Journal of the American Medical Directors Association
-
Multicenter Study
Characteristics of long-term care facilities associated with standing order programs to deliver influenza and pneumococcal vaccinations to residents in 13 states.
Standing order programs (SOPs) are effective evidence-based interventions in which nurses or pharmacists are authorized to vaccinate according to an approved protocol without a physician order or examination. National rates for influenza and pneumococcal vaccination in long-term care facilities (LTCF) are far below HP2010 goals of 90%. ⋯ Although LTCFs with certain characteristics used SOPs more often, overall few facilities (<10%) used SOPs to improve vaccination rates. SOP use varied by state indicating that state policies or other factors may promote or inhibit SOP use. More studies are needed to examine the causes of state-level variations in vaccination interventions and their relationships to health outcomes of residents in LTCFs. The federal government's resources to promote SOPs should focus on all LTCFs, but with a particular focus on those that are less likely to be using SOPs and that represent a large proportion of homes nationally (i.e., for-profit and chain facilities).
-
Multicenter Study
Predictors of anticoagulation prescription in nursing home residents with atrial fibrillation.
To determine predictors of oral anticoagulation (OAC) for atrial fibrillation (AF) in long-term care (LTC). ⋯ Prior stroke was the primary predictor of OAC use. Our model suggests that physicians may also incorporate concerns of age, bleeding, cognitive and physical function, and ethnicity into the decision-making process. Further study is needed to explore the reasons why 21% of the residents receive neither OAC nor ATT, and why OAC may be less likely to be prescribed to non-Caucasian LTC residents.