"Gleaning a lot from the history and physical exam," and "reasonably confident without imaging": a qualitative study of primary care clinicians' management of patients with low back pain.

Background: Routine seeking of imaging for patients with low back pain is not concordant with the evidence-based recommendation that imaging is rarely of diagnostic value. Inappropriate imaging is a waste of resources and can lead to undesirable downstream effects for individuals and health systems. To develop effective strategies to reduce unwarranted referrals for imaging in primary care, we must understand the drivers for, and barriers to, guideline-adherent practice.

Nurse Practitioner and Physician Collaboration in the Long-Term Care Setting: Secondary Analysis of a Scoping Review.

Objective: Over the past decade, the role of nurse practitioners (NPs) in long-term care home (LTCH) settings has significantly expanded. Despite this trend, gaps have been identified in the description of collaborative practices between NPs and physicians in the LTCH sector. This study aimed to characterize the elements of collaboration between NPs and physicians in LTCH settings by applying the "Structured Collaborative Practice Core Model.

Postoperative delirium in geriatric orthopedic and trauma patients: Care begins preoperatively!

Delirium is a common and serious neuropsychiatric syndrome affecting older adults, particularly after surgery. It manifests in three forms: hypoactive, hyperactive, and mixed, with symptoms ranging from lethargy and inattention to agitation and confusion. Delirium is often misdiagnosed or overlooked, especially in its hypoactive form, which can delay treatment and worsen patient outcomes.

What Do We Know About Nurse Practitioner/Physician Care Models in Long-Term Care: Results of a Scoping Review.

Objectives: Due to the rise of the nurse practitioner (NP) role in long-term care settings, it is important to understand the underlying structures and processes that influence NP and physician care models. This scoping review aims to answer the question, "What are the structures, processes, and outcomes of care models involving NPs and physicians in long-term care (LTC) homes?" A secondary aim was to describe the structural enablers and barriers across care models.

Research Design And Methods: Seven databases were searched.

Factors That Influence Successful Adoption of Real-Time Location Systems for Use in a Dementia Care Setting: Mixed Methods Study.

Background: Technology has been identified as a potential solution to alleviate resource gaps and augment care delivery in dementia care settings such as hospitals, long-term care, and retirement homes. There has been an increasing interest in using real-time location systems (RTLS) across health care settings for older adults with dementia, specifically related to the ability to track a person's movement and location.

Objective: In this study, we aimed to explore the factors that influence the adoption or nonadoption of an RTLS during its implementation in a specialized inpatient dementia unit in a tertiary care rehabilitation hospital.

Nurse practitioner/physician collaborative models of care: a scoping review protocol.

Background: Before the COVID-19 pandemic, many long-term care (LTC) homes experienced difficulties in providing residents with access to primary care, typically delivered by community-based family physicians or nurse practitioners (NPs). During the pandemic, legislative changes in Ontario, Canada enabled NPs to act in the role of Medical Directors thereby empowering NPs to work to their full scope of practice. Emerging from this new context, it remains unclear how NPs and physicians will best work together as primary care providers.

Real-time location systems technology in the care of older adults with cognitive impairment living in residential care: A scoping review.

Introduction: There has been growing interest in using real-time location systems (RTLS) in residential care settings. This technology has clinical applications for locating residents within a care unit and as a nurse call system, and can also be used to gather information about movement, location, and activity over time. RTLS thus provides health data to track markers of health and wellbeing and augment healthcare decisions.

Prevalence, causes, and consequences of moral distress in healthcare providers caring for people living with dementia in long-term care during a pandemic.

Healthcare providers caring for people living with dementia may experience moral distress when faced with ethically challenging situations, such as the inability to provide care that is consistent with their values. The COVID-19 pandemic produced conditions in long-term care homes (hereafter referred to as 'care homes') that could potentially contribute to moral distress. We conducted an online survey to examine changes in moral distress during the pandemic, its contributing factors and correlates, and its impact on the well-being of care home staff.

A health care record review of early mobility activities after fragility hip fracture: Utilizing the French systematic method to inform future interventions.

Background: A fragility hip fracture is a serious injury in older adults. After experiencing a fracture, a large percentage of patients do not regain their pre-fracture level of mobility. There are several international guidelines recommending early mobility after surgery.

Early mobility after fragility hip fracture: a mixed methods embedded case study.

Background: Following a hip fracture up to 60% of patients are unable to regain their pre-fracture level of mobility. For hospitalized older adults, the deconditioning effect of bedrest and functional decline has been identified as the most preventable cause of ambulation loss. Recent studies demonstrate that this older adult population spends greater than 80% of their time in bed during hospitalization, despite being ambulatory before their fracture.