Using Quality Indicator Codes to Identify Patients’ Fall Risk in Inpatient Rehabilitation Facilities

ObjectiveTo discover if quality indicator (QI) codes are associated with patient falls in inpatient rehabilitation facilities (IRFs).DesignThis retrospective cohort study explored differences between patients who fell and those who did not fall. We analyzed potential associations between QI codes and falls using univariable and multivariable logistic regression models.SettingWe collected data from electronic medical records at 4 IRFs.ParticipantsIn 2020, our 4 data collection sites admitted and discharged a total of 1742 patients older than 14 years . We only excluded patients (N=43) from statistical analysis if they were discharged before admission data had been assigned.InterventionsNot applicable.Main Outcome MeasuresUsing a data extraction report, we collected age, sex, race and ethnicity, diagnosis, falls, and QI codes for communication, self-care, and mobility performance. Staff documented communication codes on a 1-4 scale and self-care and mobility codes on a 1-6 scale, with higher codes representing greater independence.ResultsNinety-seven patients (5.71%) fell in the 4 IRFs over a 12-month period. The group who fell had lower QI codes for communication, self-care, and mobility. When adjusting for bed mobility, transfer, and stair-climbing ability, low performance with understanding, walking 10 feet, and toileting were significantly associated with falls. Patients with admission QI codes below 4 for understanding had 78% higher odds of falling. If they were assigned admission QI codes below 3 for walking 10 feet or toileting, they had 2 times greater odds of falling. We did not find a significant association between falls and patients’ diagnosis, age, sex, or race and ethnicity in our sample.ConclusionsCommunication, self-care, and mobility QI codes appear to be significantly associated with falls. Future research should explore how to use these required codes to better identify patients likely to fall in IRFs.     

Is Profit Status of Inpatient Rehabilitation Facilities Independently Associated With 30-Day Unplanned Hospital Readmission for Medicare Beneficiaries?

Objective

To investigate the effects of facility-level factors on 30-day unplanned risk-adjusted hospital readmission after discharge from inpatient rehabilitation facilities (IRFs).

Measuring Inpatient Rehabilitation Facility Quality of Care: Discharge Self-Care Functional Status Quality Measure

Objective

To describe the calculation and psychometric properties of the discharge self-care functional status quality measure implemented in the Centers for Medicare & Medicaid Services' (CMS) Inpatient Rehabilitation Facility (IRF) Quality Reporting Program on October 1, 2016.

A Novel Protocol for Contact Isolation for Multidrug-Resistant Organisms in Children on Inpatient Rehabilitation and Effects on Functional Outcomes: A Noninferiority Study

Background

The incidence of contact isolation for multidrug-resistant organisms is increasing in acute hospitals and inpatient rehabilitation units alike. There is limited evidence on the effect of contact isolation on functional outcomes during inpatient rehabilitation.

Rehabilitation nurse after temporomandibular arthroplasty

Background:Femoral subtrochanteric fracture means fractures happened 5 cm away from inferior margin level of samll trochanter.Most of this kind of fracure in unstable fractures caused by trauma mostly and characterized with large malposition,splintered and difficult to be treated.It will lead to a series of severe complications if treated improperly.Objective:To evaluate the clinical effect of the remoral interlocking intramedullary nailing for the treatment of subtrochanteric fracture.Unit:Department of Orthopedics,First Hospital of Suzhou Univerisyt Subjects:2 cases combined with fracture of shaft of femur in 10 cases of subtrochanteric fracture,including 7 males and 3 females,age 22-48 years,average age 32.8 years,4 cases suffered left side,6 cases suffered right side.8 cases of road accident,1 case of falling trauma and 1 case of crash trauma.All the cases were treated with closes reduction except 2 cases combined with fracture of shaft of femur.According to Seinsheimer classification:2 cses of ⅡB type,3 cases of ⅡC type,3 cases of Ⅲ A type,2 cases of Ⅳtype,all these 10 cases were closure trauma.Intervention:Patients received traction 5-7 days afte hos pitalization to relieve pain and maintain length of suffered limb.We took full-length X-ray of other side femur to estimate length and diameter of intramedullary pin,After lateral position,we mede 6-8cm incision along near end of femoral larger trochanter to near lateral side obliquely,cut fasciae of gluteus maximus muscle longitudinally along incision,identified level of inferior fasciae of gluteus maximus muscle,touched inside pyriform recess,pored at pyriform recess along longitudinal axis of shaft of femur,pore localizing in the middle of femur,reduced fracture under X-ray,inserted guide to distal end and dilated marrow tp 13cm.Then we put intramedullary pin with proper lentth and diameter at level of the top of larger trochanter,locked distal and approximate ends with interlocked pin.Incision need to be extended to needed length to distal end along larger trochanter,borke partly the starting point of vastus lateralis if patients received incisive reduction,expose fracture and reduce under direct,look.Patients received CPM knee joint function exercises after operation;patients load weight completely after fracture healed.Patients received routine X-ray exams 6 and 12 weeks after operation,if only few callus formed around the fracture,we suggest removing distal interlocked pin.Result:All the patients were followed up for 12-25 months,average 16.3 months.All the fractures were healed.Conclusiong:Femoral interlocked intrameduallary pin treating sbutrochanteric fracture is an ideal nternal fixation method.     

“Rehabilitation Research Framework for Patients With COVID-19” Defined by Cochrane Rehabilitation and the World Health Organization Rehabilitation Programme

The coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of research activity. Since its outset, efforts have been made to guide the rapid generation of research in medicine. There are gaps in some areas of rehabilitation research for patients with COVID-19. The development of a specific research framework might serve to help monitor the status of research (mapping), shape and strengthen research by pointing to under-investigated areas, and promote rehabilitation research in this context. This article introduces and discusses the COVID-19 Rehabilitation Research Framework (CRRF) and presents the methodology used for its development.The questions have been developed among the World Health Organization (WHO) Rehabilitation Programme, Cochrane Rehabilitation, and the experts of its Rehabilitation–COVID-19 Evidence-based Response Action International Multiprofessional Steering Committee. The framework is divided into 2 parts and includes 20 questions organized in 4 groups: epidemiology, and evidence at the micro- (individual), meso- (health services), and macro- (health systems) levels.The CRRF offers a comprehensive view of the research areas relevant to COVID-19 and rehabilitation that are necessary to inform best practice and ensure rehabilitation services and health systems can best serve the population with COVID-19. The collaboration between Cochrane Rehabilitation and the WHO Rehabilitation Programme in establishing the CRRF brought together perspectives from the health systems, health management, and clinical evidence. The authors encourage researchers to use the CRRF when planning studies on rehabilitation in the context of COVID-19.     

Stroke Rehabilitation In The United States

Stroke rehabilitation currently is a very exciting area in which to be involved.There is much going on with regard to clinical research,and much more to come.     

Inpatient mortality: a reflection of quality care?

The debate surrounding mortality as a measure of healthcare quality is not a new one. In this article, the authors review the origin of mortality indices within the healthcare industry, explore the challenges and limitations to generating and risk adjusting mortality data, and discuss the relationship between institutional mortality and quality of care. The article ends with a summary of current sources of mortality data with which healthcare professionals need to be familiar.     

Rehabilitation trainging of ankle fractures afteropen reduction

Background：Anklejointisaweightcarryingone，whichtreatmentfocusesonanatomicalreductionofarticularsurface．Theultimateaimiscompletelyrecoveryofjointfunction．Itismuchbenefitforopenreductionwithrationalrehabilitationtrainingofpostoperationtofunctionrecoveryofanklejoint．Objective：Toexplorethetreatmenteffectofrehabilitationtrainingofopenreductiononanklefracture．Unit：FirstHospitalofZiboCity．Subject：５９patientswithanklefracturewererecruitedfromJuly１９９７toJuly１９９９，３７menand２２wom…     

Rehabilitation nursing experience for acute lumbar sprain

TREATMENTEXPERIENCEFORLUMBARSPRAINMassageandtractionareoftenusedintreatmentoflumbarspraintoalleviateadhesionofmuscleandligament,enlargeintervertebralspace.Atthesametime,localdialysis,physicaltherapymightbeused,alsoacupuncturemoxibustion.Tomassagetreatment,painpointsatlumbodorsalorlumbosacralpartaremassagedfor15minutes,thereafterpressedfor10minutestopromotelumbosacralbloodcirculationandexcitelumbosacralnerves.Afterpain,spasmarerelieved,localcompressionoftraditionalChinesemedicinei…     

Rehabilitation training of children with mental retardation

INTRODUCTION５３mentallyretardedchildren（MRC）receivedrehabilitationsince１９８２，significanteffectwasobservedsuggestingthesechildrenre－habilitationpotential．MATERIALSANDMETHODSMaterial５３MRCfromourhospitalparticipatedinourstudy，including１４boysand３９girls，amongwhich，３９haddisabilitiesofotherkinds．５３childrenweredividedaccordingtoIQgroupingproposedbyWUTianming，PekingUniversity．１２childrenhadmildmentalretardation（IQ：５１－７０），１７hadmoderatementalretardati…     

Rehabilitation guidance after total hip joint replacement

BACKGROUND: Total hip joint replacement ia commonly applied in clinic, and rehabilitation guidance after operation plays an important role in postoperative recovery.OBJECTIVE: To observe the effect of rehabilitation guidance on operation after total hip joint replacement.UNIT: Orthopedics centre, Tangdu Hospital, Fourth Military Medical UniversitySUBJECTS: 20 patients, including 6 males, 14 females, age 62 - 78 years old, average 71.5 years. Old fracture 14 cases, aseptic necrosis of head of femur 2 cases, congenital dysplasia of hip joint 4     

Rehabilitation therapy of cerebral hemorrhage in acute phase

Background:Acutephaseincerebralhemorrhagereferstothefirsttwoweeksandinthisperiodpatient'sconditionisunstable.Incidenceofdisabilityincerebralhemorrhageisveryhighandhowtoreducetheincidenceinmaximumandimprovepatent'slivingqualityhasbecomeanimportantclinicproblem.Objective:Toinvestigatetheeffectofrehabilitationtherapyonlivingqualityofpatientswithcerebralhemorrhageinacutephase.Subjects:147casesofcerebralhemorrhagefromMay1999toAugust2001wereinvestigatedincluding84males,63females,aged38-87(mean:57.…