Study population and design Nursing homes across the USA were invited to participate in this study. Using a professional data collection service (Synovate Healthcare), invitations to participate were provided through a mass listing of nursing homes across the USA, without regard to regional location or economic status of residents. Institutions excluded from study participation were long-term care facilities, including rehabilitation centers, dialysis clinics, assisted living homes or adult day care centers.
Forty nursing homes who responded to the invitation were able to provide eligible patient data for analysis. These included institutions from the East, Midwest, Central Plains, Northwest, South, and Hawaii. Subject inclusion criteria included: were 18 years of age; had 1Hb level reported during the data uptake period of 1/1/04–2/1/05 (first occurrence defined as index Hb); and had a recorded serum creatinine level, maintained residency in the facility, and did not receive dialysis during the 6-month post-index follow-up period.
Within each nursing home, nurses employed by the institution were asked to: (1) perform a systematic random sampling of all patient charts; (2) review charts on-site to determine if eligibility inclusion criteria were met; (3) record abstracted information from eligible patient charts onto de-identified data collection forms; and (4) send completed data collection forms to a professional data collection and study recruiting service for data entry. The systematic random sampling procedure was initiated by randomly selecting a patient chart and evaluating its eligibility for study inclusion; subsequently, every third chart was selected and evaluated for eligibility. The sampling was to be continued until approximately 15–20 eligible residents were identified for inclusion. A summary of the data abstraction process is shown in Figure 1.
Abstracted data included resident demographics, Hb and serum creatinine, medical history and comorbid conditions (i.e., any diseases or conditions identified within the chart), concurrent medications including therapies for anemia, activities of daily living (ADL), hospital admissions, and incidents of falls. Data were taken from the medical chart as well as from the most recent Minimum Data Set (MDS) assessment. All abstracted data were de-identified in accordance with HIPAA requirements. The earliest Hb level obtained during the uptake period was identified as the index Hb level; the date of this level was the index date. The residents’ clinical parameters, management and any incidents of falls were then followed through the chart for the 6-month period following the index date.
For each resident, GFR, as well as ADL and balance scores were calculated. The chart abstractor was asked to report the serum creatinine level (mg/dL) closest in time to the index Hb level. From this data and age, gender and race reported by the abstractors, researchersused the Modification of Diet in Renal Disease (MDRD) algorithm20. Glomerular filtration rate is calculated using the equation shown in Figure 2.
The method to estimate an ADL score from the ‘ADL self performance’ ratings as reported in the MDS is described in Carpenter et al.21. Performance on seven ADL items (bed mobility, transfer, locomotion, dressing, eating, toilet use and personal hygiene) are each reported in the MDS on a scale from 0 (independent) to 4 (total dependence). The sum of the seven ratings yields a 0- to 28-point ADL score, where a higher score indicates lower ADL performance (greater dependence). This method was also applied to the ‘Test for Balance’ reported in the MDS. The two balance items (balance while standing, balance while sitting)
Study population and design Nursing homes across the USA were invited to participate in this study. Using a professional data collection service (Synovate Healthcare), invitations to participate were provided through a mass listing of nursing homes across the USA, without regard to regional location or economic status of residents. Institutions excluded from study participation were long-term care facilities, including rehabilitation centers, dialysis clinics, assisted living homes or adult day care centers.
Forty nursing homes who responded to the invitation were able to provide eligible patient data for analysis. These included institutions from the East, Midwest, Central Plains, Northwest, South, and Hawaii. Subject inclusion criteria included: were 18 years of age; had 1Hb level reported during the data uptake period of 1/1/04–2/1/05 (first occurrence defined as index Hb); and had a recorded serum creatinine level, maintained residency in the facility, and did not receive dialysis during the 6-month post-index follow-up period.
Within each nursing home, nurses employed by the institution were asked to: (1) perform a systematic random sampling of all patient charts; (2) review charts on-site to determine if eligibility inclusion criteria were met; (3) record abstracted information from eligible patient charts onto de-identified data collection forms; and (4) send completed data collection forms to a professional data collection and study recruiting service for data entry. The systematic random sampling procedure was initiated by randomly selecting a patient chart and evaluating its eligibility for study inclusion; subsequently, every third chart was selected and evaluated for eligibility. The sampling was to be continued until approximately 15–20 eligible residents were identified for inclusion. A summary of the data abstraction process is shown in Figure 1.
Abstracted data included resident demographics, Hb and serum creatinine, medical history and comorbid conditions (i.e., any diseases or conditions identified within the chart), concurrent medications including therapies for anemia, activities of daily living (ADL), hospital admissions, and incidents of falls. Data were taken from the medical chart as well as from the most recent Minimum Data Set (MDS) assessment. All abstracted data were de-identified in accordance with HIPAA requirements. The earliest Hb level obtained during the uptake period was identified as the index Hb level; the date of this level was the index date. The residents’ clinical parameters, management and any incidents of falls were then followed through the chart for the 6-month period following the index date.
For each resident, GFR, as well as ADL and balance scores were calculated. The chart abstractor was asked to report the serum creatinine level (mg/dL) closest in time to the index Hb level. From this data and age, gender and race reported by the abstractors, researchersused the Modification of Diet in Renal Disease (MDRD) algorithm20. Glomerular filtration rate is calculated using the equation shown in Figure 2.
The method to estimate an ADL score from the ‘ADL self performance’ ratings as reported in the MDS is described in Carpenter et al.21. Performance on seven ADL items (bed mobility, transfer, locomotion, dressing, eating, toilet use and personal hygiene) are each reported in the MDS on a scale from 0 (independent) to 4 (total dependence). The sum of the seven ratings yields a 0- to 28-point ADL score, where a higher score indicates lower ADL performance (greater dependence). This method was also applied to the ‘Test for Balance’ reported in the MDS. The two balance items (balance while standing, balance while sitting)
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ประชากรศึกษาและบ้านออกแบบในสหรัฐอเมริกาได้รับเชิญให้เข้าร่วมในการศึกษานี้ ใช้บริการเก็บข้อมูลแบบมืออาชีพ ( Synovate ) ) เชิญเข้าร่วมให้ความรู้ผ่านมวลรายชื่อสถานพยาบาลทั่วประเทศสหรัฐอเมริกา โดยไม่เกี่ยวกับสถานที่ในระดับภูมิภาค หรือสถานะทางเศรษฐกิจของชาวบ้าน Institutions excluded from study participation were long-term care facilities, including rehabilitation centers, dialysis clinics, assisted living homes or adult day care centers.
Forty nursing homes who responded to the invitation were able to provide eligible patient data for analysis. These included institutions from the East, Midwest, Central Plains, Northwest, South, and Hawaii.หัวข้อ : รวม การตระเตรียม ) อายุ 18 ปี มีระดับ 1hb ในระหว่างการรายงานข้อมูลระยะเวลา 1 / 1 / 04 - 2 / 1 / 05 ( เกิดก่อนกำหนดดัชนี HB ) ; และมีการบันทึกระดับ serum creatinine , รักษาผู้อยู่อาศัยในบ้านพัก และไม่ได้รับการฟอกไตระหว่าง ดัชนีการติดตามระยะเวลา 6 เดือนหลัง .
ภายในแต่ละบ้านพยาบาลพยาบาลที่ใช้โดยสถาบันผลการวิจัยพบว่า : ( 1 ) แสดงการสุ่มเลือกของแผนภูมิผู้ป่วยทั้งหมด ( 2 ) ทบทวนแผนภูมิในโรงแรมเพื่อตรวจสอบว่าเกณฑ์การมีสิทธิ์ได้เจอ ; ( 3 ) บันทึกสรุปข้อมูลจากสิทธิผู้ป่วยแผนภูมิบน เดอ ระบุแบบฟอร์มการเก็บรวบรวมข้อมูล and (4) send completed data collection forms to a professional data collection and study recruiting service for data entry. The systematic random sampling procedure was initiated by randomly selecting a patient chart and evaluating its eligibility for study inclusion; subsequently, every third chart was selected and evaluated for eligibility.ตัวอย่างจะถูกอย่างต่อเนื่องจนถึงประมาณ 15 – 20 สิทธิ์ผู้ถูกระบุสำหรับการรวม . สรุปข้อมูลนามธรรมขั้นตอนแสดงในรูปที่ 1
สรุปข้อมูลประชากรที่อยู่อาศัย HB และ serum creatinine , ประวัติทางการแพทย์และสภาพ comorbid ( เช่น โรคหรือเงื่อนไขที่ระบุในแผนภูมิ ) concurrent medications including therapies for anemia, activities of daily living (ADL), hospital admissions, and incidents of falls. Data were taken from the medical chart as well as from the most recent Minimum Data Set (MDS) assessment. All abstracted data were de-identified in accordance with HIPAA requirements.ระดับฮีโมโกลบินแรกสุดที่ได้รับในช่วงระยะเวลาการใช้ที่ถูกระบุว่าเป็นระดับดัชนี HB ; วันที่ของระดับนี้คือวันที่ดัชนี ที่พักในคลินิกพารามิเตอร์ การจัดการ และเหตุการณ์ใด ๆ ของตก แล้วตามด้วยแผนภูมิสำหรับ 6 เดือนตามวันที่ดัชนี .
สำหรับแต่ละ resident GFR เช่นเดียวกับ ADL และความสมดุลของคะแนนที่ได้ The chart abstractor was asked to report the serum creatinine level (mg/dL) closest in time to the index Hb level. From this data and age, gender and race reported by the abstractors, researchersused the Modification of Diet in Renal Disease (MDRD) algorithm20. Glomerular filtration rate is calculated using the equation shown in Figure 2.
The method to estimate an ADL score from the ‘ADL self performance’ ratings as reported in the MDS is described in Carpenter et al.21. Performance on seven ADL items (bed mobility, transfer, locomotion, dressing, eating, toilet use and personal hygiene) are each reported in the MDS on a scale from 0 (independent) to 4 (total dependence).ผลรวมของ 7 คะแนนทำให้ 0 - 28 จุดทำคะแนน ซึ่งคะแนนสูงบ่งชี้ว่าราคา ADL ประสิทธิภาพมากขึ้น ( การพึ่งพา ) วิธีนี้ยังใช้เพื่อทดสอบ ' สมดุล ' ในการรายงาน MDS . สองรายการที่สมดุล ( สมดุลขณะยืนทรงตัวขณะนั่ง )
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