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Biomedical subjects

N G Castle

Publications and source records attributed to N G Castle.

30 records · Page 2Linked to original sources
PubMed1997

Top management team characteristics and innovation in nursing homes.

This study examines how the demographic characteristics of the top management team in 236 nursing homes can affect the adoption of innovations. The computerization of the Minimum Data Set (MDS) is the innovation we examine, and tenure, education, and involvement in a professional society are the demographic characteristics investigated. Controlling for 10 organizational and environmental factors, the results are generally significant for each of these demographic factors. However, the results for top managers of nonchain nursing homes show a greater association between these demographic factors and innovation than the results for top managers of nursing homes belonging to a chain. We discuss these results in terms of their significance for innovation research, nursing homes, and top management.

Humans↗
PubMed1997

Risk factors for physical restraint use in nursing homes: pre- and post-implementation of the Nursing Home Reform Act.

The purposes of this article are (1) to identify resident and facility risk factors for the use of physical restraints since the implementation of the Nursing Home Reform Act (NHRA), and (2) to compare these results with resident and facility risk factors for the use of physical restraints prior to the implementation of the NHRA. Data were collected in 1990 and 1993, and represent residents drawn from 268 facilities in 10 states. In the 1993 cohort activities of daily living (ADL) scores, cognitive performance scale (CPS) scores, age, taking antipsychotic medications, a history of falls, and mobility problems were resident-level variables significantly associated with the use of restraints. Full-time-equivalent (FTE) nurse aides per resident, FTE RNs per resident, average occupancy, Herfindahl index, Alzheimer's special care unit, and Medicaid reimbursement policy were facility-level variables significantly associated with the use of restraints. When the 1990 cohort was compared to the 1993 cohort (pre- and post-NHRA), however, only three risk factors for the use of restraints were significant. We propose that, to date, the NHRA may have been successful in reducing the use of physical restraints, but it appears to have had less impact on the types of residents who are restrained.

Activities of Daily Living↗
PubMed1997

Mental health services and the mortality of nursing home residents.

This article examines the impact of mental health services on the mortality rate for mentally ill nursing home residents. Previous research has documented the unmet need for mental health services among nursing home residents. Some research using small data sets has indicated patient benefits from treatment. This article examines the issue using data from the nationally representative National Nursing Home Survey. In a series of multivariate logistic regressions, treatment for mental illness provided by either general practice physicians or by mental health specialists appears to have few impacts on mortality. A statistically significant treatment effect is found only for residents with schizophrenia, other psychoses, or anxiety disorders when treated by mental health specialists. The results are discussed with reference to ongoing reforms for mental health care in nursing homes.

Aged↗
PubMed1997

Quality improvement in nursing homes.

Regulation, competition, and cost containment have focused attention on quality improvement in nursing homes. Definition, measurement, and monitoring of quality are essential components of any program designed for quality assurance or continuous quality improvement.

Economic Competition↗
PubMed1997

Specialization and diversification in the nursing home industry.

Recent increases in the types of services offered by nursing facilities and in the formation of specialized care units have resulted in the emergence of two distinct but broadly defined types of services: subacute and long-term care. The authors examine the market, regulatory, and structural incentives behind diversification and specialization and speculate how these trends will affect the future of the nursing home industry.

Economic Competition↗
PubMedDate not supplied

Outcomes measurement and quality improvement in long-term care.

As healthcare providers proceed with redesigning patient care, forming centers of excellence, developing clinical pathways, focusing on best practices, and restructuring care services in their efforts to improve the structures and the processes of healthcare, outcomes research can help to determine the most effective patient care regimens. In a similar manner, outcomes are also assuming a higher priority for administrators of long-term care facilities. This article defines outcomes, discusses how they are being used in long-term care settings, presents commonly used outcomes, and describes how these outcomes can be measured and graphically displayed.

Aged↗
PubMedDate not supplied

Injuries in indoor soccer. The Lake Placid Dawn to Dark Soccer Tournament.

We conducted a prospective study of soccer injuries during the Soccer America Dawn to Dark Indoor Soccer Tournament, which was organized by the Lake Placid Soccer Center, Lake Placid, New York, 1993. Eight hundred twenty-four players competed in open men's, open women's, over-30 men's, and mixed divisions. The overall rate of injury per 100 player hours was 4.44, with a rate of 5.79 in the open men's, 4.74 in the open women's, 2.73 in the over-30 men's, and 1.54 for the mixed divisions. The differences in injury rates for men versus women and men versus older men were not statistically significant. Twenty-five of the 38 injuries (65.8%) were mild, with 27 injuries (71.4%) occurring in the lower extremities. Ankle sprains were the most common injuries and combined ligamentous injuries to the knee were the most common severe injuries. As the injuries increased in severity, they were more likely to be noncontact injuries. The data demonstrate the low incidence of injury in male and female indoor soccer participants. The data also show the similarity in the types of injuries sustained by indoor and outdoor soccer players.

Adult↗