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Biomedical subjects

J R Bayne

Publications and source records attributed to J R Bayne.

15 recordsLinked to original sources
PubMed1988

A randomized trial of quality assurance in nursing homes.

Sixty nursing homes were randomly allocated to receive or not to receive a quality assurance intervention. The experimental intervention included the use of predeveloped quality assurance packages, the services of a quality assurance consultant, and the process of working through the quality assurance cycle with one of two principal indicator conditions. Two prevalent health problems, hazardous mobility and constipation, were selected as the principal indicator conditions. To detect co-intervention, one of two hidden secondary indicator conditions (potential skin breakdown and urinary incontinence) was assessed in each facility. In the control nursing homes, both the principal and secondary indicator conditions were hidden from staff. The care for 1,525 residents was examined before and after the intervention using a retrospective record review initiated for the study purposes. Improvement in management of the principal conditions, hazardous mobility and constipation, was greater in the experimental group (P less than 0.03 and P less than 0.005, respectively). Neither group changed its management of the hidden conditions. Behavior change was achieved using quality assurance-linked interventions. Further research should focus on refining quality assurance interventions that provide staff education and motivational strategies.

Accidental Falls↗
PubMed1978

Prescribing of psychoactive drugs for chronically ill elderly patients.

The prescribing of psychoactive drugs for 1431 chronically ill elderly patients being assessed for long-term institutional or community care was surveyed. Psychoactive drugs had been prescribed for about one quarter of the patients; benzodiazepines were the most frequently prescribed group. Judging from the extensive prescribing of flurazepam and chloral hydrate, commonly used hypnotics, the main reason psychoactive drugs were prescribed was to provide night-time sedation. Antidepressants and drugs promoted as useful in improving cognitive function were infrequently prescribed. Commendable prescribing practices included the infrequent use of "cerebral vasodilators" and barbiturates. Questionable prescribing practices included the infrequent use of tricyclic antidepressants in severely depressed patients and the use of tranquilizers in patients described by their attending physician as markedly or extremely withdrawn.

Age Factors↗
PubMed1978

Management of confusion in elderly persons.

Confusional states in the elderly are not uncommon and demand a high level of diagnostic and therapeutic skills in the physician. An immediate requirement is to provide protection and care while the cause is being elucidated. Tranquilizing medication is useful but the dosage must be both sufficient for the patient to gain control and monitored to prevent overdosage. Confusion may be due to disorder in various body systems with effects on the brain, or to a primary brain disorder. Careful evaluation of general health and also of cognitive, affective and social factors is necessary to clarify diagnosis and management.

Aged↗
PubMed1977

Identifying needs and services for the aged.

The Assessment and Placement Service (APS) of the Hamilton-Wentworth District Health Council assists health professionals in identifying the needs of persons with chronic disabling diseases, and in finding appropriate resources or programs. More than 80 percent of the 9,300 persons referred between September 1971 and December 1975 were over the age of 64. Although most referrals were local, some came as far away as British Columbia and Florida for persons wishing placement locally. Of the 2,005 persons referred and placed in 1975, 1,063 came from acute disease hospitals, 201 from other institutions, 628 from the community within this District, and the remainder from elsewhere. There were 1,187 women, of whom 89.5 per cent were over the age of 64, and 811 men, of whom 65.8 per cent were over that age. In the opinion of their physicians, only 20 percent of all persons referred had normal memory, and only 13 percent had normal judgment. In the 64+ age group, 71.1 percent of the women were widows, and 25.9 percent of the men were widowers. One-third of those referred were living alone, and one-fourth with a spouse only. For placement, 453 patients went to private residences or boarding homes, often with the support of community services, and the remainder went to various institutions according to identified needs. Follow-up contact one month later showed conditions to be satisfactory in most instances. Deficiencies in the health care system were identified and reported to the Health Council.

Aged↗
PubMed1966

Characteristics of geriatric patients in mental hospitals in the Province of Quebec.

The results of a questionnaire completed by the superintendents of five of the six major mental hospitals in the Province of Quebec concerning patients aged 60 and over showed that this group made up one-fifth to two-fifths of the total populations. The proportion of the population that was over age 60 when admitted varied from just under one-third to almost three-quarters. The ratio of those who died or were discharged at age 60 or more to the total elderly population varied greatly among institutions.Between 67% and 91% of the elderly were capable of ambulation and self-care with minimal help, and from 13.5% to 53% were considered mentally capable of living in a private home or residential home.Diagnostic types varied, among hospitals, from 28% to 65% functional, 13% to 32% organic and 4% to 33% senile psychoses.Experience with preventive and treatment programs elsewhere is discussed.

Aged↗