Quels sont les critères associés à un retour à domicile précoce chez des patients âgés de 75 ans et plus, hospitalisés la nuit dans l'unité d'hospitalisation de courte durée du centre hospitalier universitaire d'Angers ? PDF Download
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Author: Charlotte de Fabre de Latude
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Book Description
Objective: Study of the mobile geriatric team's (MGT) intervention on early discharge and return at home of elderly people admitted to the Emergency Department (ED) at night and the associated characteristics. Participants: Patients from the age of 75 onwards, admitted at Angers University Hospital Emergency Department between 8:00 p.m. and 8:00 a.m., between January, 30 2011 and June, 28 2011. Methods: case-control study evaluating the impact of the MGT's intervention on a discharge in the first 24 hours and analyzing the types of recommendations made and the clinical characteristics associated with early discharge. The geriatric and gerontological recommendations were made after realizing a comprehensive geriatric assessment. Results: On the 81 patients included, 47% of the patients evaluated by the MGT were discharged within 24 hours whereas only 19% of patients not evaluated by the MGT got home early. This early discharge was possible when the MGT made geriatrics recommendations (OR: 11.519 with P=0.02) but not when it made gerontological recommendation (OR: 1.486 with P=0.755). Multiple logistic regressions found that the age of 85 years old or older was a risk factor for hospitalization (OR: 0.080 with P=0.013) whereas social isolation was associated with an early discharge (OR: 31.677 with P=0.007). Conclusion: The MGT's intervention and its geriatrics recommendations on elderly people admitted at the ED at night might enable an early discharge.
Author: Charlotte de Fabre de Latude
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Book Description
Objective: Study of the mobile geriatric team's (MGT) intervention on early discharge and return at home of elderly people admitted to the Emergency Department (ED) at night and the associated characteristics. Participants: Patients from the age of 75 onwards, admitted at Angers University Hospital Emergency Department between 8:00 p.m. and 8:00 a.m., between January, 30 2011 and June, 28 2011. Methods: case-control study evaluating the impact of the MGT's intervention on a discharge in the first 24 hours and analyzing the types of recommendations made and the clinical characteristics associated with early discharge. The geriatric and gerontological recommendations were made after realizing a comprehensive geriatric assessment. Results: On the 81 patients included, 47% of the patients evaluated by the MGT were discharged within 24 hours whereas only 19% of patients not evaluated by the MGT got home early. This early discharge was possible when the MGT made geriatrics recommendations (OR: 11.519 with P=0.02) but not when it made gerontological recommendation (OR: 1.486 with P=0.755). Multiple logistic regressions found that the age of 85 years old or older was a risk factor for hospitalization (OR: 0.080 with P=0.013) whereas social isolation was associated with an early discharge (OR: 31.677 with P=0.007). Conclusion: The MGT's intervention and its geriatrics recommendations on elderly people admitted at the ED at night might enable an early discharge.
Author: Pierre Cartron
Publisher:
ISBN:
Category :
Languages : fr
Pages : 186
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Book Description
Introduction : la réhospitalisation précoce (dans les 30 jours après la sortie, RH30) des personnes âgées de 75 ans et plus (PA 75) est un indicateur validé d'évaluation des performances des services hospitaliers et des réseaux ville-hôpital dont l'application est recommandée par l'HAS. À notre connaissance, la RH30 des PA75 n'a pas été étudiée après une sortie d'unité d'hospitalisation de très courte durée (UHTCD). L'objectif de cette étude est de décrire cette population à partir d'un centre hospitalier (CH) et d'évaluer les modalités de prise en charge en rapport avec les spécificités de l'urgence et des périodes de tension hospitalière (TH). Méthode : étude rétrospective observationnelle unicentrique au sein de l'UHTCD du CH de Bourges sur 2 ans. Résultats : du 01/01/2015 au 31/12/2016, 337 RH30 ont été incluses concernant 293 patients âgés de 84,6 ± 6,2 ans, fragiles (présence de comorbidité 76,8%, polymédication 83,7%), vivant à domicile (73,9%). Les motifs cardiorespiratoires prédominaient (33,2%). La durée médiane de séjour était de 1 [1 ; 1] journée. Faute de lits disponibles 69,7% des patients séjournaient dans les couloirs, et 21,7% avaient un courrier de sortie. Un passage aux urgences (PU) dans les 6 mois avait précédé 54,9% des séjours. Le taux des RH30 était de 17,9%, majoritairement non programmées (76,0%), liées au premier séjour (62,9%). L'intervalle entre les séjours était de 11,9 ± 8,2 jours. Les sorties d'hospitalisation en période de vacances scolaires, de weekend et de jours fériés ainsi qu'un des indicateurs recommandés disponibles de TH étaient associés à un risque de RH30. Le seul score prédictif de RH30 recommandé applicable était le LACE (Length of stay, Acuity of admission, Comorbidities, Emergency department visits) et n'identifiait que 19% de haut risque de RH30. Conclusion : le taux de RH30 en UHTCD était comparable à celui connu des autres services. Néanmoins cette situation pourrait être améliorée par la détection des patients fragiles, l'envoi d'un courrier systématique, et l'adaptation prévisionnelle des moyens. Des études complémentaires sont nécessaires pour valider un score spécifique aux UHTCD.
Author: Hichem Lakehal
Publisher:
ISBN:
Category :
Languages : fr
Pages : 354
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Book Description
En raison du vieillissement de la population, les services d'accueil des urgences (SAU reçoivent de plus en plus de personnes âgées, dont une partie présente des facteurs de morbidité particuliers conjuguant une polypathologie, des défaillances psychosociales dans un contexte de fragilité physiologique. Cette étude rétrospective a pour objectif de faire une analyse démographique et médicale des patients de 75 ans et plus hospitalisés à l'unité d'hospitalisation de très courte durée (UHTCD) après passage au SAU. Le devenir de ces mêmes patients a également été étudié.Les résultats expriment l'utilité d'un accueil spécifique et précoce du patient gériatrique dès son admission au SAU et poursuivi à l'UHTCD.
Author: World Health Organization
Publisher: World Health Organization
ISBN: 9241549602
Category : Medical
Languages : en
Pages : 203
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Book Description
First published in March 2014 under the title "Clinical management of patients with viral haemorrhagic fever: a pocket guide for front-line health workers: interim emergency guidance for West Africa".
Author: Robert A. Hoekelman
Publisher: Mosby Incorporated
ISBN: 9780323008297
Category : Medical
Languages : en
Pages : 1936
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Book Description
-- An outstanding offer, both the New Hoekelman book & CD! -- Important new information at your fingertips, whether at the office or home.
Author: Fritz Zorn
Publisher: Alfred A. Knopf
ISBN:
Category : Biography & Autobiography
Languages : en
Pages : 264
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Book Description
Author: Michael J. Ford
Publisher: Elsevier Health Sciences
ISBN: 0443074178
Category : Medical
Languages : en
Pages : 190
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Book Description
The most important core skills for medical students to master are history taking and clinical examination. This extensively revised, eighth edition has been written with the philosophy that the acquisition of clinical skills is most effectively undertaken at the bedside. This pocketbook should be used as a companion, to be taken onto the wards and into consulting rooms where the information is most needed. The book begins with a system of history taking followed by a new chapter on the analysis of key symptoms. The remaining chapters cover physical examination of each of the major systems. Each stage of the examination starts with a detailed, step-by-step description of the examination method complemented by relevant illustrations, diagrams and tables on the facing page. This book is intended primarily for use at the outset of clinical training; once students have achieved proficiency in the basic skills of interviewing and examining, the book should also prove useful for revision. An invaluable starter book concentrating purely on the fundamentals of performing a patient examination. Covers each body system and outlines the principles of: - taking a history - how to conduct a physical examination - specific examination points as appropriate Concentrates only on the main symptoms of disease and then the normal and abnormal physical findings. Mention of specific diseases is confined to those most commonly encountered. Compact and pocket-sized to be carried around easily. · Now in full colour double-page format · Clear simple colour line drawings covering the essentials of a clinical examination. · Published simultaneously with the Eleventh Edition of Macleod's Clinical Examination
Author: Philip A. Pizzo
Publisher: Lippincott Williams & Wilkins
ISBN: 9780683303995
Category : Medical
Languages : en
Pages : 849
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Book Description
Recommended in the Brandon/Hill selected list of print books and journals for the small medical library - April 2001 & 2003 The Third Edition of this very popular book offers the most authoritative and comprehensive review of the impact of the HIV disease in infants, children, and adolescents.
Author: Benoît Verdon
Publisher: Hogrefe Publishing
ISBN: 9780889375574
Category : Projective techniques
Languages : en
Pages : 0
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Book Description
"Unique synthesis from the French School of psychoanalytical projective methods This unique book synthesizes the work of leading thinkers of the French School of psychoanalytical projective methods in personality assessment. The French School is a direct successor to Rorschach's and Murray's original approaches using the Rorschach Test and the Thematic Apperception Test (TAT). Underlying this method is the idea of the coexistence of conscious and unconscious processes, of opposite instinctual pairs, and of agents that are ruled by conflicts (Freud). Transitional activity is seen as part of an intermediate space, a mediator space, and bearer of messages between the subject and the clinician (Winnicott). This book brings to life the important contributions of the French School, firstly exploring its theories and methods and then its clinical applications. Detailed case studies from different stages of life examine the psychopathology of everyday life with its severe and disabling states of suffering. Contemporary advances in research and clinical work are presented, and the groundbreaking early work of Nina Rausch de Traubenberg, Vica Shentoub, and Rosine Debray are also critically reread and discussed. Clinical tools adapted for clinicians and researchers in the appendices include a useful schema to facilitate the interpretation of the Rorschach and TAT together, a list of latent solicitations for the TAT, and the current version of the TAT Scoring Grid. This book is essential reading for clinical psychologists, psychiatrists, psychotherapists, researchers, and students interested in applying psychoanalytical theory to projective methods"--
Author: Gillian S. Mace
Publisher: Springer
ISBN:
Category : Family & Relationships
Languages : en
Pages : 296
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Book Description
The Bereaved Child: Analysis, Education, and Treatment. An ab stracted bibliography is a comprehensive abstracted bibliography focusing on the reactions and coping mechanisms of children and adolescents to the death of parents, siblings, friends, teachers, pets or even presidents. Publication~ dealing with both normative and pathological stages of bereavement are reviewed. Materials covering childhood concepts/attitudes toward death are included. Citations appear which explore child death education/counseling issues for parents and educators when they involve actual or antic ipated death. Articles are reviewed which deal with the importance of the adult role in the mourning process of the child. For example, decisions such as whether a child should attend a funeral or return to school are examined. Publications are included which explore the short and l'ong term developmental consequences of childhood death experience. It is important to note that the topic of the dying child was excluded. The Bereaved Child contains over 550 citations in author alphabetized and abstracted form. Only English-written books and periodicals are represented. A quick glance will reveal that the bulk of the material is post-1960. This reflects the recency of in terest and study in the area of childhood bereavement. Literature across multiple disciplines was scanned and included. Psychology, medicine, social work, and education are heavily represented, while no theological, literary, or popular sources were examined.
