Lorraine C. Mion

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OBJECTIVES To evaluate the predictive ability of a simple six-item triage risk screening tool (TRST) to identify elder emergency department (ED) patients at risk for ED revisits, hospitalization, or nursing home (NH) placement within 30 and 120 days following ED discharge. METHODS Prospective cohort study of 650 community-dwelling elders (age 65 years or(More)
Heart failure (HF) is the leading cause of rehospitalization in older adults. The purpose of this pilot study was to examine whether telemonitoring by an advanced practice nurse reduced subsequent hospital readmissions, emergency department visits, costs, and risk of hospital readmission for patients with HF. One hundred two patient/caregiver dyads were(More)
STUDY OBJECTIVE Elderly emergency department patients have complex medical needs and limited social support. A transitional model of care adapted from hospitals was tested for its effectiveness in the ED in reducing subsequent service use. METHODS A randomized clinical trial was conducted at 2 urban, academically affiliated hospitals. Participants were(More)
Older emergency department (ED) patients have complex medical, social, and physical problems. We established a program at four ED sites to improve case finding of at-risk older adults and provide comprehensive assessment in the ED setting with formal linkage to community agencies. The objectives of the program are to (1) improve case finding of at-risk(More)
OBJECTIVE To identify factors associated with the occurrence of deliberate self-extubation and to describe associated patient outcomes. DESIGN Case-control study. SETTING ICUs of a national referral, tertiary medical center. PARTICIPANTS Fifty adult, intubated patients who had self-extubated from mechanical ventilatory support. Two control subjects(More)
Increasing demand to deliver and document therapeutic and preventive care sharpens the need for disease management strategies that accomplish these goals efficiently while preserving quality of care. The purpose of this study was to compare selected outcomes for a new chronic disease management program involving a nurse practitioner - physician team with(More)
BACKGROUND Nurses play a key role in recognition of delirium, yet delirium is often unrecognized by nurses. Our goals were to compare nurse ratings for delirium using the Confusion Assessment Method based on routine clinical observations with researcher ratings based on cognitive testing and to identify factors associated with underrecognition by nurses. (More)
To assess acute-phase proteins in relation to ageing, we measured serum concentrations of C-reactive protein of AGP in 131 healthy elderly individuals (aged >/= 65 years) living independently in the community, and 47 healthy younger individuals. Concentrations of CRP in the older persons (median = 3.0 microg/ml) were significantly greater than in the(More)
OBJECTIVE Information is needed about patient-initiated device removal to guide quality initiatives addressing regulations aimed at minimizing physical restraint use. Research objectives were to determine the prevalence of device removal, describe patient contexts, examine unit-level adjusted risk factors, and describe consequences. DESIGN Prospective(More)
PURPOSE To describe physical restraint (PR) rates and contexts in U.S. hospitals. DESIGN This 2003-2005 descriptive study was done to measure PR prevalence and contexts (census, gender, age, ventilation status, PR type, and rationale) at 40 randomly selected acute care hospitals in six U.S. metropolitan areas. All units except psychiatric, emergency,(More)