from the literature. Setting of the project was an ambulatory healthcare centre in the rural county Oberspreewald-Lausitz in the Federal State of Brandenburg, which employed six GPs, four of which participated in the AGnES project. The analysis of changes in the number of patients in the participating GP-practices was based on the practices’ reimbursement data. Results The calculated mean capacity of AGnES-practice assistants was 1376.5 home visits/year. GPs perform on average 1200 home visits/year. Since home visits with an urgent medical reason cannot be delegated, we included only half the capacity of the AGnES-practice assistants in the analysis (corresponding to a 20 hour-work week). Considering all parameters in the calculation model, 360.1 GP-working hours/year can be saved. These GP-hours could be used to treat 170 additional patients/quarter year. In the four participating GP-practices the number of patients increased on average by 133 patients/quarter year during the project period, which corresponds to 78% of the theoretically possible number of patients. Conclusions The empirical

Effect of the delegation of GP-home visits on the development of the number of patients in an ambulatory healthcare centre in Germany

Directory of Open Access Journals (Sweden)

van den Berg Neeltje

2012-10-01

Full Text Available Abstract Background The AGnES-concept (AGnES: GP-supporting, community-based, e-health-assisted, systemic intervention was developed to support general practitioners (GPs in undersupplied regions. The project aims to delegate GP-home visits to qualified AGnES-practice assistants, to increase the number of patients for whom medical care can be provided. This paper focuses on the effect of delegating GP-home visits on the total number of patients treated. First, the theoretical number of additional patients treated by delegating home visits to AGnES-practice assistants was calculated. Second, actual changes in the number of patients in participating GP-practices were analyzed. Methods The calculation of the theoretical increase in the number of patients was based on project data, data which were provided by the Association of Statutory Health Insurance Physicians, or which came from the literature. Setting of the project was an ambulatory healthcare centre in the rural county Oberspreewald-Lausitz in the Federal State of Brandenburg, which employed six GPs, four of which participated in the AGnES project. The analysis of changes in the number of patients in the participating GP-practices was based on the practices’ reimbursement data. Results The calculated mean capacity of AGnES-practice assistants was 1376.5 home visits/year. GPs perform on average 1200 home visits/year. Since home visits with an urgent medical reason cannot be delegated, we included only half the capacity of the AGnES-practice assistants in the analysis (corresponding to a 20 hour-work week. Considering all parameters in the calculation model, 360.1 GP-working hours/year can be saved. These GP-hours could be used to treat 170 additional patients/quarter year. In the four participating GP-practices the number of patients increased on average by 133 patients/quarter year during the project period, which corresponds to 78% of the theoretically possible number of patients

IAServ: An Intelligent Home Care Web Services Platform in a Cloud for Aging-in-Place

Directory of Open Access Journals (Sweden)

Chang-Yu Chiang

2013-11-01

Full Text Available As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients’ needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet.

IAServ: an intelligent home care web services platform in a cloud for aging-in-place.

Science.gov (United States)

Su, Chuan-Jun; Chiang, Chang-Yu

2013-11-12

As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients' needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform) to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet.

The Design and Analysis of a Secure Personal Healthcare System Based on Certificates

OpenAIRE

Jungho Kang; Hague Chung; Jeongkyu Lee; Jong Hyuk Park

2016-01-01

Due to the development of information technology (IT), it has been applied to various fields such as the smart home, medicine, healthcare, and the smart car. For these fields, IT has been providing continuous prevention and management, including health conditions beyond the mere prevention of disease, improving the quality of life. e-Healthcare is a health management and medical service to provide prevention, diagnosis, treatment, and the follow-up management of diseases at any time and place...

Telemental health: responding to mandates for reform in primary healthcare.

Science.gov (United States)

Myers, Kathleen M; Lieberman, Daniel

2013-06-01

Telemental health (TMH) has established a niche as a feasible, acceptable, and effective service model to improve the mental healthcare and outcomes for individuals who cannot access traditional mental health services. The Accountability Care Act has mandated reforms in the structure, functioning, and financing of primary care that provide an opportunity for TMH to move into the mainstream healthcare system. By partnering with the Integrated Behavioral Healthcare Model, TMH offers a spectrum of tools to unite primary care physicians and mental health specialist in a mind-body view of patients' healthcare needs and to activate patients in their own care. TMH tools include video-teleconferencing to telecommute mental health specialists to the primary care setting to collaborate with a team in caring for patients' mental healthcare needs and to provide direct services to patients who are not progressing optimally with this collaborative model. Asynchronous tools include online therapies that offer an efficient first step to treatment for selected disorders such as depression and anxiety. Patients activate themselves in their care through portals that provide access to their healthcare information and Web sites that offer on-demand information and communication with a healthcare team. These synchronous and asynchronous TMH tools may move the site of mental healthcare from the clinic to the home. The evolving role of social media in facilitating communication among patients or with their healthcare team deserves further consideration as a tool to activate patients and provide more personalized care.

Military Parents' Personal Technology Usage and Interest in e-Health Information for Obesity Prevention.

Science.gov (United States)

Jai, Tun-Min; McCool, Barent N; Reed, Debra B

2016-03-01

U.S. military families are experiencing high obesity rates similar to the civilian population. The Department of Defense's Military Health System (MHS) is one of the largest healthcare providers in the United States, serving approximately 9.2 million active duty service members, retirees, spouses, and children. The annual cost to the MHS for morbidities associated with being overweight exceeds $1 billion. The preschool age has been suggested as an opportune time to intervene for the prevention of obesity. Thus, this study investigated the current level of technology usage by military service member families and assessed their needs and interests in health/nutrition information. This needs assessment is crucial for researchers/educators to design further studies and intervention programs for obesity prevention in military families with young children. In total, 288 military parents (233 Army and 55 Air Force) at two military bases whose children were enrolled in military childcare centers in the southwestern United States participated in a Technology Usage in Military Family (TUMF) survey in 2013. Overall, both bases presented similar technology usage patterns in terms of computer and mobile device usage on the Internet. Air Force base parents had a slightly higher knowledge level of nutrition/health information than Army base parents. The TUMF survey suggested practical ways such as mobile applications/Web sites, social networks, games, etc., that health educators can use to disseminate nutrition/health information for obesity prevention among military families with young children.

Smart homes, private homes? An empirical study of technology researchers' perceptions of ethical issues in developing smart-home health technologies.

Science.gov (United States)

Birchley, Giles; Huxtable, Richard; Murtagh, Madeleine; Ter Meulen, Ruud; Flach, Peter; Gooberman-Hill, Rachael

2017-04-04

Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology's potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engineers themselves. By exploring the views of engineering researchers in a large smart-home project, we sought to contribute to dialogue between ethics and the engineering community. Either face-to-face or using Skype, we conducted in-depth qualitative interviews with 20 early- and mid-career smart-home researchers from a multi-centre smart-home project, who were asked to describe their own experience and to reflect more broadly about ethical considerations that relate to smart-home design. With participants' consent, interviews were audio-recorded, transcribed and analysed using a thematic approach. Two overarching themes emerged: in 'Privacy', researchers indicated that they paid close attention to negative consequences of potential unauthorised information sharing in their current work. However, when discussing broader issues in smart-home design beyond the confines of their immediate project, researchers considered physical privacy to a lesser extent, even though physical privacy may manifest in emotive concerns about being watched or monitored. In 'Choice', researchers indicated they often saw provision of choice to end-users as a solution to ethical dilemmas. While researchers indicated that choices of end-users may need to be restricted for technological reasons, ethical standpoints that restrict choice were usually assumed and embedded in design. The tractability of informational privacy may explain the greater attention that is paid to it. However, concerns about physical privacy may

Usage Record Format Recommendation

CERN Document Server

Nilsen, J.K.; Muller-Pfeerkorn, R

2013-01-01

For resources to be shared, sites must be able to exchange basic accounting and usage data in a common format. This document describes a common format which enables the exchange of basic accounting and usage data from different resources. This record format is intended to facilitate the sharing of usage information, particularly in the area of the accounting of jobs, computing, memory, storage and cloud usage but with a structure that allows an easy extension to other resources. This document describes the Usage Record components both in natural language form and annotated XML. This document does not address how these records should be used, nor does it attempt to dictate the format in which the accounting records are stored. Instead, it denes a common exchange format. Furthermore, nothing is said regarding the communication mechanisms employed to exchange the records, i.e. transport layer, framing, authentication, integrity, etc.

Energy Consumption Information Services for Smart Home Inhabitants

Science.gov (United States)

Schwanzer, Michael; Fensel, Anna

We investigate services giving users an adequate insight on his or her energy consumption habits in order to optimize it in the long run. The explored energy awareness services are addressed to inhabitants of smart homes, equipped with smart meters, advanced communication facilities, sensors and actuators. To analyze the potential of such services, a game at a social network Facebook has been designed and implemented, and the information about players' responses and interactions within the game environment has been collected and analyzed. The players have had their virtual home energy usage visualized in different ways, and had to optimize the energy consumption basing on their own perceptions of the consumption information. Evaluations reveal, in particular, that users are specifically responsive to information shown as a real-time graph and as costs in Euro, and are able to produce and share with each other policies for managing their smart home environments.

Creating a Regional Healthcare Network: People First.

Science.gov (United States)

Michel-Verkerke, Margreet B

2016-01-01

Care organizations in the Dutch region Apeldoorn want to collaborate more in order to improve the care provision to elderly and psychiatric patients living independently. In order to support the collaboration they intend to create a regional digital healthcare network. The research was focused on the relevance of a regional healthcare network for care providers. Eleven semi-structured interviews based on the USE IT-model, were conducted with care providers and staff members. Results show that care providers need to tune their activities for this target group and create an agreement on integrated care. The relevance of a digital communication and collaboration platform is high. The regional healthcare network should support the collaboration between care providers by: 1. Offering a communication platform to replace the time consuming communication by telephone; 2. Making patient information available for patient and care provider at patients' homes; 3. Giving insight in who is giving what care to whom; and 4. Giving access to knowledge about the target group: elderly and psychiatric patients living independently.

Innovation in a Learning Health Care System: Veteran-Directed Home- and Community-Based Services.

Science.gov (United States)

Garrido, Melissa M; Allman, Richard M; Pizer, Steven D; Rudolph, James L; Thomas, Kali S; Sperber, Nina R; Van Houtven, Courtney H; Frakt, Austin B

2017-11-01

A path-breaking example of the interplay between geriatrics and learning healthcare systems is the Veterans Health Administration's (VHA's) planned roll-out of a program for providing participant-directed home- and community-based services to veterans with cognitive and functional limitations. We describe the design of a large-scale, stepped-wedge, cluster-randomized trial of the Veteran-Directed Home- and Community-Based Services (VD-HCBS) program. From March 2017 through December 2019, up to 77 Veterans Affairs Medical Centers will be randomized to times to begin offering VD-HCBS to veterans at risk of nursing home placement. Services will be provided to community-dwelling participants with support from Aging and Disability Network Agencies. The VHA Partnered Evidence-based Policy Resource Center (PEPReC) is coordinating the evaluation, which includes collaboration from operational stakeholders from the VHA and Administration for Community Living and interdisciplinary researchers from the Center of Innovation in Long-Term Services and Supports and the Center for Health Services Research in Primary Care. For older veterans with functional limitations who are eligible for VD-HCBS, we will evaluate health outcomes (hospitalizations, emergency department visits, nursing home admissions, days at home) and healthcare costs associated with VD-HCBS availability. Learning healthcare systems facilitate diffusion of innovation while enabling rigorous evaluation of effects on patient outcomes. The VHA's randomized rollout of VD-HCBS to veterans at risk of nursing home placement is an example of how to achieve these goals simultaneously. PEPReC's experience designing an evaluation with researchers and operations stakeholders may serve as a framework for others seeking to develop rapid, rigorous, large-scale evaluations of delivery system innovations targeted to older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Privacy and information security risks in a technology platform for home-based chronic disease rehabilitation and education.

Science.gov (United States)

Henriksen, Eva; Burkow, Tatjana M; Johnsen, Elin; Vognild, Lars K

2013-08-09

Privacy and information security are important for all healthcare services, including home-based services. We have designed and implemented a prototype technology platform for providing home-based healthcare services. It supports a personal electronic health diary and enables secure and reliable communication and interaction with peers and healthcare personnel. The platform runs on a small computer with a dedicated remote control. It is connected to the patient's TV and to a broadband Internet. The platform has been tested with home-based rehabilitation and education programs for chronic obstructive pulmonary disease and diabetes. As part of our work, a risk assessment of privacy and security aspects has been performed, to reveal actual risks and to ensure adequate information security in this technical platform. Risk assessment was performed in an iterative manner during the development process. Thus, security solutions have been incorporated into the design from an early stage instead of being included as an add-on to a nearly completed system. We have adapted existing risk management methods to our own environment, thus creating our own method. Our method conforms to ISO's standard for information security risk management. A total of approximately 50 threats and possible unwanted incidents were identified and analysed. Among the threats to the four information security aspects: confidentiality, integrity, availability, and quality; confidentiality threats were identified as most serious, with one threat given an unacceptable level of High risk. This is because health-related personal information is regarded as sensitive. Availability threats were analysed as low risk, as the aim of the home programmes is to provide education and rehabilitation services; not for use in acute situations or for continuous health monitoring. Most of the identified threats are applicable for healthcare services intended for patients or citizens in their own homes. Confidentiality

Evaluating Innovations in Home Care for Performance Accountability.

Science.gov (United States)

Collister, Barbara; Gutscher, Abram; Ambrogiano, Jana

2016-01-01

Concerns about rising costs and the sustainability of our healthcare system have led to a drive for innovative solutions and accountability for performance. Integrated Home Care, Calgary Zone, Alberta Health Services went beyond traditional accountability measures to use evaluation methodology to measure the progress of complex innovations to its organization structure and service delivery model. This paper focuses on the first two phases of a three-phase evaluation. The results of the first two phases generated learning about innovation adoption and sustainability, and performance accountability at the program-level of a large publicly funded healthcare organization.

Enhancing Health-Care Services with Mixed Reality Systems

Science.gov (United States)

Stantchev, Vladimir

This work presents a development approach for mixed reality systems in health care. Although health-care service costs account for 5-15% of GDP in developed countries the sector has been remarkably resistant to the introduction of technology-supported optimizations. Digitalization of data storing and processing in the form of electronic patient records (EPR) and hospital information systems (HIS) is a first necessary step. Contrary to typical business functions (e.g., accounting or CRM) a health-care service is characterized by a knowledge intensive decision process and usage of specialized devices ranging from stethoscopes to complex surgical systems. Mixed reality systems can help fill the gap between highly patient-specific health-care services that need a variety of technical resources on the one side and the streamlined process flow that typical process supporting information systems expect on the other side. To achieve this task, we present a development approach that includes an evaluation of existing tasks and processes within the health-care service and the information systems that currently support the service, as well as identification of decision paths and actions that can benefit from mixed reality systems. The result is a mixed reality system that allows a clinician to monitor the elements of the physical world and to blend them with virtual information provided by the systems. He or she can also plan and schedule treatments and operations in the digital world depending on status information from this mixed reality.

A home healthcare system in the cloud-addressing security and privacy challenges

NARCIS (Netherlands)

Deng, M.; Petkovic, M.; Nalin, M.; Baroni, I.

2011-01-01

Cloud computing is an emerging technology that is expected to support Internet scale critical applications which could be essential to the healthcare sector. Its scalability, resilience, adaptability, connectivity, cost reduction, and high performance features have high potential to lift the

WSN- and IOT-Based Smart Homes and Their Extension to Smart Buildings

Science.gov (United States)

Ghayvat, Hemant; Mukhopadhyay, Subhas; Gui, Xiang; Suryadevara, Nagender

2015-01-01

Our research approach is to design and develop reliable, efficient, flexible, economical, real-time and realistic wellness sensor networks for smart home systems. The heterogeneous sensor and actuator nodes based on wireless networking technologies are deployed into the home environment. These nodes generate real-time data related to the object usage and movement inside the home, to forecast the wellness of an individual. Here, wellness stands for how efficiently someone stays fit in the home environment and performs his or her daily routine in order to live a long and healthy life. We initiate the research with the development of the smart home approach and implement it in different home conditions (different houses) to monitor the activity of an inhabitant for wellness detection. Additionally, our research extends the smart home system to smart buildings and models the design issues related to the smart building environment; these design issues are linked with system performance and reliability. This research paper also discusses and illustrates the possible mitigation to handle the ISM band interference and attenuation losses without compromising optimum system performance. PMID:25946630

WSN- and IOT-Based Smart Homes and Their Extension to Smart Buildings

Directory of Open Access Journals (Sweden)

Hemant Ghayvat

2015-05-01

Full Text Available Our research approach is to design and develop reliable, efficient, flexible, economical, real-time and realistic wellness sensor networks for smart home systems. The heterogeneous sensor and actuator nodes based on wireless networking technologies are deployed into the home environment. These nodes generate real-time data related to the object usage and movement inside the home, to forecast the wellness of an individual. Here, wellness stands for how efficiently someone stays fit in the home environment and performs his or her daily routine in order to live a long and healthy life. We initiate the research with the development of the smart home approach and implement it in different home conditions (different houses to monitor the activity of an inhabitant for wellness detection. Additionally, our research extends the smart home system to smart buildings and models the design issues related to the smart building environment; these design issues are linked with system performance and reliability. This research paper also discusses and illustrates the possible mitigation to handle the ISM band interference and attenuation losses without compromising optimum system performance.

WSN- and IOT-Based Smart Homes and Their Extension to Smart Buildings.

Science.gov (United States)

Ghayvat, Hemant; Mukhopadhyay, Subhas; Gui, Xiang; Suryadevara, Nagender

2015-05-04

Our research approach is to design and develop reliable, efficient, flexible, economical, real-time and realistic wellness sensor networks for smart home systems. The heterogeneous sensor and actuator nodes based on wireless networking technologies are deployed into the home environment. These nodes generate real-time data related to the object usage and movement inside the home, to forecast the wellness of an individual. Here, wellness stands for how efficiently someone stays fit in the home environment and performs his or her daily routine in order to live a long and healthy life. We initiate the research with the development of the smart home approach and implement it in different home conditions (different houses) to monitor the activity of an inhabitant for wellness detection. Additionally, our research extends the smart home system to smart buildings and models the design issues related to the smart building environment; these design issues are linked with system performance and reliability. This research paper also discusses and illustrates the possible mitigation to handle the ISM band interference and attenuation losses without compromising optimum system performance.

75 FR 35497 - Updated Guidance: Prevention Strategies for Seasonal Influenza in Healthcare Settings

Science.gov (United States)

2010-06-22

..., students and trainees, contractual personnel, home healthcare personnel, and persons not directly involved... recipient persons, because droplets generally travel only short distances (approximately 6 feet or less... which aerosol-generating procedures are performed. Management of laundry, food service utensils, and...

Living and dying: responsibility for end-of-life care in care homes without on-site nursing provision - a prospective study.

Science.gov (United States)

Handley, Melanie; Goodman, Claire; Froggatt, Katherine; Mathie, Elspeth; Gage, Heather; Manthorpe, Jill; Barclay, Stephen; Crang, Clare; Iliffe, Steve

2014-01-01

The aim of the study was to describe the expectations and experiences of end-of-life care of older people resident in care homes, and how care home staff and the healthcare practitioners who visited the care home interpreted their role. A mixed-method design was used. The everyday experience of 121 residents from six care homes in the East of England were tracked; 63 residents, 30 care home staff with assorted roles and 19 National Health Service staff from different disciplines were interviewed. The review of care home notes demonstrated that residents had a wide range of healthcare problems. Length of time in the care homes, functional ability or episodes of ill-health were not necessarily meaningful indicators to staff that a resident was about to die. General Practitioner and district nursing services provided a frequent but episodic service to individual residents. There were two recurring themes that affected how staff engaged with the process of advance care planning with residents; 'talking about dying' and 'integrating living and dying'. All participants stated that they were committed to providing end-of-life care and supporting residents to die in the care home, if wanted. However, the process was complicated by an ongoing lack of clarity about roles and responsibilities in providing end-of-life care, doubts from care home and primary healthcare staff about their capacity to work together when residents' trajectories to death were unclear. The findings suggest that to support this population, there is a need for a pattern of working between health and care staff that can encourage review and discussion between multiple participants over sustained periods of time. © 2013 John Wiley & Sons Ltd.

[Frailty, disability and multi-morbidity: the relationship with quality of life and healthcare costs in elderly people].

Science.gov (United States)

Lutomski, Jennifer E; Baars, Maria A E; Boter, Han; Buurman, Bianca M; den Elzen, Wendy P J; Jansen, Aaltje P D; Kempen, Gertrudis I J M; Steunenberg, Bas; Steyerberg, Ewout W; Olde Rikkert, Marcel G M; Melis, René J F

2014-01-01

To assess the independent and combined impact of frailty, multi-morbidity, and activities of daily living (ADL) limitations on self-reported quality of life and healthcare costs in elderly people. Cross-sectional, descriptive study. Data came from The Older Persons and Informal Caregivers Minimum DataSet (TOPICS-MDS), a pooled dataset with information from 41 projects across the Netherlands from the Dutch national care for the Elderly programme. Frailty, multi-morbidity and ADL limitations, and the interactions between these domains, were used as predictors in regression analyses with quality of life and healthcare costs as outcome measures. Analyses were stratified by living situation (independent or care home). Directionality and magnitude of associations were assessed using linear mixed models. A total of 11,093 elderly people were interviewed. A substantial proportion of elderly people living independently reported frailty, multi-morbidity, and/or ADL limitations (56.4%, 88.3% and 41.4%, respectively), as did elderly people living in a care home (88.7%, 89.2% and 77,3%, respectively). One-third of elderly people living at home (31.9%) reported all three conditions compared with two-thirds of elderly people living in a care home (68.3%). In the multivariable analysis, frailty had a strong impact on outcomes independently of multi-morbidity and ADL limitations. Elderly people experiencing problems across all three domains reported the poorest quality-of-life scores and the highest healthcare costs, irrespective of their living situation. Frailty, multi-morbidity and ADL limitations are complementary measurements, which together provide a more holistic understanding of health status in elderly people. A multi-dimensional approach is important in mapping the complex relationships between these measurements on the one hand and the quality of life and healthcare costs on the other.

Non-hip, non-spine fractures drive healthcare utilization following a fracture: the Global Longitudinal study of Osteoporosis in Women (GLOW)

Science.gov (United States)

Ioannidis, G.; Flahive, J.; Pickard, L.; Papaioannou, A.; Chapurlat, R. D.; Saag, K. G.; Silverman, S.; Anderson, F. A.; Gehlbach, S. H.; Hooven, F. H.; Boonen, S.; Compston, J. E.; Cooper, C.; Díez-Perez, A.; Greenspan, S. L.; LaCroix, A. Z.; Lindsay, R.; Netelenbos, J. C.; Pfeilschifter, J.; Rossini, M.; Roux, C.; Sambrook, P. N.; Siris, E. S.; Watts, N. B.

2016-01-01

Summary We evaluated healthcare utilization associated with treating different fracture types in over 51,000 women aged ≥55 years. Over the course of 1 year, there were five times more non-hip, non-spine fractures than hip or spine fractures, resulting in twice as many days of hospitalization and rehabilitation/nursing home care for non-hip, non-spine fractures. Purpose To evaluate the medical healthcare utilization associated with treating several types of fractures in women aged 55 years or older from various geographic regions. Methods Information from the Global Longitudinal study of Osteoporosis in Women (GLOW) was collected via self-administered patient questionnaires at baseline and year 1 (n=51,491). Self-reported clinically recognized low-trauma fractures at year 1 were classified as incident spine, hip, wrist/hand, arm/shoulder, pelvis, rib, leg, and other fractures. Healthcare utilization data were self-reported and included whether the fracture was treated at a doctor’s office/clinic or at a hospital. Patients were also asked if they had undergone surgery or been treated at a rehabilitation center or nursing home. Results Over the 1-year study period, there were 195 spine, 134 hip, and 1,654 non-hip, non-spine fractures. In the GLOW cohort, clinical vertebral fractures resulted in 617 days of hospitalization and 512 days of rehabilitation/nursing home care, while hip fractures accounted for 1,306 days of hospitalization and 1,650 days of rehabilitation/nursing home care. Of particular interest is the result that non-hip, non-spine fractures resulted in 3,805 days in hospital and 5,186 days of rehabilitation/nursing home care. Conclusions While hip and vertebral fractures are well recognized for their associated increase in health resource utilization, non-hip, non-spine fractures, by virtue of their 5-fold greater number, require significantly more healthcare resources. PMID:22525976

Perception of Smart Home Technologies to\\ud Assist Elderly People

OpenAIRE

CHERNBUMROONG, Saisakul; ATKINS, Anthony; YU, Hongnian

2010-01-01

In the last decade, the number of elderly\\ud population has increased significantly which affects\\ud human in many aspects, especially in healthcare. Many\\ud studies have shown increases in expenditures on longterm\\ud care. New models of care are needed including\\ud supported self-care and home-based services. Advance\\ud in sensor and network technologies have made these\\ud possible. A smart home which is a residence equipped\\ud with smart technologies providing services that enhance\\ud human...

Substitution of Formal and Informal Home Care Service Use and Nursing Home Service Use: Health Outcomes, Decision-Making Preferences, and Implications for a Public Health Policy.

Science.gov (United States)

Chen, Chia-Ching; Yamada, Tetsuji; Nakashima, Taeko; Chiu, I-Ming

2017-01-01

The purposes of this study are: (1) to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC) service use; (2) to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3) to investigate health outcome disparity based on substitutability. The methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR), which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly. There exists a complement relationship between the informal home care (IHC) and community-based FHC services, and the elasticity's ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH) services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services. Policy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.

Substitution of Formal and Informal Home Care Service Use and Nursing Home Service Use: Health Outcomes, Decision-Making Preferences, and Implications for a Public Health Policy

Directory of Open Access Journals (Sweden)

Chia-Ching Chen

2017-11-01

Full Text Available ObjectivesThe purposes of this study are: (1 to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC service use; (2 to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3 to investigate health outcome disparity based on substitutability.Methodology and dataThe methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR, which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly.ResultsThere exists a complement relationship between the informal home care (IHC and community-based FHC services, and the elasticity’s ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services.ConclusionPolicy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.

Starting a hospital-based home health agency: Part II--Key success factors.

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Montgomery, P

1993-09-01

In Part II of a three-part series, the financial, technological and legislative issues of a hospital-based home health-agency are discussed. Beginning a home healthcare service requires intensive research to answer key environmental and operational questions--need, competition, financial projections, initial start-up costs and the impact of delayed depreciation. Assessments involving technology, staffing, legislative and regulatory issues can help project service volume, productivity and cost-control.

Menores y acceso a Internet en el hogar: las normas familiares Internet Access by Minors at Home: Usage Norms Imposed by Parents

Directory of Open Access Journals (Sweden)

Mercè Morey López

2010-03-01

Full Text Available Este artículo analiza el establecimiento de normas por parte de los progenitores a sus hijos sobre la utilización de Internet en los hogares. Los datos se han obtenido mediante encuestación sobre una muestra representativa de los menores de las Islas Baleares de entre 6 y 16 años, habiéndose analizado las siguientes dimensiones: acceso de los menores a Internet desde el hogar; grado de autonomía o acompañamiento en la navegación; normativización impuesta en el hogar por parte de sus padres y madres; tipos de normas impuestas; relación entre normas y género; valoración de los menores de los conocimientos y habilidades de sus progenitores para navegar por Internet y, finalmente, el acompañamiento de los padres y madres a la hora de navegar por Internet. Se constata que poco más del 53% de los menores de entre 6 y 14 años, y del 62% de los de 15 y 16 años navegan a través de Internet sin que sus progenitores les establezcan limitaciones. Cuando establecen algún tipo de normas, éstas se refieren, principalmente, a restricciones de carácter temporal. Por tanto, se infiere que los padres y madres no son conscientes de los peligros de la Red o que, al menos, actúan de forma poco razonable. Ello muestra la necesidad de sensibilizar y formar a las familias para que asuman su responsabilidad educativa.This paper examines and discusses the rules and standards set by parents for their children on Internet usage at home. Data that supports the paper have been obtained by surveying a representative sample of children in the Balearic Islands aged between 6 and 16 years; the analysis dimensions are: access by minors to the Internet from home; location of the computer from which have online access; level of autonomy or accompaniment while surfing the Net; norms imposed by their parents; types of rules imposed; relationship between norms and gender; the minors’ opinion and assessment of the knowledge and abilities of their parents on use of

Health status of UK care home residents: a cohort study.

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Gordon, Adam Lee; Franklin, Matthew; Bradshaw, Lucy; Logan, Pip; Elliott, Rachel; Gladman, John R F

2014-01-01

UK care home residents are often poorly served by existing healthcare arrangements. Published descriptions of residents' health status have been limited by lack of detail and use of data derived from surveys drawn from social, rather than health, care records. to describe in detail the health status and healthcare resource use of UK care home residents a 180-day longitudinal cohort study of 227 residents across 11 UK care homes, 5 nursing and 6 residential, selected to be representative for nursing/residential status and dementia registration. Barthel index (BI), Mini-mental state examination (MMSE), Neuropsychiatric index (NPI), Mini-nutritional index (MNA), EuroQoL-5D (EQ-5D), 12-item General Health Questionnaire (GHQ-12), diagnoses and medications were recorded at baseline and BI, NPI, GHQ-12 and EQ-5D at follow-up after 180 days. National Health Service (NHS) resource use data were collected from databases of local healthcare providers. out of a total of 323, 227 residents were recruited. The median BI was 9 (IQR: 2.5-15.5), MMSE 13 (4-22) and number of medications 8 (5.5-10.5). The mean number of diagnoses per resident was 6.2 (SD: 4). Thirty per cent were malnourished, 66% had evidence of behavioural disturbance. Residents had contact with the NHS on average once per month. residents from both residential and nursing settings are dependent, cognitively impaired, have mild frequent behavioural symptoms, multimorbidity, polypharmacy and frequently use NHS resources. Effective care for such a cohort requires broad expertise from multiple disciplines delivered in a co-ordinated and managed way.

The Patient-Centered Medical Home Neighbor: A Critical Concept for a Redesigned Healthcare Delivery System

Science.gov (United States)

2011-01-25

Sharing Knowledge: Achieving Breakthrough Performance 2010 Military Health System Conference The Patient -Centered Medical Home Neighbor: A Critical...DATE 25 JAN 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE The Patient -Centered Medical Home Neighbor: A...Conference What is the Patient -Centered Medical Home?  …a vision of health care as it should be  …a framework for organizing systems of care at both the

Integrity mechanism for eHealth tele-monitoring system in smart home environment.

Science.gov (United States)

Mantas, Georgios; Lymberopoulos, Dimitrios; Komninos, Nikos

2009-01-01

During the past few years, a lot of effort has been invested in research and development of eHealth tele-monitoring systems that will provide many benefits for healthcare delivery from the healthcare provider to the patient's home. However, there is a plethora of security requirements in eHealth tele-monitoring systems. Data integrity of the transferred medical data is one of the most important security requirements that should be satisfied in these systems, since medical information is extremely sensitive information, and even sometimes life threatening information. In this paper, we present a data integrity mechanism for eHealth tele-monitoring system that operates in a smart home environment. Agent technology is applied to achieve data integrity with the use of cryptographic smart cards. Furthermore, the overall security infrastructure and its various components are described.

Beyond the numbers : A user-centered design approach for personal reflective healthcare technologies

NARCIS (Netherlands)

Jimenez Garcia, J.C.

2014-01-01

The current healthcare paradigm shifts towards considering the patients’ home as the primary self-care environment. Health care is changing from being solely delivered by professionals in hospitals, to considering daily-life experiences and patients’ personal contexts. In order to meet this

Challenges in Gaining Large Scale Carbon Reductions through Wireless Home Automation Systems

DEFF Research Database (Denmark)

Larsen, Peter Gorm; Rovsing, Poul Ejnar; Toftegaard, Thomas Skjødeberg

2010-01-01

Buildings account for more than a 35 % of the energy consumption in Europe. Therefore a step towards more sustainable lifestile is to use home automation to optimize the energy consumption “automatically”. This paper reports about the usage and some of the remaining challenges of especially...... wireless but also powerline communication in a home automation setting. For many years, home automation has been visible to many, but accessible to only a few, because of inadequate integration of systems. A vast number of both standard and proprietary communication protocols are used, and systems...... are often difficult to install and configure so professional assistance is needed. In this paper we report about our experience in constructing an open universal home automation framework enabling interoperability of multiple communication protocols. The framework can easily be expanded in order to support...

Skin tears: care and management of the older adult at home.

Science.gov (United States)

Holmes, Regina F; Davidson, Martha W; Thompson, Bonnie J; Kelechi, Teresa J

2013-02-01

Skin tears experienced by older adults require special skills to promote healing. Home healthcare providers are in key positions to manage skin tears and prevent further skin trauma. Several guidelines, risk assessments, classifications, and products exist to manage high-risk patients. Frequent evaluation of the effectiveness of the treatment and prevention strategies in an overall skin care protocol for home care patients is critical to reduce skin tear incidence and promote prompt healing when skin tears are present.

Simulation of Smart Home Activity Datasets

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Jonathan Synnott

2015-06-01

Full Text Available A globally ageing population is resulting in an increased prevalence of chronic conditions which affect older adults. Such conditions require long-term care and management to maximize quality of life, placing an increasing strain on healthcare resources. Intelligent environments such as smart homes facilitate long-term monitoring of activities in the home through the use of sensor technology. Access to sensor datasets is necessary for the development of novel activity monitoring and recognition approaches. Access to such datasets is limited due to issues such as sensor cost, availability and deployment time. The use of simulated environments and sensors may address these issues and facilitate the generation of comprehensive datasets. This paper provides a review of existing approaches for the generation of simulated smart home activity datasets, including model-based approaches and interactive approaches which implement virtual sensors, environments and avatars. The paper also provides recommendation for future work in intelligent environment simulation.

Simulation of Smart Home Activity Datasets.

Science.gov (United States)

Synnott, Jonathan; Nugent, Chris; Jeffers, Paul

2015-06-16

A globally ageing population is resulting in an increased prevalence of chronic conditions which affect older adults. Such conditions require long-term care and management to maximize quality of life, placing an increasing strain on healthcare resources. Intelligent environments such as smart homes facilitate long-term monitoring of activities in the home through the use of sensor technology. Access to sensor datasets is necessary for the development of novel activity monitoring and recognition approaches. Access to such datasets is limited due to issues such as sensor cost, availability and deployment time. The use of simulated environments and sensors may address these issues and facilitate the generation of comprehensive datasets. This paper provides a review of existing approaches for the generation of simulated smart home activity datasets, including model-based approaches and interactive approaches which implement virtual sensors, environments and avatars. The paper also provides recommendation for future work in intelligent environment simulation.

Design requirements for ubiquitous computing environments for healthcare professionals.

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Bång, Magnus; Larsson, Anders; Eriksson, Henrik

2004-01-01

Ubiquitous computing environments can support clinical administrative routines in new ways. The aim of such computing approaches is to enhance routine physical work, thus it is important to identify specific design requirements. We studied healthcare professionals in an emergency room and developed the computer-augmented environment NOSTOS to support teamwork in that setting. NOSTOS uses digital pens and paper-based media as the primary input interface for data capture and as a means of controlling the system. NOSTOS also includes a digital desk, walk-up displays, and sensor technology that allow the system to track documents and activities in the workplace. We propose a set of requirements and discuss the value of tangible user interfaces for healthcare personnel. Our results suggest that the key requirements are flexibility in terms of system usage and seamless integration between digital and physical components. We also discuss how ubiquitous computing approaches like NOSTOS can be beneficial in the medical workplace.

"Willing but unwilling": attitudinal barriers to adoption of home-based health information technology among older adults.

Science.gov (United States)

Young, Rachel; Willis, Erin; Cameron, Glen; Geana, Mugur

2014-06-01

While much research focuses on adoption of electronic health-care records and other information technology among health-care providers, less research explores patient attitudes. This qualitative study examines barriers to adoption of home-based health information technology, particularly personal electronic health records, among older adults. We conducted in-depth interviews (30-90 min duration) with 35 American adults, aged 46-72 years, to determine their perceptions of and attitudes toward home-based health information technology. Analysis of interview data revealed that most barriers to adoption fell under four themes: technological discomfort, privacy or security concerns, lack of relative advantage, and perceived distance from the user representation. Based on our findings, systems to promote home-based health information technology should incorporate familiar computer applications, alleviate privacy and security concerns, and align with older adults' active and engaged self-image.

A Scoping Review of Economic Evaluations Alongside Randomised Controlled Trials of Home Monitoring in Chronic Disease Management.

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Kidholm, Kristian; Kristensen, Mie Borch Dahl

2018-04-01

Many countries have considered telemedicine and home monitoring of patients as a solution to the demographic challenges that health-care systems face. However, reviews of economic evaluations of telemedicine have identified methodological problems in many studies as they do not comply with guidelines. The aim of this study was to examine economic evaluations alongside randomised controlled trials of home monitoring in chronic disease management and hereby to explore the resources included in the programme costs, the types of health-care utilisation that change as a result of home monitoring and discuss the value of economic evaluation alongside randomised controlled trials of home monitoring on the basis of the studies identified. A scoping review of economic evaluations of home monitoring of patients with chronic disease based on randomised controlled trials and including information on the programme costs and the costs of equipment was carried out based on a Medline (PubMed) search. Nine studies met the inclusion criteria. All studies include both costs of equipment and use of staff, but there is large variation in the types of equipment and types of tasks for the staff included in the costs. Equipment costs constituted 16-73% of the total programme costs. In six of the nine studies, home monitoring resulted in a reduction in primary care or emergency contacts. However, in total, home monitoring resulted in increased average costs per patient in six studies and reduced costs in three of the nine studies. The review is limited by the small number of studies found and the restriction to randomised controlled trials, which can be problematic in this area due to lack of blinding of patients and healthcare professionals and the difficulty of implementing organisational changes in hospital departments for the limited period of a trial. Furthermore, our results may be based on assessments of older telemedicine interventions.

Energy conservation through smart homes in a smart city: A lesson for Singapore households

International Nuclear Information System (INIS)

Bhati, Abhishek; Hansen, Michael; Chan, Ching Man

2017-01-01

Energy saving is a hot topic due to the proliferation of climate changes and energy challenges globally. However, people's perception about using smart technology for energy saving is still in the concept stage. This means that people talk about environmental awareness readily, yet in reality, they accept to pay the given energy bill. Due to the availability of electricity and its integral role, modulating consumers’ attitudes towards energy savings can be a challenge. Notably, the gap in today's smart technology design in smart homes is the understanding of consumers’ behaviour and the integration of this understanding into the smart technology. As part of the Paris Climate change agreement (2015), it is paramount for Singapore to introduce smart technologies targeted to reduce energy consumption. This paper focused on the perception of Singapore households on smart technology and its usage to save energy. Areas of current research include: (1) energy consumption in Singapore households, (2) public programs and policies in energy savings, (3) use of technology in energy savings, and (4) household perception of energy savings in smart homes. Furthermore, three case studies are reviewed in relation to smart homes and smart technology, while discussing the maturity of existing solutions. - Highlights: • Analyse perception of Singapore households about the usage of smart technology to save energy. • Reviews energy consumption, public policies and household perception of energy savings. • Three case studies were developed and reviewed in relation to smart homes and smart technology. • Analyse research gap of household behaviours and perceptions as smart home design focus.

A rapid assessment of the availability and use of obstetric care in Nigerian healthcare facilities.

Directory of Open Access Journals (Sweden)

Daniel O Erim

Full Text Available BACKGROUND: As part of efforts to reduce maternal deaths in Nigeria, pregnant women are being encouraged to give birth in healthcare facilities. However, little is known about whether or not available healthcare facilities can cope with an increasing demand for obstetric care. We thus carried out this survey as a rapid and tactical assessment of facility quality. We visited 121 healthcare facilities, and used the opportunity to interview over 700 women seeking care at these facilities. FINDINGS: Most of the primary healthcare facilities we visited were unable to provide all basic Emergency Obstetric Care (bEmOC services. In general, they lack clinical staff needed to dispense maternal and neonatal care services, ambulances and uninterrupted electricity supply whenever there were obstetric emergencies. Secondary healthcare facilities fared better, but, like their primary counterparts, lack neonatal care infrastructure. Among patients, most lived within 30 minutes of the visited facilities and still reported some difficulty getting there. Of those who had had two or more childbirths, the conditional probability of a delivery occurring in a healthcare facility was 0.91 if the previous delivery occurred in a healthcare facility, and 0.24 if it occurred at home. The crude risk of an adverse neonatal outcome did not significantly vary by delivery site or birth attendant, and the occurrence of such an outcome during an in-facility delivery may influence the mother to have her next delivery outside. Such an outcome during a home delivery may not prompt a subsequent in-facility delivery. CONCLUSIONS: In conclusion, reducing maternal deaths in Nigeria will require attention to both increasing the number of facilities with high-quality EmOC capability and also assuring Nigerian women have access to these facilities regardless of where they live.

Prospective study of determinants and costs of home births in Mumbai slums.

Science.gov (United States)

Das, Sushmita; Bapat, Ujwala; More, Neena Shah; Chordhekar, Latika; Joshi, Wasundhara; Osrin, David

2010-07-30

Around 86% of births in Mumbai, India, occur in healthcare institutions, but this aggregate figure hides substantial variation and little is known about urban home births. We aimed to explore factors influencing the choice of home delivery, care practices and costs, and to identify characteristics of women, households and the environment which might increase the likelihood of home birth. As part of the City Initiative for Newborn Health, we used a key informant surveillance system to identify births prospectively in 48 slum communities in six wards of Mumbai, covering a population of 280,000. Births and outcomes were documented prospectively by local women and mothers were interviewed in detail at six weeks after delivery. We examined the prevalence of home births and their associations with potential determinants using regression models. We described 1708 (16%) home deliveries among 10,754 births over two years, 2005-2007. The proportion varied from 6% to 24%, depending on area. The most commonly cited reasons for home birth were custom and lack of time to reach a healthcare facility during labour. Seventy percent of home deliveries were assisted by a traditional birth attendant (dai), and 6% by skilled health personnel. The median cost of a home delivery was US$ 21, of institutional delivery in the public sector US$ 32, and in the private sector US$ 118. In an adjusted multivariable regression model, the odds of home delivery increased with illiteracy, parity, socioeconomic poverty, poorer housing, lack of water supply, population transience, and hazardous location. We estimate 32,000 annual home births to residents of Mumbai's slums. These are unevenly distributed and cluster with other markers of vulnerability. Since cost does not appear to be a dominant disincentive to institutional delivery, efforts are needed to improve the client experience at public sector institutions. It might also be productive to concentrate on intensive outreach in vulnerable areas by

PALLIATIVE CARE – ITS ROLE IN HEALTHCARE SYSTEMS

Directory of Open Access Journals (Sweden)

Urška Lunder

2003-11-01

Full Text Available Background. In the last decades a palliative care has been well established in the majority of West European countries. However, majority of these countries are not able to follow needs for palliative care because of demographic changes (older population, changes of morbidity pattern (increase of chronic progressive diseases and social changes (disability of families to care for their relatives at their homes. Research is showing evidence on palliative care effectiveness at end of life and in bereavement. There is still a great need for healthcare professionals’ change in their attitudes, knowledge and skills. In many National strategic plans (United Kingdom, Ireland, Sweden, Australia, New Zealand and Canada palliative care becomes a priority in the national public health. New organizational planning supports establishement of palliative care departments in hospitals and other healthcare settings and consultant teams at all levels of healthcare system. Hospices, caritative and independent organizations, will remain as a source of good clinical practice and philosophy of care at the end of life also in the future.

The use of advanced medical technologies at home : A systematic review of the literature

NARCIS (Netherlands)

ten Haken, Ingrid; Allouch, Somaya Ben; van Harten, Willem H.

2018-01-01

Background: The number of medical technologies used in home settings has increased substantially over the last 10-15 years. In order to manage their use and to guarantee quality and safety, data on usage trends and practical experiences are important. This paper presents a literature review on

Medicare claims indicators of healthcare utilization differences after hospitalization for ischemic stroke: Race, gender, and caregiving effects.

Science.gov (United States)

Roth, David L; Sheehan, Orla C; Huang, Jin; Rhodes, James D; Judd, Suzanne E; Kilgore, Meredith; Kissela, Brett; Bettger, Janet Prvu; Haley, William E

2016-10-01

Background Differences in healthcare utilization after stroke may partly explain race or gender differences in stroke outcomes and identify factors that might reduce post-acute stroke care costs. Aim To examine systematic differences in Medicare claims for healthcare utilization after hospitalization for ischemic stroke in a US population-based sample. Methods Claims were examined over a six-month period after hospitalization for 279 ischemic stroke survivors 65 years or older from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Statistical analyses examined differences in post-acute healthcare utilization, adjusted for pre-stroke utilization, as a function of race (African-American vs. White), gender, age, stroke belt residence, income, Medicaid dual-eligibility, Charlson comorbidity index, and whether the person lived with an available caregiver. Results After adjusting for covariates, women were more likely than men to receive home health care and to use emergency department services during the post-acute care period. These effects were maintained even after further adjustment for acute stroke severity. African-Americans had more home health care visits than Whites among patients who received some home health care. Having a co-residing caregiver was associated with reduced acute hospitalization length of stay and fewer post-acute emergency department and primary care physician visits. Conclusions Underutilization of healthcare after stroke does not appear to explain poorer long-term stroke outcomes for women and African-Americans in this epidemiologically-derived sample. Caregiver availability may contribute to reduced formal care and cost during the post-acute period.

Exploring technological and architectural solutions for nursing home residents, care professionals and technical staff: Focus groups with professional stakeholders.

NARCIS (Netherlands)

M.H. Wetzels; H.T.G. Weffers; A.M.C. Dooremalen; Joost van Hoof; Eveline Wouters

2014-01-01

Buildings with innovative technologies and architectural solutions are needed as a means of support for future nursing homes alongside adequate care services. This study investigated how various groups of stakeholders from healthcare and technology envision the nursing home of the future in the

Smart home design for electronic devices monitoring based wireless gateway network using cisco packet tracer

Science.gov (United States)

Sihombing, Oloan; Zendrato, Niskarto; Laia, Yonata; Nababan, Marlince; Sitanggang, Delima; Purba, Windania; Batubara, Diarmansyah; Aisyah, Siti; Indra, Evta; Siregar, Saut

2018-04-01

In the era of technological development today, the technology has become the need for the life of today's society. One is needed to create a smart home in turning on and off electronic devices via smartphone. So far in turning off and turning the home electronic device is done by pressing the switch or remote button, so in control of electronic device control less effective. The home smart design is done by simulation concept by testing system, network configuration, and wireless home gateway computer network equipment required by a smart home network on cisco packet tracer using Internet Thing (IoT) control. In testing the IoT home network wireless network gateway system, multiple electronic devices can be controlled and monitored via smartphone based on predefined configuration conditions. With the Smart Ho me can potentially increase energy efficiency, decrease energy usage costs, control electronics and change the role of residents.

Lightweight UDP Pervasive Protocol in Smart Home Environment Based on Labview

Science.gov (United States)

Kurniawan, Wijaya; Hannats Hanafi Ichsan, Mochammad; Rizqika Akbar, Sabriansyah; Arwani, Issa

2017-04-01

TCP (Transmission Control Protocol) technology in a reliable environment was not a problem, but not in an environment where the entire Smart Home network connected locally. Currently employing pervasive protocols using TCP technology, when data transmission is sent, it would be slower because they have to perform handshaking process in advance and could not broadcast the data. On smart home environment, it does not need large size and complex data transmission between monitoring site and monitoring center required in Smart home strain monitoring system. UDP (User Datagram Protocol) technology is quick and simple on data transmission process. UDP can broadcast messages because the UDP did not require handshaking and with more efficient memory usage. LabVIEW is a programming language software for processing and visualization of data in the field of data acquisition. This paper proposes to examine Pervasive UDP protocol implementations in smart home environment based on LabVIEW. UDP coded in LabVIEW and experiments were performed on a PC and can work properly.

Racial and ethnic disparities in the healing of pressure ulcers present at nursing home admission.

Science.gov (United States)

Bliss, Donna Z; Gurvich, Olga; Savik, Kay; Eberly, Lynn E; Harms, Susan; Mueller, Christine; Garrard, Judith; Cunanan, Kristen; Wiltzen, Kjerstie

2017-09-01

Pressure ulcers increase the risk of costly hospitalization and mortality of nursing home residents, so timely healing is important. Disparities in healthcare have been identified in the nursing home population but little is known about disparities in the healing of pressure ulcers. To assess racial and ethnic disparities in the healing of pressure ulcers present at nursing home admission. Multi-levels predictors, at the individual resident, nursing home, and community/Census tract level, were examined in three large data sets. Minimum Data Set records of older individuals admitted to one of 439 nursing homes of a national, for-profit chain over three years with a stages 2-4 pressure ulcer (n=10,861) were searched to the 90-day assessment for the first record showing pressure ulcer healing. Predictors of pressure ulcer healing were analyzed for White admissions first using logistic regression. The Peters-Belson method was used to assess racial or ethnic disparities among minority group admissions. A significantly smaller proportion of Black nursing home admissions had their pressure ulcer heal than expected had they been part of the White group. There were no disparities in pressure ulcer healing disadvantaging other minority groups. Significant predictors of a nonhealing of pressure ulcer were greater deficits in activities of daily living and pressure ulcer severity. Reducing disparities in pressure ulcer healing is needed for Blacks admitted to nursing homes. Knowledge of disparities in pressure ulcer healing can direct interventions aiming to achieve equity in healthcare for a growing number of minority nursing home admissions. Copyright © 2017 Elsevier B.V. All rights reserved.

How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations.

Science.gov (United States)

Bronkhorst, Babette

2017-08-01

Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.

The impact of leadership coaching in an Australian healthcare setting.

Science.gov (United States)

Grant, Anthony M; Studholme, Ingrid; Verma, Raj; Kirkwood, Lea; Paton, Bronwyn; O'Connor, Sean

2017-04-10

Purpose There is limited empirical literature on the effectiveness of leadership coaching in healthcare settings. The purpose of this paper is to explore the efficacy of leadership coaching for individuals implementing strategic change in the Australian public health system. Design/methodology/approach Using a within-subjects (pre-post) design, participants ( n=31) undertook six one-hour coaching sessions. Coaching was conducted by professional leadership coaches. Both quantitative and qualitative data were collected. Findings Participation was associated with significant improvements in goal attainment, solution-focused thinking, leadership self-efficacy, perspective-taking capacity, self-insight and resilience, and ambiguity tolerance. There were significant reductions in stress and anxiety. The benefits of coaching transferred from the workplace to the home. Many participants reported being able to use insights gained in coaching in their personal lives, and reported better work/life balance, less stress and better quality relationships at home. Originality/value Few studies have provided evaluation of leadership coaching in healthcare setting. Leadership coaching in the public health system may be an important methodology for facilitating goal attainment and fostering resilience in this vital social sector, benefiting workers in the health services, their families and ultimately their patients and the broader community.

Privacy, boundaries and smart homes for health: An ethnographic study.

Science.gov (United States)

Burrows, Alison; Coyle, David; Gooberman-Hill, Rachael

2018-03-01

This article explores how people negotiate borders and boundaries within the home, in the context of health and the introduction of new technologies. We draw on an ethnographic study involving a socially diverse group of people, which included people with experience of telecare or smart home energy systems. Participants engaged in various strategies to regulate the borders of their home, even though new technologies have begun to change the nature of these borders. Participants managed health conditions but also their use of technology through boundary work that permitted devices to be more or less visible and integrated within the home. Findings highlight that if smart healthcare technologies are to be accepted in the home then there is a need for mechanisms that allow people to control the interpretation of data and flow of information generated about them and their households. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Wellness protocol for smart homes an integrated framework for ambient assisted living

CERN Document Server

Ghayvat, Hemant

2017-01-01

This book focuses on the development of wellness protocols for smart home monitoring, aiming to forecast the wellness of individuals living in ambient assisted living (AAL) environments. It describes in detail the design and implementation of heterogeneous wireless sensors and networks as applied to data mining and machine learning, which the protocols are based on. Further, it shows how these sensor and actuator nodes are deployed in the home environment, generating real-time data on object usage and other movements inside the home, and therefore demonstrates that the protocols have proven to offer a reliable, efficient, flexible, and economical solution for smart home systems. Documenting the approach from sensor to decision making and information generation, the book addresses various issues concerning interference mitigation, errors, security and large data handling. As such, it offers a valuable resource for researchers, students and practitioners interested in interdisciplinary studies at the intersecti...

Home versus in-patient treatment for deep vein thrombosis.

Science.gov (United States)

Othieno, Richard; Okpo, Emmanuel; Forster, Rachel

2018-01-09

studies used unclear randomisation techniques, and blinding was a concern for many. Also, indirectness was a concern, as most studies included a large number of participants randomised to the home (LMWH) treatment group who were treated in hospital for some or all of the treatment period. A further issue for some outcomes was heterogeneity that was evident in measurement and reporting of outcomes. Low-quality evidence suggests that patients treated at home with LMWH are less likely to have recurrence of VTE than those treated in hospital. However, data show no clear differences in major or minor bleeding, nor in mortality (low-quality evidence), indicating that home treatment is no worse than in-patient treatment for these outcomes. Because most healthcare systems are moving towards more LMWH usage in the home setting it is unlikely that additional large trials will be undertaken to compare these treatments. Therefore, home treatment is likely to become the norm, and further research will be directed towards resolving practical issues by devising local guidelines that include clinical prediction rules, developing biomarkers and imaging that can be used to tailor therapy to disease severity, and providing training for community healthcare workers who administer treatment and monitor treatment progress.

Multi-usages of the Ilan geothermal field, NE Taiwan

Science.gov (United States)

Lee, C. S.; Tseng, P.; Wang, S.; Chang, C.

2017-12-01

The tectonics of Taiwan is very dynamic. The area produces more than 30,000 earthquakes/year; the mountains uplift 4-5 cm/year; the rainfall culminates 3,000 mm/year; there are some 4,000 hot spring operators. One of the two hot geothermal areas is located in NE Taiwan - the Ilan geothermal field. In order to develop the geothermal energy for the electricity need, the Ministry of Science and Technology have provided the fund to drill two 2,500 deep wells. The results are not so encourage for the need of an Enhanced Geothermal System. However, one of the wells has a bottom temperature of 160oC and the water up loading with 60 ton/hr. This can be combined with the near-by wells drilled by the private drilling company and the Cardinal Tien Junior College of Healthcare and Management to develop the multi-usages of the geothermal energy, such as 1 MW of electricity for the college and village, the long-term healthcare and hot spring medicare, aquaculture and agriculture need etc. The universities and private drilling company cooperate together to join the development. Hope this will provide a new model for the need of a self-sufficient community. The geothermal is a clean, renewable, and no pollution energy. Taiwan is in an initial stage of using this green energy.

AT HOME IN HOSPITAL? COMPETING CONSTRUCTIONS OF HOSPITAL ENVIRONMENTS

Directory of Open Access Journals (Sweden)

Peter Kellett

2009-03-01

Full Text Available Large institutions housed in large buildings are frequently regarded as the antithesis of personalised, small scale, domestic, home environments. However the attribute of ‘homeliness’ appears to be used more broadly to describe places where people feel a sense of attachment, control and identification. In a large multi-disciplinary study of a hospital rebuilding project in northern England a range of users were interviewed to ascertain their responses to the original older buildings and later the new purpose built hospital. We found both staff and patients retained a strong sense of affection for the older buildings and frequently used the language of home to describe their responses. In contrast, the newer buildings were generally recognised as efficient but impersonal, lacking many of the positive qualities they were familiar with. In addition some respondents suggested that despite efforts to include art projects, the new architectural language was inappropriate for healthcare, believing that small scale, ‘home-like’ environments were more conducive to health and well-being. The authors will draw on anthropological and architectural frameworks to analyse the data which consists of extensive interview transcripts complemented by photographs. The paper aims to understand the conceptualisations which underpin the various user responses and to offer a critique of the design language of the current healthcare building programme.

Benefits and implementation of home hemodialysis: A narrative review

Directory of Open Access Journals (Sweden)

Ayman Karkar

2015-01-01

Full Text Available Home hemodialysis (HD is a modality of renal replacement therapy that can be safely and independently performed at home by end-stage renal disease (ESRD patients. Home HD can be performed at the convenience of the patients on a daily basis, every other day and overnight (nocturnal. Despite the great and many perceived benefits of home HD, including the significant improvements in health outcomes and resource utilization, the adoption of home HD has been limited; lack or inadequate pre-dialysis education and training constitute a major barrier. The lack of self-confidence and/or self-efficacy to manage own therapy, lack of family and/or social support, fear of machine and cannulation of blood access and worries of possible catastrophic events represent other barriers for the implementation of home HD besides inadequate competence and/or expertise in caring for home HD patients among renal care providers (nephrologists, dialysis nurses, educators. A well-studied, planned and prepared and carefully implemented central country program supported by adequate budget can play a positive role in overcoming the challenges to home HD. Healthcare authorities, with the increasingly financial and logistic demands and the relatively higher mortality and morbidity rates of the conventional in-center HD, should tackle home HD as an attractive and cost-effective modality with more freedom, quality of life and improvement of clinical outcomes for the ESRD patients.

Do people with intellectual disability use Nintendo Wii when placed in their home as part of a physiotherapy program? An observational study.

Science.gov (United States)

Chung, Alison M J; Harvey, Lisa A; Hassett, Leanne M

2016-01-01

To examine how much, and in what way, Nintendo Wii™ (Wii) is used when prescribed as part of a home-physiotherapy program for people with intellectual disability. Twenty people with intellectual disability were recruited. The following parameters were recorded about play patterns over a 12-week period: frequency, duration, perceived exertion, play position, play mode, initiation of play and games from Wii Sports and Wii Fit Plus. Participants used the Wii for a median of 101 min per week (interquartile range [IQR]: 50-172) in weeks one and two across a median of three days per week (IQR: 3-4), decreasing down to a median of 35 min per week (IQR: 0-141) in weeks 11 and 12 across a median of one day per week (IQR: 0-3). Usage of the Wii drops off rapidly when it is placed in the homes of people with intellectual disability as part of a physiotherapy program. Implications for Rehabilitation Usage of the Nintendo Wii drops off rapidly when it is placed in the homes of people with intellectual disability and they are instructed to use it as part of a home physiotherapy program. Games commonly played include bowling and boxing in Wii Sport, and penguin slide, ski jump and tight rope walk in Wii Fit Plus. Physiotherapists should use person and family centred practice to ensure that Nintendo Wii is a suitable intervention for the person with an intellectual disability and provide support to encourage ongoing usage.

BSNCare+: A Robust IoT-Oriented Healthcare System with Non-Repudiation Transactions

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Kuo-Hui Yeh

2016-12-01

Full Text Available Recently, the rapid advancement in technologies of modern intelligent objects has led to a new network paradigm, called the Internet of Things (IoT, in which every networked and automated object has been connected in a pervasive manner. New types of IoT-based application services are thus presented. In a healthcare oriented environment, the usage of IoT has brought opportunities for assisting physicians (or nurses to provide on-demand and real-time body-care services to patients with higher accuracy and better efficiency. However, while IoT-oriented techniques deliver such advantages, they may encounter system security vulnerabilities and patient privacy threats not seen in the past. In this paper, we propose a robust IoT-based healthcare system, called BSNCare+, in which body sensor networks (BSNs are adopted as the underlying communication architecture. In the proposed healthcare system, we exploit lightweight crypto-primitives to construct a secure communication mechanism that does achieve data confidentiality and entity authentication among intelligent body sensors, the mobile gateway and the backend BSN-Care server. In addition, we evaluate the performance of the proposed healthcare system using the Raspberry PI series platform. The results show the practicability and feasibility of BSNCare+.

Differences in smartphone usage

DEFF Research Database (Denmark)

Gustarini, Mattia; Scipioni, Marcello Paolo; Fanourakis, Marios

2016-01-01

We analyze the users’ intimacy to investigate the differences in smartphone usage, considering the user’s location and number and kind of people physically around the user. With a first user study we (1) validate the intimacy concept, (2) evaluate its correlation to smartphone usage features and ...

The PHQ-2 on OASIS-C: A New Resource for Identifying Geriatric Depression Among Home Health Patients

OpenAIRE

Sheeran, Thomas; Reilly, Catherine F.; Raue, Patrick J.; Weinberger, Mark I.; Pomerantz, Judith; Bruce, Martha L.

2010-01-01

Since Medicare first implemented the home care Outcome and Assessment Information Set (OASIS) in 1999, we have learned a great deal about depression among the homebound elderly. First, we know that major depression is a highly prevalent illness in home care. With depression rates at almost 15%, home care—along with nursing homes—has among the highest rates of any healthcare setting (Bruce et al., 2002; Parmelee et al., 1992; Jones et al., 2003).

Key factors influencing the implementation success of home telecare application.

NARCIS (Netherlands)

Postema, T.R.F.; Peeters, J.M.; Friele, R.D.

2012-01-01

Rationale: The introduction of home telecare in healthcare organizations has shown mixed results in practice. The aim of this study is to arrive at a set of key factors that can be used in further implementation of video communication. We argue that key factors are mainly found in the organizational

The use of advanced medical technologies at home : a systematic review of the literature

NARCIS (Netherlands)

Haken, ten I. (Ingrid); Ben Allouch, S. (Somaya); Harten, van W.H. (Wim)

2018-01-01

https://doi.org/10.1186/s12889-018-5123-4 Background: The number of medical technologies used in home settings has increased substantially over the last 10–15 years. In order to manage their use and to guarantee quality and safety, data on usage trends and practical experiences are important.

Older LGBT people's experiences and concerns with healthcare professionals and services in Ireland.

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Sharek, Danika Burke; McCann, Edward; Sheerin, Fintan; Glacken, Michele; Higgins, Agnes

2015-09-01

The specific healthcare needs and concerns for older lesbian, gay, bisexual and transgender (LGBT) persons have not been explored to any degree within Ireland. The aim of this paper, which is part of a larger study, is to detail older LGBT persons' usage, experiences and concerns with accessing healthcare services, disclosing their LGBT identity to professionals, preferences for care and their suggestions for improvement in services, including nursing services. A mixed methods research design combining quantitative survey and qualitative interview approaches of equal significance was used. 144 respondents completed an 84-item questionnaire concerning their use of healthcare services, experiences and needs. The qualitative phase involved in-depth interviews where 36 participants' experiences and concerns around health services were explored more in-depth. Quantitative data were analysed using descriptive statistics. Qualitative analysis employed the constant comparative process to generate the leading themes. Only one in three participants believed that healthcare professionals have sufficient knowledge of LGBT issues, and less than half (43%) felt respected as an LGBT person by healthcare professionals. Although 26% had chosen not to reveal their LGBT status for fear of a negative response, many positive encounters of coming out to healthcare professionals were relayed in the interviews. LGBT persons have specific concerns around residential care, particularly in relation to the perception that the Irish healthcare services emanate a heteronormative culture. Irish healthcare services need to reflect on how they currently engage with older LGBT persons at both an organisational and practitioner level. Consideration needs to be given to the specific concerns of ageing LGBT persons, particularly in relation to long-term residential care. Healthcare practitioners need to be knowledgeable of, and sensitive to, LGBT issues. © 2014 John Wiley & Sons Ltd.

A qualitative study of in-home robotic telepresence for home care of community-living elderly subjects

DEFF Research Database (Denmark)

Boissy, Patrice; Corriveau, Hélène; Michaud, François

2007-01-01

was illustrated using a photograph of a mobile robot, and participants were then asked to suggest potential health care applications. Interview data derived from the transcript of each group discussion were analyzed using qualitative induction based on content analysis. The analyses yielded statements that were...... categorized under three themes: potential applications, usability issues and user requirements. Teleoperated mobile robotic systems in the home were thought to be useful in assisting multidisciplinary patient care through improved communication between patients and healthcare professionals, and offering...

Measuring and modelling occupancy time in NHS continuing healthcare

Directory of Open Access Journals (Sweden)

Millard Peter H

2011-06-01

Full Text Available Abstract Background Due to increasing demand and financial constraints, NHS continuing healthcare systems seek to find better ways of forecasting demand and budgeting for care. This paper investigates two areas of concern, namely, how long existing patients stay in service and the number of patients that are likely to be still in care after a period of time. Methods An anonymised dataset containing information for all funded admissions to placement and home care in the NHS continuing healthcare system was provided by 26 (out of 31 London primary care trusts. The data related to 11289 patients staying in placement and home care between 1 April 2005 and 31 May 2008 were first analysed. Using a methodology based on length of stay (LoS modelling, we captured the distribution of LoS of patients to estimate the probability of a patient staying in care over a period of time. Using the estimated probabilities we forecasted the number of patients that are likely to be still in care after a period of time (e.g. monthly. Results We noticed that within the NHS continuing healthcare system there are three main categories of patients. Some patients are discharged after a short stay (few days, some others staying for few months and the third category of patients staying for a long period of time (years. Some variations in proportions of discharge and transition between types of care as well as between care groups (e.g. palliative, functional mental health were observed. A close agreement of the observed and the expected numbers of patients suggests a good prediction model. Conclusions The model was tested for care groups within the NHS continuing healthcare system in London to support Primary Care Trusts in budget planning and improve their responsiveness to meet the increasing demand under limited availability of resources. Its applicability can be extended to other types of care, such as hospital care and re-ablement. Further work will be geared towards

Considerations for the design of safe and effective consumer health IT applications in the home.

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Zayas-Cabán, Teresa; Dixon, Brian E

2010-10-01

Consumer health IT applications have the potential to improve quality, safety and efficiency of consumers' interactions with the healthcare system. Yet little attention has been paid to human factors and ergonomics in the design of consumer health IT, potentially limiting the ability of health IT to achieve these goals. This paper presents the results of an analysis of human factors and ergonomics issues encountered by five projects during the design and implementation of home-based consumer health IT applications. Agency for Healthcare Research and Quality-funded consumer health IT research projects, where patients used the IT applications in their homes, were reviewed. Project documents and discussions with project teams were analysed to identify human factors and ergonomic issues considered or addressed by project teams. The analysis focused on system design and design processes used as well as training, implementation and use of the IT intervention. A broad range of consumer health IT applications and diverse set of human factors and ergonomics issues were identified. The design and implementation processes used resulted in poor fit with some patients' healthcare tasks and the home environment and, in some cases, resulted in lack of use. Clinician interaction with patients and the information provided through health IT applications appeared to positively influence adoption and use. Consumer health IT application design would benefit from the use of human factors and ergonomics design and evaluation methods. Considering the context in which home-based consumer health IT applications are used will likely affect the ability of these applications to positively impact the quality, safety and efficiency of patient care.

The interdependent roles of patients, families and professionals in cystic fibrosis: a system for the coproduction of healthcare and its improvement.

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Sabadosa, Kathryn A; Batalden, Paul B

2014-04-01

A quality healthcare system is coproduced by patients, families and healthcare professionals working interdependently to cocreate and codeliver care. Cystic fibrosis (CF) patients and families rely on healthcare professionals to provide the best possible care and timely, accurate information. They know that the care at home and in clinical settings needs to be seamless, using shared information and decisions. A parent's journey of better care begins with her son's diagnosis and moves to her involvement to improve the systems and processes of care for others. She reflects on this work and identifies five elements that contributed to the coproduction of improved care: (1) mental and emotional readiness to engage; (2) curiosity and the search for insight; (3) reframe challenges into opportunities for improvement; (4) listen and learn from everyone, bringing home what is relevant; and (5) personal participation. Joined with the reflections of an improvement scientist, they note that chronic care relies on informed, activated patients and prepared, proactive healthcare professionals working together and that it is more than 'patient-centric'. They propose a model for the coimprovement of systems of care.

Gaming Device Usage Patterns Predict Internet Gaming Disorder: Comparison across Different Gaming Device Usage Patterns

OpenAIRE

Soo-Hyun Paik; Hyun Cho; Ji-Won Chun; Jo-Eun Jeong; Dai-Jin Kim

2017-01-01

Gaming behaviors have been significantly influenced by smartphones. This study was designed to explore gaming behaviors and clinical characteristics across different gaming device usage patterns and the role of the patterns on Internet gaming disorder (IGD). Responders of an online survey regarding smartphone and online game usage were classified by different gaming device usage patterns: (1) individuals who played only computer games; (2) individuals who played computer games more than smart...

Decontamination of breast pump milk collection kits and related items at home and in hospital: guidance from a Joint Working Group of the Healthcare Infection Society and Infection Prevention Society.

Science.gov (United States)

Price, E; Weaver, G; Hoffman, P; Jones, M; Gilks, J; O'Brien, V; Ridgway, G

2016-03-01

A variety of methods are in use for decontaminating breast pump milk collection kits and related items associated with infant feeding. This paper aims to provide best practice guidance for decontamination of this equipment at home and in hospital. It has been compiled by a Joint Working Group of the Healthcare Infection Society and the Infection Prevention Society. The guidance has been informed by a search of the literature in Medline, the British Nursing Index, the Cumulative Index to Nursing and Allied Health Literature, Midwifery and Infant Care, and the results of two surveys of UK neonatal units in 2002/3 and 2006, and of members of the Infection Prevention Society in 2014. Since limited good quality evidence was available from these sources, much of the guidance represents good practice based on the consensus view of the Working Group. This guidance provides practical recommendations to support the safe decontamination of breast pump milk collection kits for healthcare professionals to use and communicate to other groups such as parents and carers. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Living and dying: responsibility for end-of-life care in care homes without on-site nursing provision - a prospective study

OpenAIRE

Handley, M; Goodman, C; Froggatt, K; Mathie, E; Gage, H; Manthorpe, J; Barclay, S; Crang, C; Iliffe, S

2014-01-01

The aim of the study was to describe the expectations and experiences of end-of-life care of older people resident in care homes, and how care home staff and the healthcare practitioners who visited the care home interpreted their role. A mixed-method design was used. The everyday experience of 121 residents from six care homes in the East of England were tracked; 63 residents, 30 care home staff with assorted roles and 19 National Health Service staff from different disciplines were intervie...

Physical exercise at the workplace prevents deterioration of work ability among healthcare workers

DEFF Research Database (Denmark)

Jakobsen, Markus D.; Sundstrup, Emil; Brandt, Mikkel

2015-01-01

BACKGROUND: Imbalance between individual resources and work demands can lead to musculoskeletal disorders and reduced work ability. The purpose of this study was to investigate the effect of workplace- versus home-based physical exercise on work ability among healthcare workers. METHODS: Two......) performed during working hours for 5x10 min per week and up to 5 group-based coaching sessions on motivation for regular physical exercise, or 2) home-based physical exercise (HOME) performed during leisure time for 5x10 min per week. Both groups received ergonomic counseling on patient handling and use...... of lifting aides. The main outcome measure was the change from baseline to 10-week follow-up in WAI. RESULTS: Significant group by time interaction was observed for WAI (p 

[Considering body ethics in the healthcare profession].

Science.gov (United States)

Wang, Shin-Yun

2014-10-01

This article uses the theory of body phenomenology and Watson's caring theory to develop and apply body ethics to the clinical healthcare profession. This attempt is meant to facilitate deep, humanistic experiences for healthcare personnel. The analysis of body phenomenology reveals that the soul is banished from her familiar and comfortable "at-home" status when illness and pain invade the body. In such situations, the body becomes an external object that is self-alienated. This experience induces experiences such as solitude and violence. However, it also holds the potential to expose the original morality of the body. Additionally, this article discusses popular tools used in clinical ethics such as principalism and virtual-based ethics, which are based on moral reasoning and moral feeling. In contrast to these, body ethics seek a more profound and humble level of sensibility that is able to implant authenticity into the ethics. Finally, we offer some suggestions related to Watson's caring theory.

Development of Home-Based Sleep Monitoring System for Obstructive Sleep Apnea.

Science.gov (United States)

Wu, Peirong; Chen, Guan-Ting; Cui, Yanyan; Li, Jin-Wei; Kuo, Terry B J; Chang, Polun

2017-01-01

Obstructive Sleep Apnea (OSA) has been proven to increase the risk of high blood pressure, heart attack, stroke, obesity, and diabetes. If people would like to know whether they are suffering from this sleep disorder, they need to go to particular hospital with which a sleep center that could perform polysomnography (PSG); however, for most people, this is not convenient. Consequently, the goal of this study is to develop a convenient, lower priced, and easy-to-use home-based sleep monitoring system. The researchers have developed the "Sleep Healthcare Management System" for OSA patients and healthcare providers. It combines smartphone and wearable devices that can perform real-time sleep monitoring. Healthcare providers could apply their professional knowledge to provide customized feedback via a web application. When the patient is diagnosed with an abnormal sleep health condition, healthcare providers may be able to provide appropriate and timely care.

Web-based integrated public healthcare information system of Korea: development and performance.

Science.gov (United States)

Ryu, Seewon; Park, Minsu; Lee, Jaegook; Kim, Sung-Soo; Han, Bum Soo; Mo, Kyoung Chun; Lee, Hyung Seok

2013-12-01

The Web-based integrated public healthcare information system (PHIS) of Korea was planned and developed from 2005 to 2010, and it is being used in 3,501 regional health organizations. This paper introduces and discusses development and performance of the system. We reviewed and examined documents about the development process and performance of the newly integrated PHIS. The resources we analyzed the national plan for public healthcare, information strategy for PHIS, usage and performance reports of the system. The integrated PHIS included 19 functional business areas, 47 detailed health programs, and 48 inter-organizational tasks. The new PHIS improved the efficiency and effectiveness of the business process and inter-organizational business, and enhanced user satisfaction. Economic benefits were obtained from five categories: labor, health education and monitoring, clinical information management, administration and civil service, and system maintenance. The system was certified by a patent from the Korean Intellectual Property Office and accredited as an ISO 9001. It was also reviewed and received preliminary comments about its originality, advancement, and business applicability from the Patent Cooperation Treaty. It has been found to enhance the quality of policy decision-making about regional healthcare at the self-governing local government level. PHIS, a Web-based integrated system, has contributed to the improvement of regional healthcare services of Korea. However, when it comes to an appropriate evolution, the needs and changing environments of community-level healthcare service and IT infrastructure should be analyzed properly in advance.

Optimizing medication safety in the home.

Science.gov (United States)

LeBlanc, Raeanne Genevieve; Choi, Jeungok

2015-06-01

Medication safety among community-dwelling older adults in the United States is an ongoing health issue impacting health outcomes, chronic disease management, and aging in place at home. This article describes a medication safety improvement project that aimed to: (1) Increase the ability of participants to manage medications, (2) Identify and make necessary medication changes, (3) Create an accurate up-to-date medication list to be available in the home, and (4) Provide communication between the primary care provider, participant, and case manager. An in-home medication assessment was completed for 25 participants using an evidence-based medication management software system. This process was used to review medications; identify medication-related problems; create a shared medication list; and convey this information to the primary care provider, case manager, and client while addressing needed medication changes. Educational interventions on management and understanding of medications were provided to participants to emphasize the correct use of medications and use of a personal medication record. Outcome improvements included provision of an accurate medication list, early identification of medication-related problems, identification of drug duplication, and identification of medication self-management challenges that can be useful for optimizing medication safety-related home healthcare and inform future interventions.

Korean parents’ perceptions on the importance of computer usage for themselves and their children: An exploratory study

Directory of Open Access Journals (Sweden)

Hee Jeong LIM

2009-03-01

Full Text Available Many families today have access to computers that help them with their daily living activities, such asfinding employment and helping children with schoolwork. Minority families residing in the United Statesthough often do not own home computers. With a greater number of immigrant families arriving to theUnited States, questions are raised whether parents unfamiliar with the new culture view computers asimportant teaching tools for themselves and their children. An exploratory study was conducted lookingat Korean parents whose children were enrolled in a Southern California elementary school, since thisminority group consistently falls within the top ten immigrant sending countries. The study’s purpose wasto examine parent perceptions on the importance placed on computer usage for themselves and theirchildren. Findings suggest that Korean parents place a high value on computer usage and see it as vitalto job success and academic achievement.

Prospective study of determinants and costs of home births in Mumbai slums

Directory of Open Access Journals (Sweden)

Das Sushmita

2010-07-01

Full Text Available Abstract Background Around 86% of births in Mumbai, India, occur in healthcare institutions, but this aggregate figure hides substantial variation and little is known about urban home births. We aimed to explore factors influencing the choice of home delivery, care practices and costs, and to identify characteristics of women, households and the environment which might increase the likelihood of home birth. Methods As part of the City Initiative for Newborn Health, we used a key informant surveillance system to identify births prospectively in 48 slum communities in six wards of Mumbai, covering a population of 280 000. Births and outcomes were documented prospectively by local women and mothers were interviewed in detail at six weeks after delivery. We examined the prevalence of home births and their associations with potential determinants using regression models. Results We described 1708 (16% home deliveries among 10 754 births over two years, 2005-2007. The proportion varied from 6% to 24%, depending on area. The most commonly cited reasons for home birth were custom and lack of time to reach a healthcare facility during labour. Seventy percent of home deliveries were assisted by a traditional birth attendant (dai, and 6% by skilled health personnel. The median cost of a home delivery was US$ 21, of institutional delivery in the public sector US$ 32, and in the private sector US$ 118. In an adjusted multivariable regression model, the odds of home delivery increased with illiteracy, parity, socioeconomic poverty, poorer housing, lack of water supply, population transience, and hazardous location. Conclusions We estimate 32 000 annual home births to residents of Mumbai's slums. These are unevenly distributed and cluster with other markers of vulnerability. Since cost does not appear to be a dominant disincentive to institutional delivery, efforts are needed to improve the client experience at public sector institutions. It might also be

Psychosocial Status and Economic Dependence for Healthcare and Nonhealthcare among Elderly Population in Rural Coastal Karnataka.

Science.gov (United States)

Rent, Priyanka Dsouza; Kumar, Sudeep; Dmello, Mackwin Kenwood; Purushotham, Jagannath

2017-01-01

The elderly who will constitute 10% of the Indian population by 2021 face problems such as deteriorating healthcare status, loneliness, and economic constraints among others. All these factors together may affect the psychosocial status of the elderly and their health-seeking behavior. With this background, the current study tried to evaluate the psychosocial status, economic dependence for health and nonhealth expenses and awareness regarding geriatric welfare services (GWS) among elderly patients. The study was carried out among 599 men and women aged above 60 who visited rural healthcare centers in two districts of Karnataka during September-December 2016. A semi-structured interview schedule was administered by a trained medical professional after taking informed consent. Majority of the respondents said that they had company at home, interacted with people outside home and that their advice was honored. About 75.8% of the respondents reported that they were either partially or completely financially dependent on someone else. The mean cost of hospitalization was reported to be Rs. 11,086. Majority of those hospitalized depended on their children to pay for healthcare (66.9%), whereas 16.9% had availed government insurance schemes and 14.6% paid out of pocket. Nearly 64.9% of the respondents were aware of the GWS while 32.6% had used them. The absence of financial risk pooling mechanisms and social support may cause elderly to forego treatment because of the need to pay for healthcare and further deteriorate their psychosocial status. Government initiatives to improve healthcare and social services to the elderly maybe advocated.

Field Evaluation of Advances in Energy-Efficiency Practices for Manufactured Homes

Energy Technology Data Exchange (ETDEWEB)

Levy, E. [Advanced Residential Integrated Energy Solutions (ARIES) Collaboration, New York, NY (United States); Dentz, J. [Advanced Residential Integrated Energy Solutions (ARIES) Collaboration, New York, NY (United States); Ansanelli, E. [Advanced Residential Integrated Energy Solutions (ARIES) Collaboration, New York, NY (United States); Barker, G. [Advanced Residential Integrated Energy Solutions (ARIES) Collaboration, New York, NY (United States); Rath, P. [Advanced Residential Integrated Energy Solutions (ARIES) Collaboration, New York, NY (United States); Dadia, D. [Advanced Residential Integrated Energy Solutions (ARIES) Collaboration, New York, NY (United States)

2016-03-01

Three side-by-side lab houses were built, instrumented and monitored in an effort to determine through field testing and analysis the relative contributions of select technologies toward reducing energy use in new manufactured homes. The lab houses in Russellville, Alabama compared the performance of three homes built to varying levels of thermal integrity and HVAC equipment: a baseline HUD-code home equipped with an electric furnace and a split system air conditioner; an ENERGY STAR manufactured home with an enhanced thermal envelope and traditional split system heat pump; and a house designed to qualify for Zero Energy Ready Home designation with a ductless mini-split heat pump with transfer fan distribution system in place of the traditional duct system for distribution. Experiments were conducted in the lab houses to evaluate impact on energy and comfort of interior door position, window blind position and transfer fan operation. The report describes results of tracer gas and co-heating tests and presents calculation of the heat pump coefficient of performance for both the traditional heat pump and the ductless mini-split. A series of calibrated energy models was developed based on measured data and run in three locations in the Southeast to compare annual energy usage of the three homes.

An ethical analysis of a home visit case study.

Science.gov (United States)

Pibernat, Artur Dalfó; Vidal, Jessica Rosell; Pibernat, Enric Dalfó; Rodríguez, Francisco Javier Pelegrina; Colomer, Gerard; Cid, Maria Feijoo

2017-12-01

This article will explore a clinical case study of a home visit carried out by the case manager nurse. In this case, we will discuss the dilemma of finding the balance between autonomy and beneficence from the perspective of principlist ethics, virtue ethics and the 'ethics of care'. The main conflict in this case study deals with all proposals are unsuitable and it is not necessary for a nurse to pay him a home visit, whereas for the healthcare system it is considered necessary. We could conclude that, during the home visit, the case manager aspires to achieve excellence, and throughout his clinical relationship with Francesc, searches for a series of virtues, respecting certain fundamental principles. In this way, the case managers ensure that Jaume's care is more humanised. The case has been anonymised and confidentiality maintained.

Cloud Image Data Center for Healthcare Network in Taiwan.

Science.gov (United States)

Weng, Shao-Jen; Lai, Lai-Shiun; Gotcher, Donald; Wu, Hsin-Hung; Xu, Yeong-Yuh; Yang, Ching-Wen

2016-04-01

This paper investigates how a healthcare network in Taiwan uses a practical cloud image data center (CIDC) to communicate with its constituent hospital branches. A case study approach was used. The study was carried out in the central region of Taiwan, with four hospitals belonging to the Veterans Hospital healthcare network. The CIDC provides synchronous and asynchronous consultation among these branches. It provides storage, platforms, and services on demand to the hospitals. Any branch-client can pull up the patient's medical images from any hospital off this cloud. Patients can be examined at the branches, and the images and reports can be further evaluated by physicians in the main Taichung Veterans General Hospital (TVGH) to enhance the usage and efficiency of equipment in the various branches, thereby shortening the waiting time of patients. The performance of the CIDC over 5 years shows: (1) the total number of cross-hospital images accessed with CDC in the branches was 132,712; and (2) TVGH assisted the branches in keying in image reports using the CIDC 4,424 times; and (3) Implementation of the system has improved management, efficiency, speed and quality of care. Therefore, the results lead to the recommendation of continuing and expanding the cloud computing architecture to improve information sharing among branches in the healthcare network.

Home or foster home care versus institutional long-term care for functionally dependent older people.

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Young, Camilla; Hall, Amanda M; Gonçalves-Bradley, Daniela C; Quinn, Terry J; Hooft, Lotty; van Munster, Barbara C; Stott, David J

2017-04-03

Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this will reduce costs and improve the quality of care compared. To assess the effects of long-term home or foster home care versus institutional care for functionally dependent older people. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Library, MEDLINE, Embase, CINAHL, and two trials registers to November 2015. We included randomised and non-randomised trials, controlled before-after studies and interrupted time series studies complying with the EPOC study design criteria and comparing the effects of long-term home care versus institutional care for functionally dependent older people. Two reviewers independently extracted data and assessed the risk of bias of each included study. We reported the results narratively, as the substantial heterogeneity across studies meant that meta-analysis was not appropriate. We included 10 studies involving 16,377 participants, all of which were conducted in high income countries. Included studies compared community-based care with institutional care (care homes). The sample size ranged from 98 to 11,803 (median N = 204). There was substantial heterogeneity in the healthcare context, interventions studied, and outcomes assessed. One study was a randomised trial (N = 112); other included studies used designs that had potential for bias, particularly due lack of randomisation, baseline imbalances, and non-blinded outcome assessment. Most studies did not select (or exclude) participants for any specific disease state, with the exception of one study that only included patients if they had a stroke. All studies had methodological limitations, so readers should interpret results with caution.It is uncertain

Fixing the broken image of care homes, could a 'care home innovation centre' be the answer?

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Hockley, Jo; Harrison, Jennifer Kirsty; Watson, Julie; Randall, Marion; Murray, Scott

2017-03-01

The UK has many excellent care homes that provide high-quality care for their residents; however, across the care home sector, there is a significant need for improvement. Even though the majority of care homes receive a rating of 'good' from regulators, still significant numbers are identified as requiring 'improvement' or are 'inadequate'. Such findings resonate with the public perceptions of long-term care as a negative choice, to be avoided wherever possible-as well as impacting on the career choices of health and social care students. Projections of current demographics highlight that, within 10 years, the part of our population that will be growing the fastest will be those people older than 80 years old with the suggestion that spending on long-term care provision needs to rise from 0.6% of our Gross Domestic Product in 2002 to 0.96% by 2031. Teaching/research-based care homes have been developed in the USA, Canada, Norway, the Netherlands and Australia in response to scandals about care, and the shortage of trained geriatric healthcare staff. There is increasing evidence that such facilities help to reduce inappropriate hospital admissions, increase staff competency and bring increased enthusiasm about working in care homes and improve the quality of care. Is this something that the UK should think of developing? This commentary details the core goals of a Care Home Innovation Centre for training and research as a radical vision to change the culture and image of care homes, and help address this huge public health issue we face. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Pain Intervention for people with Dementia in nursing homes (PID): study protocol for a quasi-experimental nurse intervention.

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Koppitz, Andrea; Bosshard, Georg; Blanc, Geneviève; Hediger, Hannele; Payne, Sheila; Volken, Thomas

2017-04-21

It is estimated that 19 to 83% of people with dementia suffer from pain that is inadequately treated in the last months of life. A large number of healthcare workers who care for these people in nursing homes lack appropriate expertise and may therefore not always recognise, assess and treat pain in those with dementia who have complex problems on time, properly and efficiently. The aim of this intervention trial is to identify care needs of people with dementia suffering from pain living in a nursing home. A quasi-experimental nurse-led intervention trial based on a convenience sample of four nursing homes in the Swiss Canton of Zurich examines the effects on dementia patients (n = 411), the healthcare institution and the qualification level of the healthcare workers compared to historical controls, using an event analysis and a multilevel analysis. Healthcare workers will be individually trained how to assess, intervene and evaluate acute and chronic pain. There are three data-monitoring cycles (T0, T1, T2) and two intervention cycles (I1, I2) with a total study duration of 425 days. There is also a process evaluation based on Dobbins analyses that analyse in particular the potentials for change in clinical practice of change agents. The aim of the intervention trial is to improve pain management strategies in older people with dementia in nursing homes. Clinically significant findings will be expected that will help reduce suffering in the sense of "total pain" for people with dementia. The joint intra- and interdisciplinary collaboration between practice and supply-oriented (nursing) research will have both a lasting effect on the efficiency measurement and provide scientifically sound results. Nursing homes can integrate the findings from the intervention trial into their internal quality control process. The potential for improvements can be directly influenced by the nursing home itself. Registration trial number: DRKS00009726 on DRKS, registered 10

Key factors influencing the implementation success of a home telecare application.

NARCIS (Netherlands)

Postema, T.R.F.; Peeters, J.M.; Freide, R.D.

2012-01-01

Rationale The introduction of home telecare in healthcare organizations has shown mixed results in practice. The aim of this study is to arrive at a set of key factors that can be used in further implementation of video communication. We argue that key factors are mainly found in the organizational

Virtual Video Prototyping for Healthcare Systems

DEFF Research Database (Denmark)

Bardram, Jakob Eyvind; Bossen, Claus; Lykke-Olesen, Andreas

2002-01-01

Virtual studio technology enables the mixing of physical and digital 3D objects and thus expands the way of representing design ideas in terms of virtual video prototypes, which offers new possibilities for designers by combining elements of prototypes, mock-ups, scenarios, and conventional video....... In this article we report our initial experience in the domain of pervasive healthcare with producing virtual video prototypes and using them in a design workshop. Our experience has been predominantly favourable. The production of a virtual video prototype forces the designers to decide very concrete design...... issues, since one cannot avoid paying attention to the physical, real-world constraints and to details in the usage-interaction between users and technology. From the users' perspective, during our evaluation of the virtual video prototype, we experienced how it enabled users to relate...

Two-year mortality, complications, and healthcare use in children with medicaid following tracheostomy.

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Watters, Karen; O'Neill, Margaret; Zhu, Hannah; Graham, Robert J; Hall, Matthew; Berry, Jay

2016-11-01

To assess patient characteristics associated with adverse outcomes in the first 2 years following tracheostomy, and to report healthcare utilization and cost of caring for these children. Retrospective cohort study. Children (0-16 years) in Medicaid from 10 states undergoing tracheostomy in 2009, identified with International Classification of Diseases, Ninth Revision, Clinical Modification procedure codes and followed through 2011, were selected using the Truven Health Medicaid Marketscan Database (Truven Health Analytics, Inc., Ann Arbor, MI). Patient demographic and clinical characteristics were assessed with likelihood of death and tracheostomy complication using chi-square tests and logistic regression. Healthcare use and spending across the care continuum (hospital, outpatient, community, and home) were reported. A total of 502 children underwent tracheostomy in 2009, with 34.1% eligible for Medicaid because of disability. Median age at tracheostomy was 8 years (interquartile range 1-16 years), and 62.7% had a complex chronic condition. Two-year rates of in-hospital mortality and tracheostomy complication were 8.9% and 38.8%, respectively. In multivariable analysis, the highest likelihood of mortality occurred in children age tracheostomy complication was in children with a complex chronic condition versus those without a complex chronic condition (OR 3.3; 95% CI, 1.1-9.9). Total healthcare spending in the 2 years following tracheostomy was $53.3 million, with hospital, home, and primary care constituting 64.4%, 9.4%, and 0.5% of total spending, respectively. Mortality and morbidity are high, and spending on primary and home care is small following tracheostomy in children with Medicaid. Future studies should assess whether improved outpatient and community care might improve their health outcomes. 4. Laryngoscope, 126:2611-2617, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Discourses of healthcare professionals about health surveillance actions for Tuberculosis control

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Fernando Mitano

Full Text Available Abstract OBJECTIVE To analyze the meanings produced in the Health Surveillance actions for tuberculosis control, carried out by healthcare professionals in Mozambique. METHOD Qualitative study using the theoretical and methodological framework of the French Discourse Analysis. RESULTS A total of 15 healthcare professionals with more than one year of experience in disease control actions participated in the study. Four discursive blocks have emerged from the analysis: tuberculosis diagnosis process; meeting, communication and discussion of treatment; local strategies for tuberculosis control; involvement of family and community leaders in the tuberculosis control. CONCLUSION The statements of the healthcare professionals suggest, as Health Surveillance actions, practices that include collecting sputum in the patient's home and sending it to the laboratory; deployment of the medical team with a microscope for tuberculosis testing; and testing for diseases that may be associated with tuberculosis. In this context, the actions of Health Surveillance for tuberculosis control involve valuing all actors: family, community leaders, patients and health professionals.

Keeping pace with the ebbs and flows in daily nursing home operations

NARCIS (Netherlands)

Bekker, René; Moeke, Dennis; Schmidt, Bas

2018-01-01

Nursing homes are challenged to develop staffing strategies that enable them to efficiently meet the healthcare demand of their residents. In this study, we investigate how demand for care and support fluctuates over time and during the course of a day, using demand data from three independent

Risks, consequences, and prevention of falls of older people in oral healthcare centers.

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de Baat, Cees; de Baat, Paul; Gerritsen, Anneloes E; Flohil, Karien A; van der Putten, Gert-Jan; van der Maarel-Wierink, Claar D

2017-03-01

One-third of community-dwelling people older than 65 years of age fall each year, and half of them fall at least twice a year. Older care home residents are approximately three times more likely to fall when compared to community-dwelling older people. Risk indicators for falls are related to the older people's body, environment, behavior, and activities. An important health risk indicator is (orthostatic or postprandial) hypotension, which may induce cerebral hypoperfusion. Although the majority of falls remain without major consequences, 10% to 25% of falls in care homes result in bodily trauma. Prevalent fall-related injuries are brain injury, lower extremity fracture including hip fracture and forearm/wrist fracture, facial fracture, humeral fracture, and rib/scapular fracture. As fall accidents by older people can have severe consequences, prevention of falls is of paramount importance. Healthcare providers, including oral healthcare providers, should inform older people on risks of falling and draw attention to potentially hazardous arrangements. © 2016 Special Care Dentistry Association and Wiley Periodicals, Inc.

Codon usage bias and the evolution of influenza A viruses. Codon Usage Biases of Influenza Virus

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Wong Emily HM

2010-08-01

Full Text Available Abstract Background The influenza A virus is an important infectious cause of morbidity and mortality in humans and was responsible for 3 pandemics in the 20th century. As the replication of the influenza virus is based on its host's machinery, codon usage of its viral genes might be subject to host selection pressures, especially after interspecies transmission. A better understanding of viral evolution and host adaptive responses might help control this disease. Results Relative Synonymous Codon Usage (RSCU values of the genes from segment 1 to segment 6 of avian and human influenza viruses, including pandemic H1N1, were studied via Correspondence Analysis (CA. The codon usage patterns of seasonal human influenza viruses were distinct among their subtypes and different from those of avian viruses. Newly isolated viruses could be added to the CA results, creating a tool to investigate the host origin and evolution of viral genes. It was found that the 1918 pandemic H1N1 virus contained genes with mammalian-like viral codon usage patterns, indicating that the introduction of this virus to humans was not through in toto transfer of an avian influenza virus. Many human viral genes had directional changes in codon usage over time of viral isolation, indicating the effect of host selection pressures. These changes reduced the overall GC content and the usage of G at the third codon position in the viral genome. Limited evidence of translational selection pressure was found in a few viral genes. Conclusions Codon usage patterns from CA allowed identification of host origin and evolutionary trends in influenza viruses, providing an alternative method and a tool to understand the evolution of influenza viruses. Human influenza viruses are subject to selection pressure on codon usage which might assist in understanding the characteristics of newly emerging viruses.

Freedom and Confinement: Patients’ Experiences of Life with Home Haemodialysis

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C. Vestman

2014-01-01

Full Text Available Patients with chronic end stage renal disease need dialysis to survive; however, they also need a treatment that suits their life situation. It is important that healthcare providers provide reliable, up-to-date information about different dialysis treatment options. Since home haemodialysis is a relatively new treatment, it is necessary to gather more knowledge about what the treatment entails from the patient’s perspective. The aim of this study was to describe patients’ experiences of having home haemodialysis. To gain access to the patients’ experiences, they were asked to write narratives, which describe both their good and bad experiences of life with the treatment. The narratives were analysed with a qualitative method. The results of this analysis are subdivided into five themes: freedom to be at home and control their own treatment, feeling of being alone with the responsibility, changes in the home environment, need for support, and security and well-being with home haemodialysis. The conclusion is that home haemodialysis provides a certain level of freedom, but the freedom is limited as the treatment itself is restrictive. In order to improve patients’ experiences with home haemodialysis, more research based on patients’ experiences is needed and it is necessary to involve the patients in the development of the care.

Frequency of Hospital Use Before and After Home-Delivery Meal by Meals On Wheels, of Tarrant County, Texas.

Science.gov (United States)

Cho, J; Thorud, J L; Marishak-Simon, S; Hammack, L; Stevens, A B

2018-01-01

Patients recently discharged from the hospital are vulnerable and are at high risk for readmission. Home-delivered meals may be beneficial in improving their health and facilitating independent living in the community. The purpose of this study was to identify the association between home-delivered meals and use of hospital services. This study includes 120 clients recently discharged from an inpatient hospital stay or from an emergency department (ED) visit who received meal services from Meals On Wheels, Inc., of Tarrant County. Healthcare utilization data was extracted from the Dallas-Fort Worth Hospital Council Foundation, a regional all claims database used by over 90% of hospitals in Dallas-Fort Worth area. Signed tests and generalized linear models (GLM) were performed. A total of 16,959 meals were delivered from March 2013 through March 2014. Each client received an average of 6.19 meals per week. The average number of ED visits decreased from 5.03 before receipt of meals to 1.45 after receipt of meals, z = -5.23, p meals were less likely to experience ED visits and hospitalizations after controlling for demographic characteristics and levels of physical functioning. The findings of this study indicate that home-delivered meals services may contribute to a reduction in hospital based care services among frail and vulnerable adults. Additional studies should consider the short and long-term effects of home-delivered meals services on healthcare utilization and the potential to decrease healthcare costs.

[The influence of leadership experience on the style of resolving management decisions by executives of healthcare institutions].

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Vezhnovets', T A

2013-12-01

The aim of our study was to examine the influence of age and management experience of executives in healthcare institutions at the style of decision-making. The psychological study of 144 executives was conducted. We found out that the age of executives in healthcare institutions does not affect the style of managerial decision making, while experience in leadership position does. Also it was established that the more experienced leader is, the more often he will make decision in authoritative, autonomous, marginal style and the less management experience is, the more likely is the usage of indulgent and situational style. Moreover, the authoritarian style is typical for younger executives, marginal and autonomous is typical for elder executives.

Retrofitting a 1960s Split-Level, Cold-Climate Home

Energy Technology Data Exchange (ETDEWEB)

Puttagunta, Srikanth [Consortium for Advanced Residential Buildings, Norwalk, CT (United States)

2015-07-01

National programs such as Home Performance with ENERGY STAR® and numerous other utility air sealing programs have brought awareness to homeowners of the benefits of energy efficiency retrofits. Yet, these programs tend to focus on the low-hanging fruit: air-sealing the thermal envelope and ductwork where accessible, switch to efficient lighting, and low-flow fixtures. At the other end of the spectrum, deep-energy retrofit programs are also being encouraged by various utilities across the country. While deep energy retrofits typically seek 50% energy savings, they are often quite costly and most applicable to gut-rehab projects. A significant potential for lowering energy usage in existing homes lies between the low hanging fruit and deep energy retrofit approaches - retrofits that save approximately 30% in energy over the existing conditions. A key is to be non-intrusive with the efficiency measures so the retrofit projects can be accomplished in occupied homes. This cold climate retrofit project involved the design and optimization of a home in Connecticut that sought to improve energy savings by at least 30% (excluding solar PV) over the existing home's performance. This report documents the successful implementation of a cost-effective solution package that achieved performance greater than 30% over the pre-retrofit - what worked, what did not, and what improvements could be made.

The Design and Analysis of a Secure Personal Healthcare System Based on Certificates

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Jungho Kang

2016-11-01

Full Text Available Due to the development of information technology (IT, it has been applied to various fields such as the smart home, medicine, healthcare, and the smart car. For these fields, IT has been providing continuous prevention and management, including health conditions beyond the mere prevention of disease, improving the quality of life. e-Healthcare is a health management and medical service to provide prevention, diagnosis, treatment, and the follow-up management of diseases at any time and place in connection with information communication technology, without requiring patients to visit hospitals. However, e-Healthcare has been exposed to eavesdropping, manipulation, and the forgery of information that is personal, biological, medical, etc., and is a security threat from malicious attackers. This study suggests a security service model to exchange personal health records (PHRs for e-Healthcare environments. To be specific, this study suggests a scheme in which communicators are able to securely authorize and establish security channels by constituting the infrastructure each organization relies on. In addition, the possibility of establishing a security service model is indicated by suggesting an e-Healthcare system for a secure e-Healthcare environment as a secure personal health record system. This is anticipated to provide securer communication in e-Healthcare environments in the future through the scheme suggested in this study.

Home Healthcare Program for Soil-Transmitted Helminthiasis in Schoolchildren along the Mekong River Basin.

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Kaewpitoon, Soraya J; Loyd, Ryan A; Kaewpitoon, Natthawut

2015-05-01

Soil-transmitted helminths (STH) are among the most important groups of infectious agents responsible for physical and intellectual growth retardation in children worldwide. Current status is need requiredfor the development of control programs. To determine the STH infections among the schoolchildren in the Mekong River basin near rural Ubon Ratchathani, Thailand and Champassak, Laos PDR, including their caregiver knowledge and attitude concerning prevention of STH infections. A cross sectional survey was designed as a home healthcare programfrom October 2009 to April 2012. 1,957 fecal samples were collected from children aged 5-12 years in five districts of Ubon Ratchathani province (1,012 fecal samples; Khong Chiam, Si Mueang Mai, Phibun Mangsahan, Sirindhorn, and Pho Sai), Thailand, and one district of Champassak Province (945 fecal samples; Pakse), Lao PDR. Fecal samples were prepared by the modified formalin ethylacetate concentration technique, and determined by light microscope. The knowledge and attitude of children's caregivers concerning prevention of soil-transmitted helminth infections were completed interviewed by semi-structured questionnaires. The overall intestinal helminth prevalence rate was 11.88%. Classified by species the STHs were as follows: Ascaris lumbricoides (30.9%), Trichuris trichiura (21.7%), and hookworm (20.5%). The highest prevalence was recorded in children aged 9 years and above. The highest prevalence of STH infection was found in the Pakse district of Laos PDR (16.08%). The intensities of infection with A. lumbricoides, T trichiura, and Hookworm were 1.82 ± 0.36, 1.32 ± 0.30, and 1.29 ± 0.32, respectively. 1,077 of caregivers were completed interviewed and found that the caregivers had fair levels of knowledge and attitude regarding soil-transmitted helminthiasis. These results suggest that priority should be given to STH eradication, the development of control programs in the Mekong River Basin, and the provision of

A Smart Telecare System at Digital Home: Perceived Usefulness, Satisfaction, and Expectations for Healthcare Professionals

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Laura Vadillo

2017-01-01

Full Text Available Sensors, combined with intelligent systems, can enhance the quality of the Telecare services deployed at home, improving the capability for detection of risk situations and the users care. However, there are no specific studies that evaluate this kind of Telecare systems by professionals that work in a Telecare center. This paper shows the results of an assessment of the current satisfaction and future expectations of the Telecare professionals when using advanced Telecare solutions deployed at home. The study has been conducted through structured interviews with 24 Telecare experts working in the Telecare center of the Spanish Red Cross for attending alarm calls for elderly people. The interviews had the support of the TALISMAN Telecare system that is a next-generation Telecare service deployed in the accessible digital home of Universidad Politécnica de Madrid. All participants showed overall satisfaction with TALISMAN and their intention to use it. Results showed that perceived usefulness is an important influencing factor to the intention to use it and the Quality of the Information is a key factor in the perceived usefulness. TALISMAN, as an example of a next-generation Telecare system, is seen as a tool with high potential for improving the care of elderly people at home.

HEP@Home - A distributed computing system based on BOINC

CERN Document Server

Amorim, A; Andrade, P; Amorim, Antonio; Villate, Jaime; Andrade, Pedro

2005-01-01

Project SETI@HOME has proven to be one of the biggest successes of distributed computing during the last years. With a quite simple approach SETI manages to process large volumes of data using a vast amount of distributed computer power. To extend the generic usage of this kind of distributed computing tools, BOINC is being developed. In this paper we propose HEP@HOME, a BOINC version tailored to the specific requirements of the High Energy Physics (HEP) community. The HEP@HOME will be able to process large amounts of data using virtually unlimited computing power, as BOINC does, and it should be able to work according to HEP specifications. In HEP the amounts of data to be analyzed or reconstructed are of central importance. Therefore, one of the design principles of this tool is to avoid data transfer. This will allow scientists to run their analysis applications and taking advantage of a large number of CPUs. This tool also satisfies other important requirements in HEP, namely, security, fault-tolerance an...

Swedish healthcare providers' perceptions of preconception expanded carrier screening (ECS)-a qualitative study.

Science.gov (United States)

Matar, A; Kihlbom, U; Höglund, A T

2016-07-01

Reproductive autonomy, medicalization, and discrimination against disabled and parental responsibility are the main ongoing ethical debates concerning reproductive genetic screening. To examine Swedish healthcare professionals' views on preconception expanded carrier screening (ECS), a qualitative study involving academic and clinical institutions in Sweden was conducted in September 2014 to February 2015. Eleven healthcare professionals including clinicians, geneticists, a midwife, and a genetic counselor were interviewed in depth using a semi-structured interview guide. The questionnaire was constructed after reviewing the main literature and meetings with relevant healthcare providers. The interviews were recorded, transcribed verbatim, and content analyzed for categories and subcategories. Participants nurtured many ethical and non-ethical concerns regarding preconception ECS. Among the ethical concerns were the potential for discrimination, medicalization, concerns with prioritization of healthcare resources, and effects on reproductive freedom. The effects of implementation of preconception ECS, its stakeholders, regulations, and motivation are some of non-ethical concerns. These concerns, if not addressed, may affect the uptake and usage of carrier screening within Swedish healthcare system. As this is a qualitative study with a small non-random sample size, the findings cannot be generalized. The participants had little to no working experience with expanded screening panels. Moreover, the interviews were conducted in English, a second language for the participants, which might have limited the expression of their views. However, the authors claim that the findings may be pertinent to similar settings in other Scandinavian countries.

Home Palliative Care for Patients with Advanced Chronic Kidney Disease: Preliminary Results

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José L. Teruel

2015-10-01

Full Text Available Healthcare for patients with advanced chronic kidney disease (ACKD on conservative treatment very often poses healthcare problems that are difficult to solve. At the end of 2011, we began a program based on the care and monitoring of these patients by Primary Care Teams. ACKD patients who opted for conservative treatment were offered the chance to be cared for mainly at home by the Primary Care doctor and nurse, under the coordination of the Palliative Care Unit and the Nephrology Department. During 2012, 2013, and 2014, 76 patients received treatment in this program (mean age: 81 years; mean Charlson age-comorbidity index: 10, and mean glomerular filtration rate: 12.4 mL/min/1.73 m2. The median patient follow-up time (until death or until 31 December 2014 was 165 days. During this period, 51% of patients did not have to visit the hospital’s emergency department and 58% did not require hospitalization. Forty-eight of the 76 patients died after a median time of 135 days in the program; 24 (50% died at home. Our experience indicates that with the support of the Palliative Care Unit and the Nephrology Department, ACKD patients who are not dialysis candidates may be monitored at home by Primary Care Teams.

Home Palliative Care for Patients with Advanced Chronic Kidney Disease: Preliminary Results

Science.gov (United States)

Teruel, José L.; Rexach, Lourdes; Burguera, Victor; Gomis, Antonio; Fernandez-Lucas, Milagros; Rivera, Maite; Diaz, Alicia; Collazo, Sergio; Liaño, Fernando

2015-01-01

Healthcare for patients with advanced chronic kidney disease (ACKD) on conservative treatment very often poses healthcare problems that are difficult to solve. At the end of 2011, we began a program based on the care and monitoring of these patients by Primary Care Teams. ACKD patients who opted for conservative treatment were offered the chance to be cared for mainly at home by the Primary Care doctor and nurse, under the coordination of the Palliative Care Unit and the Nephrology Department. During 2012, 2013, and 2014, 76 patients received treatment in this program (mean age: 81 years; mean Charlson age-comorbidity index: 10, and mean glomerular filtration rate: 12.4 mL/min/1.73 m2). The median patient follow-up time (until death or until 31 December 2014) was 165 days. During this period, 51% of patients did not have to visit the hospital’s emergency department and 58% did not require hospitalization. Forty-eight of the 76 patients died after a median time of 135 days in the program; 24 (50%) died at home. Our experience indicates that with the support of the Palliative Care Unit and the Nephrology Department, ACKD patients who are not dialysis candidates may be monitored at home by Primary Care Teams. PMID:27417813

Dignity, dependence and relational autonomy for older people living in nursing homes

DEFF Research Database (Denmark)

Tolo Heggestad, Anne Kari; Høy, Bente; Wilhelm Rehnsfeldt, Arne

2015-01-01

Dignity is a core concept in nursing care . In earlier theories on dignity, close links have been drawn between dignity and autonomy, and autonomy has been closely related to independence . These traditional understandings of dignity and autonomy may be challenged when an individual moves...... into a nursing home . Our findings show that negative views about dependence, institutional frames and structures in the nursing home, and the attitudes and actions of healthcare personnel may diminish independence and lead to a lack of autonomy . Each of these areas can be experienced as a serious threat...

Home-based mobile cardio-pulmonary rehabilitation consultant system.

Science.gov (United States)

Lee, Hsu-En; Wang, Wen-Chih; Lu, Shao-Wei; Wu, Bo-Yuan; Ko, Li-Wei

2011-01-01

Cardiovascular diseases are the most popular cause of death in the world recently. For postoperatives, cardiac rehabilitation is still asked to maintain at home (phase II) to improve cardiac function. However, only one third of outpatients do the exercise regularly, reflecting the difficulty for home-based healthcare: lacking of monitoring and motivation. Hence, a cardio-pulmonary rehabilitation system was proposed in this research to improve rehabilitation efficiency for better prognosis. The proposed system was built on mobile phone and receiving electrocardiograph (ECG) signal from a wireless ECG holter via Bluetooth connection. Apart from heart rate (HR) monitor, an ECG derived respiration (EDR) technique is also included to provide respiration rate (RR). Both HR and RR are the most important vital signs during exercise but only used one physiological signal recorder in this system. In clinical test, there were 15 subjects affording Bruce Task (treadmill) to simulate rehabilitation procedure. Correlation between this system and commercial product (Custo-Med) was up to 98% in HR and 81% in RR. Considering the prevention of sudden heart attack, an arrhythmia detection expert system and healthcare server at the backend were also integrated to this system for comprehensive cardio-pulmonary monitoring whenever and wherever doing the exercise.

Home birth and hospital birth trends in Bo, Sierra Leone.

Science.gov (United States)

Jacobsen, Kathryn H; Abdirahman, Hafsa A; Ansumana, Rashid; Bockarie, Alfred S; Bangura, Umaru; Jimmy, David Henry; Malanoski, Anthony P; Sundufu, Abu James; Stenger, David A

2012-06-01

As of April 2010, all maternity care at government healthcare facilities in Sierra Leone is provided at no cost to patients. In late 2010, we conducted a community health census of 18 sections of the city of Bo (selected via randomized cluster sampling from 68 total sections). Among the 3421 women with a history of pregnancy who participated in the study, older women most often reported having a history of both home and hospital deliveries, while younger women showed a preference for hospital births. The proportion of lastborn children delivered at a healthcare facility increased from 71.8% of offspring 10-14 years old to 81.1% of those one to nine years old and 87.3% of infants born after April 2010. These findings suggest that the new maternal healthcare initiative has accelerated an existing trend toward a preference for healthcare facility births, at least in some urban parts of Sierra Leone. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Life-resistant housing - home automation through the eyes of the caregiver : what opportunities do caregivers see for the use of home automation in order to support independent living for the elderly?

NARCIS (Netherlands)

Oppewal-Raadsveld, Betty

Design and outcomes of research regarding the question which changes in the field of housing and healthcare technology would, according to caregivers, enable people over 50 in shrinking areas in The Northern Netherlands to continue living in their own homes as long as possible.

Psychosocial status and economic dependence for healthcare and nonhealthcare among elderly population in rural coastal Karnataka

Directory of Open Access Journals (Sweden)

Priyanka Dsouza Rent

2017-01-01

Full Text Available Introduction: The elderly who will constitute 10% of the Indian population by 2021 face problems such as deteriorating healthcare status, loneliness, and economic constraints among others. All these factors together may affect the psychosocial status of the elderly and their health-seeking behavior. With this background, the current study tried to evaluate the psychosocial status, economic dependence for health and nonhealth expenses and awareness regarding geriatric welfare services (GWS among elderly patients. Materials and Methods: The study was carried out among 599 men and women aged above 60 who visited rural healthcare centers in two districts of Karnataka during September–December 2016. A semi-structured interview schedule was administered by a trained medical professional after taking informed consent. Results: Majority of the respondents said that they had company at home, interacted with people outside home and that their advice was honored. About 75.8% of the respondents reported that they were either partially or completely financially dependent on someone else. The mean cost of hospitalization was reported to be Rs. 11,086. Majority of those hospitalized depended on their children to pay for healthcare (66.9%, whereas 16.9% had availed government insurance schemes and 14.6% paid out of pocket. Nearly 64.9% of the respondents were aware of the GWS while 32.6% had used them. Conclusion: The absence of financial risk pooling mechanisms and social support may cause elderly to forego treatment because of the need to pay for healthcare and further deteriorate their psychosocial status. Government initiatives to improve healthcare and social services to the elderly maybe advocated.

Development and validation of a remote home safety protocol.

Science.gov (United States)

Romero, Sergio; Lee, Mi Jung; Simic, Ivana; Levy, Charles; Sanford, Jon

2018-02-01

Environmental assessments and subsequent modifications conducted by healthcare professionals can enhance home safety and promote independent living. However, travel time, expense and the availability of qualified professionals can limit the broad application of this intervention. Remote technology has the potential to increase access to home safety evaluations. This study describes the development and validation of a remote home safety protocol that can be used by a caregiver of an elderly person to video-record their home environment for later viewing and evaluation by a trained professional. The protocol was developed based on literature reviews and evaluations from clinical and content experts. Cognitive interviews were conducted with a group of six caregivers to validate the protocol. The final protocol included step-by-step directions to record indoor and outdoor areas of the home. The validation process resulted in modifications related to safety, clarity of the protocol, readability, visual appearance, technical descriptions and usability. Our final protocol includes detailed instructions that a caregiver should be able to follow to record a home environment for subsequent evaluation by a home safety professional. Implications for Rehabilitation The results of this study have several implications for rehabilitation practice The remote home safety evaluation protocol can potentially improve access to rehabilitation services for clients in remote areas and prevent unnecessary delays for needed care. Using our protocol, a patient's caregiver can partner with therapists to quickly and efficiently evaluate a patient's home before they are released from the hospital. Caregiver narration, which reflects a caregiver's own perspective, is critical to evaluating home safety. In-home safety evaluations, currently not available to all who need them due to access barriers, can enhance a patient's independence and provide a safer home environment.

The importance of Internet usage for urologic patients.

Science.gov (United States)

Sahin, Cahit; Tuncer, Murat; Yazici, Ozgur; Kafkasli, Alper; Can, Utku; Eryildirim, Bilal; Koca, Orhan; Sarica, Kemal

2014-12-30

To evaluate Internet usage frequency, rate of searched diseases and impact of Internet derived data on future patient physician relationship in patients applying to an Urology Department. A well prepared questionnaire has been given to 1000 referring cases, out of which 589 accepted to participate on a volunteer basis to a face to face interview. Patients were divided into subgroups with respect to age, gender and as well as their educational and economical status. Regarding Internet, questions inquired the use of Internet, the point of view about it, opinions about healthcare system and most commonly urological diseases searched in Internet. Of 589 patients participating, 38.2% reported access to the Internet; in relation to subgroup analysis of data, there was a statistically significant relationship between the use of Internet and age (p Internet and the majority of these cases share all these information with their physicians during their visit. These findings indicate that all physicians should consider this fact seriously and make their future plans in the light of internet based activities which provides numerous advantages.

Healthcare preferences of lesbian, gay, bisexual, transgender and questioning youth.

Science.gov (United States)

Hoffman, Neal D; Freeman, Katherine; Swann, Stephanie

2009-09-01

home and family. Subgroup analyses underscore the need for greater sensitivity to both cultural and developmental differences among LGBTQ youth. These results provide a foundation for further research about healthcare services and delivery systems for youth, training initiatives for healthcare providers, and the role of utilizing the Internet for health research purposes to access and recruit hard-to-reach youth.

Healthcare professionals' use of health clouds: Integrating technology acceptance and status quo bias perspectives.

Science.gov (United States)

Hsieh, Pi-Jung

2015-07-01

Cloud computing technology has recently been seen as an important milestone in medical informatics development. Despite its great potential, there are gaps in our understanding of how users evaluate change in relation to the health cloud and how they decide to resist it. Integrating technology acceptance and status quo bias perspectives, this study develops an integrated model to explain healthcare professionals' intention to use the health cloud service and their intention to resist it. A field survey was conducted in Taiwan to collect data from healthcare professionals; a structural equation model was used to examine the data. A valid sample of 209 healthcare professionals was collected for data analysis. The results show that healthcare professionals' resistance to the use of the health cloud is the result of regret avoidance, inertia, perceived value, switching costs, and perceived threat. Attitude, subjective norm, and perceived behavior control are shown to have positive and direct effects on healthcare professionals' intention to use the health cloud. The results also indicate a significant negative effect in the relationship between healthcare professionals' intention and resistance to using the health cloud. Our study illustrates the importance of incorporating user resistance in technology acceptance studies in general and in health technology usage studies in particular. This study also identifies key factors for practitioners and hospitals to make adoption decisions in relation to the health cloud. Further, the study provides a useful reference for future studies in this subject field. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Cost-effectiveness of home telemedical cardiotocography compared with traditional outpatient monitoring.

Science.gov (United States)

Tõrõk, M; Kovács, F; Doszpod, J

2000-01-01

We compared the cost of passive sensor telemedical non-stress cardiotocography performed at home and the same test performed by traditional equipment in an outpatient clinic in the Budapest area. The costs were calculated using two years' registered budget data from the home monitoring service in Budapest and the outpatient clinic of the department of obstetrics and gynaecology at the Haynal Imre University of Health Sciences. The traditional test at the university outpatient clinic cost 3652 forint for the health-care and 1000 forint in additional expenses for the patient (travel and time off work). This means that the total cost for each test in the clinic was 4652 forint. The cost of home telemedical cardiotocography was 1500 forint per test, but each test took 2.1 times as long. For a more realistic comparison between the two methods, we adjusted the cost to take account of the extra length of time that home monitoring required. The adjusted cost for home care was 3150 forint, some 32% lower than in the clinic. Passive sensor telemedical non-stress cardiotocography at home was therefore less expensive than the same test performed in the traditional way in an outpatient clinic.

Knowledge Management Implementation and the Tools Utilized in Healthcare for Evidence-Based Decision Making: A Systematic Review.

Science.gov (United States)

Shahmoradi, Leila; Safadari, Reza; Jimma, Worku

2017-09-01

Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: "Healthcare and Knowledge Management"; "Knowledge Management Tools in Healthcare" and "Community of Practices in healthcare". It was found that utilization of knowledge management in healthcare is encouraging. There exist numbers of opportunities for knowledge management implementation, though there are some barriers as well. Some of the opportunities that can transform healthcare are advances in health information and communication technology, clinical decision support systems, electronic health record systems, communities of practice and advanced care planning. Providing the right knowledge at the right time, i.e., at the point of decision making by implementing knowledge management in healthcare is paramount. To do so, it is very important to use appropriate tools for knowledge management and user-friendly system because it can significantly improve the quality and safety of care provided for patients both at hospital and home settings.

A Tamper-Resistant and Portable Healthcare Folder

Directory of Open Access Journals (Sweden)

Nicolas Anciaux

2008-01-01

Full Text Available Electronic health record (EHR projects have been launched in most developed countries to increase the quality of healthcare while decreasing its cost. The benefits provided by centralizing the healthcare information in database systems are unquestionable in terms of information quality, availability, and protection against failure. Yet, patients are reluctant to give to a distant server the control over highly sensitive data (e.g., data revealing a severe or shameful disease. This paper capitalizes on a new hardware portable device, associating the security of a smart card to the storage capacity of a USB key, to give back to the patient the control over his medical data. This paper shows how this device can complement a traditional EHR server to (1 protect and share highly sensitive data among trusted parties and (2 provide a seamless access to the data even in disconnected mode. The proposed architecture is experimented in the context of a medicosocial network providing medical care and social services at home for elderly people.

Current marketing practices in the nursing home sector.

Science.gov (United States)

Calhoun, Judith G; Banaszak-Holl, Jane; Hearld, Larry R

2006-01-01

Marketing is widely recognized as an essential business function across all industries, including healthcare. While many long-term care facilities adopted basic healthcare marketing practices and hired marketing staff by the early 1990s, a paucity of research on nursing home marketing exists in the literature. This study examines the extent to which nursing homes have developed more formulated marketing and related communication and promotional strategies as market competition has increased in this sector during the past two decades. In addition, we explored managers' perceptions of their control over marketing decision making, the impact of competition on the use of marketing practices, and areas for enhanced competitive positioning. Administrators from 230 nursing homes in 18 Southeastern Michigan counties were surveyed regarding (1) the adoption level of approximately 40 literature-based, best-practice marketing strategies; (2) the types of staff involved with the marketing function; and (3) their perception of their level of control over marketing functions and of local competition. Results from 101 (44 percent) survey participants revealed that although respondents viewed their markets as highly competitive, their marketing practices remained focused on traditional and relatively constrained practices. In relation to the importance of customer relationship management, the majority of the administrators reported intensive efforts being focused on residents and their families, referrers, and staff, with minimal efforts being extended to insurers and other types of payers. A significant positive relation was found between the intensity of marketing initiatives and the size of the facility (number of beds), whereas significant negative correlations were revealed in relation to occupancy and the perceived level of control over the function.

ICT in University Education: Usage and Challenges among ...

African Journals Online (AJOL)

This study was a survey which explored ICT usage and challenges among academic staff. Thus, the main purpose of this study was to determine the areas of ICT usage among academic staff; identify the obstacles to their ICT usage and identify their areas of training need in ICT usage. Five research questions were posed ...

Factors Affecting the Readiness of Medical Doctors and Patients with Chronic Conditions toward the Usage of Smartphones in the Saudi Arabian Healthcare Sector

Directory of Open Access Journals (Sweden)

Bassam M Al-Mahadeen

2015-01-01

Full Text Available Numerous studies have reported the rapid increase in the number of individuals who use smartphones. However, smartphones appear to be increasingly used by healthcare workers, particularly physicians and nurses. Therefore, this study aims to investigate the readiness of medical doctors and patients with chronic conditions in using and adopting smartphones for communication. This study employs the Technology Acceptance Model to examine the behavior of people in using smartphones from the perspectives of trust and rural areas. To realize our objective, we conducted a questionnaire survey that involved medical doctors and patients with chronic conditions. Our particular focus was Al Qunfudhah City in Saudi Arabia. More than 200 questionnaires were distributed to people belonging to different healthcare sectors in the rural areas of Al Qunfudhah City. Our aim was to include every possible scenario and to obtain excellent perspectives. The results that we eventually analyzed indicated that trust factor and rural areas significantly influence the readiness of people belonging to the healthcare sector toward using smartphones. The results of our study concur with the findings of other studies. Our results indicate that smartphones and other high-technology gadgets are now necessary and accepted devices in the different healthcare fields. However, further studies should explore the challenges and effects of smartphone use in the healthcare sector.

A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy

Science.gov (United States)

2011-01-01

Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i) Telecollaboration and teleconsultation services between remotely located healthcare providers, ii) telemedicine services in emergencies, iii) home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv) eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc) and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G), and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances, homes of "at

A feasibility study for the provision of electronic healthcare tools and services in areas of Greece, Cyprus and Italy

Directory of Open Access Journals (Sweden)

Konnis Georgios

2011-06-01

Full Text Available Abstract Background Through this paper, we present the initial steps for the creation of an integrated platform for the provision of a series of eHealth tools and services to both citizens and travelers in isolated areas of thesoutheast Mediterranean, and on board ships travelling across it. The platform was created through an INTERREG IIIB ARCHIMED project called INTERMED. Methods The support of primary healthcare, home care and the continuous education of physicians are the three major issues that the proposed platform is trying to facilitate. The proposed system is based on state-of-the-art telemedicine systems and is able to provide the following healthcare services: i Telecollaboration and teleconsultation services between remotely located healthcare providers, ii telemedicine services in emergencies, iii home telecare services for "at risk" citizens such as the elderly and patients with chronic diseases, and iv eLearning services for the continuous training through seminars of both healthcare personnel (physicians, nurses etc and persons supporting "at risk" citizens. These systems support data transmission over simple phone lines, internet connections, integrated services digital network/digital subscriber lines, satellite links, mobile networks (GPRS/3G, and wireless local area networks. The data corresponds, among others, to voice, vital biosignals, still medical images, video, and data used by eLearning applications. The proposed platform comprises several systems, each supporting different services. These were integrated using a common data storage and exchange scheme in order to achieve system interoperability in terms of software, language and national characteristics. Results The platform has been installed and evaluated in different rural and urban sites in Greece, Cyprus and Italy. The evaluation was mainly related to technical issues and user satisfaction. The selected sites are, among others, rural health centers, ambulances

Home-based versus centre-based cardiac rehabilitation.

Science.gov (United States)

Taylor, Rod S; Dalal, Hayes; Jolly, Kate; Moxham, Tiffany; Zawada, Anna

2010-01-20

; HDL-cholesterol; LDL-cholesterol) or proportion of smokers at follow up or health-related quality of life. There was no consistent difference in the healthcare costs of the two forms of cardiac rehabilitation. Home- and centre-based cardiac rehabilitation appear to be equally effective in improving the clinical and health-related quality of life outcomes in acute MI and revascularisation patients. This finding, together with an absence of evidence of difference in healthcare costs between the two approaches, would support the extension of home-based cardiac rehabilitation programmes such as the Heart Manual to give patients a choice in line with their preferences, which may have an impact on uptake of cardiac rehabilitation in the individual case.

The Scope of Usage-based Theory

OpenAIRE

Paul eIbbotson

2013-01-01

Usage-based approaches typically draw on a relatively small set of cognitive processes, such as categorization, analogy, and chunking to explain language structure and function. The goal of this paper is to first review the extent to which the “cognitive commitment” of usage-based theory has had success in explaining empirical findings across domains, including language acquisition, processing, and typology. We then look at the overall strengths and weaknesses of usage-based theory and highli...

Economic burden of multidrug-resistant bacteria in nursing homes in Germany: a cost analysis based on empirical data.

Science.gov (United States)

Huebner, Claudia; Roggelin, Marcus; Flessa, Steffen

2016-02-23

Infections and colonisations with multidrug-resistant organisms (MDROs) increasingly affect different types of healthcare facilities worldwide. So far, little is known about additional costs attributable to MDROs outside hospitals. The aim of this study was to analysis the economic burden of multidrug-resistant bacteria in nursing homes in Germany. The cost analysis is performed from a microeconomic perspective of the healthcare facilities. Study took place in six long-term care facilities in north-eastern Germany. Data of 71 residents with a positive MDRO status were included. The study analysed MDRO surveillance data from 2011 to 2013. It was supplemented by an empirical analysis to determine the burden on staff capacity and materials consumption. 11,793 days with a positive multidrug-resistant pathogen diagnosis could be included in the analysis. On average, 11.8 (SD ± 6.3) MDRO cases occurred per nursing home. Mean duration per case was 163.3 days (SD ± 97.1). The annual MDRO-related costs varied in nursing homes between €2449.72 and €153,263.74 on an average €12,682.23 per case. Main cost drivers were staff capacity (€43.95 per day and €7177.04 per case) and isolation materials (€24.70 per day and €4033.51 per case). The importance of MDROs in nursing homes could be confirmed. MDRO-related cost data in this specific healthcare sector were collected for the first time. Knowledge about the burden of MDROs will enable to assess the efficiency of hygiene intervention measures in nursing homes in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The TECS model leads to active use of technology in home care

DEFF Research Database (Denmark)

Jensen, Ulla Gars; Skov, Hanne

2017-01-01

Digitization in healthcare is accelerating worldwide. This article focuses on the X-Changery development project involving home-care nurses and their use of the iPad as a new tool in patients’ homes. The goal of the project was to bring knowledge from recent research on technological literacy...... in working life back to a work setting, thus giving nurses new technology competencies with the aim of enhancing their professionalism through the use of the iPad as a work tool. Through field observations, learning labs and focus-group interviews we can see that X-Changery gave home-care nurses a common...... language to exchange experiences and share knowledge about the iPad as a work tool. Use of the iPad in patients’ homes led to new habits and routines. Nurses acquired relational expertise, implying active use of technology. The results show the importance of focusing on and funding reflection...

Work values and intention to become a registered nurse among healthcare assistants.

Science.gov (United States)

Trede, Ines; Schweri, Juerg

2014-06-01

To examine the work values of Swiss healthcare assistant students, who, at the end of their vocational education in hospitals and nursing homes, choose to pursue a registered nurse degree. A prospective, cross-sectional survey was administered to a full cohort of healthcare assistant students in their last year of study in the canton of Bern (n=272). Multivariate methods (logistic regression) were applied to estimate the joint effect of work experience and work values in choosing to pursue a registered nurse education. Among work values, extrinsic values (regarding wage, career und educational perspectives) had a strong effect on the decisions of healthcare assistant students to pursue further education as registered nurses. Grades, socio-economic background and satisfaction during education also had an effect. Higher valuation of income, career and further education affect the career intentions of nursing assistants who have already obtained a recognized healthcare education and nursing experience. Teachers and trainers should actively identify the work values and expectations of these students. Provision of adequate advice and suggestions for the career development of these students may be an important route by which to address the nursing shortage and recruitment problems. © 2013.

The meaning of home for ageing women living alone: An evolutionary concept analysis.

Science.gov (United States)

Barry, Arro; Heale, Roberta; Pilon, Roger; Lavoie, Anne Marise

2018-05-01

The concept of home to women ageing should be visited in the light of ongoing cultural, political, temporal and disciplinary evolutions. In part, to compliment policies increasing focus on supporting older adults to age in place and a growing attention on the home as a place where healthcare is designed and provided. The following concept analysis utilises Rodgers' evolutionary method to inductively analyse literature in order to elicit the meaning and experience of home among older women who are ageing at home. Literature was collected over an 18-month period during 2014-2015 and the sample was made up of 49 articles. The analysis led to the concept of home among women ageing in communities to be defined by four attributes. These attributes are home as (i) a resource, (ii) an attachment, (iii) the precariousness of maintaining and sustaining home and (iv) a cultural expectation. This analysis of the meaning and experience of home among women ageing at home has shed light on the needs for this group of women, while highlighting the need to continue to further clarify and define the concept through research. © 2017 John Wiley & Sons Ltd.

The Impact of Severe Obesity on Healthcare Resource Utilisation in Spain.

Science.gov (United States)

Espallardo, Olga; Busutil, Rafael; Torres, Antonio; Zozaya, Néboa; Villoro, Renata; Hidalgo-Vega, Álvaro

2017-08-01

Obesity is not only a health problem but also a source of increased monetary expenditures. The objectives of this study were to analyse the use of healthcare resources in the Spanish adult population with class II obesity and above (BMI ≥35 kg/m 2 ) and to compare it with other BMI groups. We used the Spanish National Health Survey, a longitudinal population-based survey (n = 18,682), to analyse healthcare resource utilisation by BMI groups. Adjusted and unadjusted logistic regression models were used to calculate odds ratios (OR) for healthcare use among class II and over obese subjects versus normal BMI. Persons with BMI ≥35 are more likely to attend general practitioner (GP)'s consultations (17%), to visit the emergency department (26%), to consume medications (36%), to be hospitalised (49%), to require nursing consultations (61%) and to require psychology consultations (83%). The proportion of obese people receiving home visits is 2.6 times higher than among normal BMI. After controlling for sex and age groups, people with severe obesity (BMI ≥35 kg/m 2 ) were more prone to requiring home care visits (OR 2.3; CI [1.3; 4.2]), GP visits (OR 2.1; CI [1.5; 3.0]), psychologist visits (OR 1.96; CI [1.3; 2.99]), emergency service visits (OR 1.5; CI [1.2; 1.8]), nurse visits (OR 1.46; CI [1.2; 1.9]) and hospitalisations (OR 1.43; CI [1.1; 1.9]) and after also adjusting for relevant comorbidities like hypertension, diabetes and cardiovascular diseases: GP visits (OR 1.85; CI [1.3; 2.7]), psychologist visits (OR 1.8; CI [1.2; 2.7]), specialised care visits (OR 0.92; CI [0.7; 1.2]) and physiotherapist visits (OR 0.7; CI [0.5; 1.0]). Severe obesity significantly increases healthcare resource utilisation in Spain. The results shed light on the real magnitude of the burden of obesity in Spain.

Prevalence and content of written ethics policies on euthanasia in Catholic healthcare institutions in Belgium (Flanders).

Science.gov (United States)

Gastmans, Chris; Lemiengre, Joke; van der Wal, Gerrit; Schotsmans, Paul; Dierckx de Casterlé, Bernadette

2006-04-01

Euthanasia is performed worldwide, regardless of the existence of laws governing it. Belgium became the second country in the world to enact a law on euthanasia in 2002. Healthcare institutions bear responsibility for guaranteeing the quality of care for patients at the end of life, and for ensuring support for caregivers involved. Therefore, institutional ethics policies on end-of-life decision-making, especially on euthanasia, may be useful. A cross-sectional mail survey of general directors of Catholic hospitals and nursing homes in Belgium was used to describe the prevalence and content of written ethics policies for competent terminally ill, incompetent terminally ill, and non-terminally ill patients. Of the 298 targeted institutions, 81% of hospitals and 62% of nursing homes returned complete questionnaires. Of these, 79% of hospitals and 30% of nursing homes had a written ethics policy on euthanasia. Of hospitals 83% and of nursing homes 85% permitted euthanasia for competent terminally ill patients only in exceptional cases in accordance with legal due care criteria and provisions outlined by the palliative filter procedure. Euthanasia for incompetent terminally ill patients was prohibited by 27% of the hospitals and by 60% of the nursing homes. For non-terminally ill patients, these figures were 43 and 64%, respectively. Catholic healthcare institutions in Belgium (Flanders) made great efforts to develop written ethics policies on euthanasia. Only a small group of institutions completely prohibited euthanasia. Most of the institutions considered euthanasia to be an option if all possible alternatives (e.g., palliative filter procedure, which contains more rigorous criteria than those in the Belgian Euthanasia Act), have been thoroughly investigated.

Impact of nursing home residence on hospital epidemiology of meticillin-resistant Staphylococcus aureus: a perspective from Asia.

Science.gov (United States)

Verrall, A; Merchant, R; Dillon, J; Ying, D; Fisher, D

2013-03-01

In a Singapore hospital practising meticillin-resistant Staphylococcus aureus (MRSA) admission screening, the relative risk for MRSA colonization for those admitted from nursing homes was 6.89 (95% confidence interval: 5.74-8.26; 41% of 190 vs 6.0% of 14,849). However, the MRSA burden on admission attributable to nursing home residence was low (6.9%). Risk factors independently associated with MRSA colonization in patients admitted from nursing homes were previous hospital admissions, broken skin, prior use of antibiotics and Chinese ethnicity. Low rates of nursing home use means that the overall impact of nursing home residence on MRSA in our hospital is low. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

The Community Intervention Team as a means of Improving the transition from hospital to home for patients

OpenAIRE

Kearns, Michelle; Curran, Margaret; Collier, Dorcas; Burke, Mary; Lawler, Michelle

2017-01-01

Introduction: Too frequently patients are discharged from hospital to their home without local support from healthcare professionals. Without this support patients are often readmitted to hospital unnecessarily.Short description of practice change implemented: Networked Community intervention team (CIT) services make a unique contribution in facilitating the transition between hospital and home.Aim and theory of change: The aim is to facilitate early discharge from an acute setting, providing...

Virtual Video Prototyping of Pervasive Healthcare Systems

DEFF Research Database (Denmark)

Bardram, Jakob Eyvind; Bossen, Claus; Madsen, Kim Halskov

2002-01-01

Virtual studio technology enables the mixing of physical and digital 3D objects and thus expands the way of representing design ideas in terms of virtual video prototypes, which offers new possibilities for designers by combining elements of prototypes, mock-ups, scenarios, and conventional video....... In this article we report our initial experience in the domain of pervasive healthcare with producing virtual video prototypes and using them in a design workshop. Our experience has been predominantly favourable. The production of a virtual video prototype forces the designers to decide very concrete design...... issues, since one cannot avoid paying attention to the physical, real-world constraints and to details in the usage-interaction between users and technology. From the users' perspective, during our evaluation of the virtual video prototype, we experienced how it enabled users to relate...

Appliance based control for Home Power Management Systems

International Nuclear Information System (INIS)

Özkan, Hanife Apaydın

2016-01-01

This study scrutinizes energy-friendly smart home appliances (hereafter ‘smart appliances’), control of these appliances and their effects on the efficient use of energy. To accomplish this, smart appliances and their operation principles are introduced and their energy savings compared to conventional appliances are analyzed using precise measurements. Then, a real-time Appliance-based Home Power Management System (Ab-HPMS) which manages power consumption of smart appliances and that of the house as a whole is proposed. For Ab-HPMS, an appliance control algorithm, called Appliance-based Rolling Wave Planning (Ab-RWP), is developed with the aim of reducing electricity cost and improving energy efficiency while maintaining user comfort. Ab-RWP algorithm interacts with appliances in a priority order based on user comfort which is determined by utilizing their smart operational characteristics. Operations of smart appliances and their integrations with Ab-HPMS are modeled with Petri nets to verify that they meet the requirements expressed in the specifications. Simulation results demonstrate that proposed Ab-HPMS provides improvements in terms of the energy consumption reduction of about 5%–16%, cost reduction of about 10%–24% and peak reduction at high demand period of about 38%–53% compared to conventional appliances usage. - Highlights: • The effects of smart home appliances on energy saving are investigated. • Petri nets models of smart appliances are developed to simulate their operations in smart home. • A real-time appliance-based home power management system (Ab-HPMS) is proposed. • Power density function is evaluated to interrupt the operation of smart washing machine.

A systematic mapping review of Randomized Controlled Trials (RCTs in care homes

Directory of Open Access Journals (Sweden)

Gordon Adam L

2012-06-01

Full Text Available Abstract Background A thorough understanding of the literature generated from research in care homes is required to support evidence-based commissioning and delivery of healthcare. So far this research has not been compiled or described. We set out to describe the extent of the evidence base derived from randomized controlled trials conducted in care homes. Methods A systematic mapping review was conducted of the randomized controlled trials (RCTs conducted in care homes. Medline was searched for “Nursing Home”, “Residential Facilities” and “Homes for the Aged”; CINAHL for “nursing homes”, “residential facilities” and “skilled nursing facilities”; AMED for “Nursing homes”, “Long term care”, “Residential facilities” and “Randomized controlled trial”; and BNI for “Nursing Homes”, “Residential Care” and “Long-term care”. Articles were classified against a keywording strategy describing: year and country of publication; randomization, stratification and blinding methodology; target of intervention; intervention and control treatments; number of subjects and/or clusters; outcome measures; and results. Results 3226 abstracts were identified and 291 articles reviewed in full. Most were recent (median age 6 years and from the United States. A wide range of targets and interventions were identified. Studies were mostly functional (44 behaviour, 20 prescribing and 20 malnutrition studies rather than disease-based. Over a quarter focussed on mental health. Conclusions This study is the first to collate data from all RCTs conducted in care homes and represents an important resource for those providing and commissioning healthcare for this sector. The evidence-base is rapidly developing. Several areas - influenza, falls, mobility, fractures, osteoporosis – are appropriate for systematic review. For other topics, researchers need to focus on outcome measures that can be compared and collated.

Facebook usage by students in higher education

NARCIS (Netherlands)

Wesseling, N.F.; de la Poza, Elena; Dormènech, Jozep; Lloret, Jaime; Vincent Vela, M. Cinta; Zuriaga Agustí, Elena

2015-01-01

In this paper I measure first year student Facebook usage as part of a broader PhD study into the influence of social media usage on the success of students in higher education. A total of 906 students were asked to complete 3 surveys on Facebook usage with their peers, for two consecutive years

Healthcare Databases in Thailand and Japan: Potential Sources for Health Technology Assessment Research.

Directory of Open Access Journals (Sweden)

Surasak Saokaew

Full Text Available Health technology assessment (HTA has been continuously used for value-based healthcare decisions over the last decade. Healthcare databases represent an important source of information for HTA, which has seen a surge in use in Western countries. Although HTA agencies have been established in Asia-Pacific region, application and understanding of healthcare databases for HTA is rather limited. Thus, we reviewed existing databases to assess their potential for HTA in Thailand where HTA has been used officially and Japan where HTA is going to be officially introduced.Existing healthcare databases in Thailand and Japan were compiled and reviewed. Databases' characteristics e.g. name of database, host, scope/objective, time/sample size, design, data collection method, population/sample, and variables were described. Databases were assessed for its potential HTA use in terms of safety/efficacy/effectiveness, social/ethical, organization/professional, economic, and epidemiological domains. Request route for each database was also provided.Forty databases- 20 from Thailand and 20 from Japan-were included. These comprised of national censuses, surveys, registries, administrative data, and claimed databases. All databases were potentially used for epidemiological studies. In addition, data on mortality, morbidity, disability, adverse events, quality of life, service/technology utilization, length of stay, and economics were also found in some databases. However, access to patient-level data was limited since information about the databases was not available on public sources.Our findings have shown that existing databases provided valuable information for HTA research with limitation on accessibility. Mutual dialogue on healthcare database development and usage for HTA among Asia-Pacific region is needed.

Healthcare Databases in Thailand and Japan: Potential Sources for Health Technology Assessment Research.

Science.gov (United States)

Saokaew, Surasak; Sugimoto, Takashi; Kamae, Isao; Pratoomsoot, Chayanin; Chaiyakunapruk, Nathorn

2015-01-01

Health technology assessment (HTA) has been continuously used for value-based healthcare decisions over the last decade. Healthcare databases represent an important source of information for HTA, which has seen a surge in use in Western countries. Although HTA agencies have been established in Asia-Pacific region, application and understanding of healthcare databases for HTA is rather limited. Thus, we reviewed existing databases to assess their potential for HTA in Thailand where HTA has been used officially and Japan where HTA is going to be officially introduced. Existing healthcare databases in Thailand and Japan were compiled and reviewed. Databases' characteristics e.g. name of database, host, scope/objective, time/sample size, design, data collection method, population/sample, and variables were described. Databases were assessed for its potential HTA use in terms of safety/efficacy/effectiveness, social/ethical, organization/professional, economic, and epidemiological domains. Request route for each database was also provided. Forty databases- 20 from Thailand and 20 from Japan-were included. These comprised of national censuses, surveys, registries, administrative data, and claimed databases. All databases were potentially used for epidemiological studies. In addition, data on mortality, morbidity, disability, adverse events, quality of life, service/technology utilization, length of stay, and economics were also found in some databases. However, access to patient-level data was limited since information about the databases was not available on public sources. Our findings have shown that existing databases provided valuable information for HTA research with limitation on accessibility. Mutual dialogue on healthcare database development and usage for HTA among Asia-Pacific region is needed.

HIV status disclosure to perinatally-infected adolescents in Zimbabwe: a qualitative study of adolescent and healthcare worker perspectives.

Directory of Open Access Journals (Sweden)

Khameer K Kidia

Full Text Available Due to the scale up of antiretroviral therapy, increasing numbers of HIV-infected children are living into adolescence. As these children grow and surpass the immediate threat of death, the issue of informing them of their HIV status arises. This study aimed to understand how perinatally-infected adolescents learn about their HIV-status as well as to examine their preferences for the disclosure process.In-depth interviews were conducted with 31 (14 male, 17 female perinatally-infected adolescents aged 16-20 at an HIV clinic in Harare, Zimbabwe, and focused on adolescents' experiences of disclosure. In addition, 15 (1 male, 14 female healthcare workers participated in two focus groups that were centred on healthcare workers' practices surrounding disclosure in the clinic. Purposive sampling was used to recruit participants. A coding frame was developed and major themes were extracted using grounded theory methods.Healthcare workers encouraged caregivers to initiate disclosure in the home environment. However, many adolescents preferred disclosure to take place in the presence of healthcare workers at the clinic because it gave them access to accurate information as well as an environment that made test results seem more credible. Adolescents learned more specific information about living with an HIV-positive status and the meaning of that status from shared experiences among peers at the clinic.HIV-status disclosure to adolescents is distinct from disclosure to younger children and requires tailored, age-appropriate guidelines. Disclosure to this age group in a healthcare setting may help overcome some of the barriers associated with caregivers disclosing in the home environment and make the HIV status seem more credible to an adolescent. The study also highlights the value of peer support among adolescents, which could help reduce the burden of psychosocial care on caregivers and healthcare workers.

Applications Based on Service-Oriented Architecture (SOA) in the Field of Home Healthcare.

Science.gov (United States)

Avila, Karen; Sanmartin, Paul; Jabba, Daladier; Jimeno, Miguel

2017-07-25

This article makes a literature review of applications developed in the health industry which are focused on patient care from home and implement a service-oriented (SOA) design in architecture. Throughout this work, the applicability of the concept of Internet of Things (IoT) in the field of telemedicine and health care in general is evaluated. It also performs an introduction to the concept of SOA and its main features, making a small emphasis on safety aspects. As a central theme, the description of different solutions that can be found in the health industry is developed, especially those whose goal is health care at home; the main component of these solutions are body sensor networks. Finally, an analysis of the literature from the perspectives of functionalities, security implementation and semantic interoperability is made to have a better understanding of what has been done and which are probable research paths to be studied in the future.

Utilization of Away-From-Home Food Establishments, Dietary Approaches to Stop Hypertension Dietary Pattern, and Obesity.

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Penney, Tarra L; Jones, Nicholas R V; Adams, Jean; Maguire, Eva R; Burgoine, Thomas; Monsivais, Pablo

2017-11-01

Eating meals away from home has been associated with the consumption of unhealthy foods and increased body weight. However, more rigorous assessment of the contribution of different types of away-from-home food establishments to overall diet quality and obesity is minimal. This study examined usage of these food establishments, accordance to the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and obesity status in a nationally representative sample of adults in the United Kingdom. A cross-sectional analysis of data from a national survey (N=2,083 aged ≥19 years, from 2008 to 2012) with dietary intake measured using a 4-day food diary, and height and weight measured objectively. Exposures included usage of (i.e., by proportion of energy) all away-from-home food establishments combined, and fast-food outlets, restaurants, and cafés separately. Outcomes included accordance with the DASH diet, and obesity status. Multivariable logistic regressions were conducted in 2016 to estimate associations between food establishments, diet quality, and obesity. People consuming a higher proportion of energy from any away-from-home food establishment had lower odds of DASH accordance (OR=0.45, 95% CI=0.31, 0.67) and increased odds of obesity (OR=1.48, 95% CI=1.10, 1.99). After adjustment, only use of fast-food outlets was significantly associated with lower odds of DASH accordance (OR=0.48, 95% CI=0.33, 0.69) and higher odds of obesity (OR=1.30, 95% CI=1.01, 1.69). Although a greater reliance on eating away-from-home is associated with less-healthy diets and obesity, dietary public health interventions that target these food establishments may be most effective if they focus on modifying the use of fast-food outlets. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Immersion Suit Usage Within the RAAF

Science.gov (United States)

1992-01-01

IMMERSION SUIT USED UVIC QDIS HOLDINGS 202. in 12 Sizes, held by ALSS 492SQN REQUIREMENTS No comment USAGE POLICY REFERENCE DIRAF) AAP 7215.004-1 (P3C...held by ALSS 492SQN. REQUIREMENTS No comment ISACE POLICY REFERENCE DIIAF) AAP 7215.004-1 (P3C Flight Manual) RAAF Supplement No 92 USAGE POUICY UVIC...TYPE P3C REFERENCE Telecon FLTLT Toft I I SQNfRESO AVMED Dated 22 Mar 91 IMMERSION SUIT USED UVIC QDIS HOLDINGS No comment REQUIREMENTS No comment USAGE

Clinical prioritisations of healthcare for the aged--professional roles.

Science.gov (United States)

Nortvedt, P; Pedersen, R; Grøthe, K H; Nordhaug, M; Kirkevold, M; Slettebø, A; Brinchmann, B S; Andersen, B

2008-05-01

Although fair distribution of healthcare services for older patients is an important challenge, qualitative research exploring clinicians' considerations in clinical prioritisation within this field is scarce. To explore how clinicians understand their professional role in clinical prioritisations in healthcare services for old patients. A semi-structured interview-guide was employed to interview 45 clinicians working with older patients. The interviews were analysed qualitatively using hermeneutical content analysis. 20 physicians and 25 nurses working in public hospitals and nursing homes in different parts of Norway. The clinicians struggle with not being able to attend to the comprehensive needs of older patients, and being unfaithful to professional ideals and expectations. There is a tendency towards lowering the standards and narrowing the role of the clinician. This is done in order to secure the vital needs of the patient, but is at the expense of good practice and holistic role modelling. Increased specialisation, advances and increase in medical interventions, economical incentives, organisational structures, and biomedical paradigms, may all contribute to a narrowing of the clinicians' role. Distributing healthcare services in a fair way is generally not described as integral to the clinicians' role in clinical prioritisations. If considerations of justice are not included in clinicians' role, it is likely that others will shape major parts of their roles and responsibilities in clinical prioritisations. Fair distribution of healthcare services for older patients is possible only if clinicians accept responsibility in these questions.

Clinical characteristics of pneumonia in bedridden patients receiving home care: a 3-year prospective observational study.

Science.gov (United States)

Ishida, Tadashi; Tachibana, Hiromasa; Ito, Akihiro; Ikeda, Satoshi; Furuta, Kenjiro; Nishiyama, Akihiro; Noyama, Maki; Tokioka, Fumiaki; Yoshioka, Hiroshige; Arita, Machiko

2015-08-01

The aim of the study was to describe the epidemiology, clinical features, antimicrobial treatment, and outcomes of bedridden pneumonia patients receiving home healthcare. A 3-year prospective observational study of poor performance status (PS) 3-4 patients receiving long-term home healthcare and hospitalized at a single center with pneumonia between October 2010 and September 2013 was conducted, and their clinical characteristics were compared with non-bedridden community-acquired pneumonia (CAP) patients. A total of 131 CAP patients with PS 3-4, and 400 CAP patients with PS 0-2 were evaluated. The PS 3-4 patients were older, and exhibited a higher frequency of underlying diseases. Aspiration was thought to be associated with pneumonia in 77.1% of the PS 3-4 patients. Streptococcus pneumoniae was the leading pathogen in both groups, whereas the frequency of streptococci and polymicrobial infections was higher in the PS 3-4 group. The incidence of multidrug-resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa was lower than in previous healthcare-associated pneumonia reports. The in-hospital mortality and recurrence rates were significantly higher in the PS 3-4 group than in the good PS group (17.6% vs. 6.0%, p < 0.001 and 15.3% vs. 7.5%, p = 0.008, respectively). The clinical characteristics of pneumonia in poor PS patients were similar to healthcare-associated pneumonia (HCAP), except for the frequency of drug-resistant pathogens. Hence, it might be beneficial to categorize pneumonia in home residents with poor PS separately from pneumonia in CAP patients who were previously healthy or experienced mild comorbidities. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

How parental attitudes affect the risky computer and Internet usage patterns of adolescents: a population-based study in the Bursa District of Turkey.

Science.gov (United States)

Uncu, Yeşim; Vural, Pinar; Büyükuysal, Cağatay; Alper, Züleyha; Kiliç, Emine Zinnur

2014-12-01

We aimed to evaluate the computer usage patterns of adolescents and to determine the effects of family life and parental attitude on these patterns. This was a descriptive, cross-sectional, population-based survey that included 935 children between 11 and 16 years of age who were students in the second level of primary school and their parents as well. The following instruments were used in the survey: student and parent questionnaires on computer usage patterns and the Parental Attitude Research Instrument (PARI) to assess parental attitudes towards child-rearing and family life. Of the study population, the majority of the students had a computer in their homes and spent a lot of time on the Internet. Parental control over the amount of time spent on the Internet and the websites that were visited had sometimes limited and contradictory effects on computer usage among the students. A democratic parental attitude was the best approach. Using the computer as a reward or punishment had a negative impact on the children's computer usage patterns. Although parents are confused concerning the benefits and harms of the Internet for their children and not certain how to manage their children's use of the computer and safe navigation of the Internet, a democratic parental attitude appears to be the best approach for reaching the most beneficial computer usage patterns for students.