Strategies to Prevent Hospital Transfers in the SNF Environment

This project focuses on the CNL curriculum element of Care Environment Management. The purpose of this project is to reduce hospital readmissions in geriatric patients who are currently having any changes of medical condition within the SNF microsystem. In this project, the CNL functions as the team manager and care coordinator. The CNL facilitated, and utilized patients’ outcome data to make changes in care processes to reduce acute hospital transfers in the skilled nursing facility. The CNL lead the interdisciplinary team and was resource or point of contact for this project. The CNL educated nurses to utilize (Interventions to Reduce Acute Care Transfers) INTERACT™ Early Warning Tool. Roger’s Diffusion of Innovation was the theoretical framework for this project. Root cause analysis (RCA) was done, to identify contributing factors that lead to an increase incidences of avoidable hospital transfers and readmissions. Both internal and external data in the SNF’s microsystem identified a common theme, lack of in communication between social services (discharge planners), nursing, and physicians. . After consideration of the INTERACT tool the DON and CNL identified the two INTERACT communication tools and two INTERACT decision support tools to implement. Some examples of the INTERACT tools are shown in Appendix G. The INTERACT tools are designed to improve the identification, management, communication, evaluation, and documentation about acute changes in patients condition (Ouslander et al., 2011). The plan is to decrease acute hospital transfers and admissions by 2%. INTERACT toolkit, improved workflow for nursing staff and decrease avoidable hospital transfers. In March of 2016, 12.31% of patients were transferred to the acute from the SNF environment; as of July 2016, the percentage of acute hospital transfers has decreased significantly to 5.36%. Goals and objective for this project was to decrease acute hospital transfers by 2%, currently hospital transfers have decrease to 6.95%. This exceeds the two percent benchmark that was set prior to the implementation of this CNL project. Reference: Ouslander, J. G., Diaz, S., Hain, D., & Tappen, R. (2011). Frequency and diagnoses associated with 7- and 30-day readmission of Skilled Nursing Facility patients to a nonteaching community hospital. Journal of the American Medical Directors Association. doi:DOI:10.1016/j.jamda.2010.02.01

Magnetic Properties And Giant Magnetoresistance Of Melt-spun Granular Cu100-x-cox Alloys

Room-temperature measurements of magnetization and giant magnetoresistance were performed on rapidly solidified granular Cu100-xCox systems (x=5,10,15). The magnetoresistance of melt-spun Cu100-xCox ribbons was enhanced either by suitable furnace annealings or by exploiting the dc Joule-heating technique in the attempt of precipitating smaller magnetic particles. The particle-size distribution, the particle density, and mean distance are obtained for all compositions and heat treatments through a suitable analysis of the magnetic behavior of samples. The magnetoresistance is plotted as a function of the reduced magnetization, and a significant deviation from the quadratic behavior predicted by the independent-moment approach is observed at low fields. A simple theory taking explicitly into account the correlation existing among the magnetic particles is proposed. A general expression for the magnetoresistance in granular magnetic systems is obtained, and shown to accurately fit all the experimental curves, indicating that this effect is basically determined by the ratios between two distinct correlation ranges for the magnetic-moment fluctuations and the electronic mean free path. © 1995 The American Physical Society.5221153981541

Short-time dynamics of correlated magnetic moments in superparamagnetic Cu-Co melt spun alloys exhibiting giant magnetoresistance

Evidence for correlation among superparamagnetic particles in melt-spun Cu100-xCox systems (x = 5-20) exhibiting a giant magnetoresistance is obtained by plotting this quantity as a function of reduced magnetization. Two ranges, R-theta(H-e) and R-theta(H-e), have been recently introduced to describe the extent of correlation among angles of tilt (theta) and of twist (phi) of superparamagnetic moments precessing around a local field axis. The angle of tilt appears to be spatially correlated over a distance larger by a factor of 3 than the angle of twist. This difference is explained by analyzing the short-time dynamics of magnetic moments in superparamagnetic granular systems with long-range interactions (of dipolar and the RKKY-like type). The typical time constants characterizing the process of scattering of conduction electrons by adjacent magnetic moments (electronic time of flight, relaxation times for theta and phi) are discussed in detail. An explicit expression for R-phi(H) is obtained by considering the competition between a magnetic interaction favoring parallel (or antiparallel) alignment or adjacent moments, and thermal disturbances resulting in a continuous loss of the phase coherence. (C) 1997 American Institute of Physics

Magnetic properties and giant magnetoresistance of melt-spun granular Cu-100-x Co-x alloys

Room-temperature measurements of magnetization and giant magnetoresistance were performed on rapidly solidified granular Cu100-xCox systems (x=5,10,15). The magnetoresistance of melt-spun Cu100-xCox ribbons was enhanced either by suitable furnace annealings or by exploiting the de Joule-heating technique in the attempt of precipitating smaller magnetic particles. The particle-size distribution, the particle density, and mean distance are obtained for all compositions and heat treatments through a suitable analysis of the magnetic behavior of samples. The magnetoresistance is plotted as a function of the reduced magnetization, and a significant deviation from the quadratic behavior predicted by the independent-moment approach is observed at low fields. A simple theory taking explicitly into account the correlation existing among the magnetic particles is proposed. A general expression for the magnetoresistance in granular magnetic systems is obtained, and shown to accurately fit all the experimental curves, indicating that this effect is basically determined by the ratios between two distinct correlation ranges for the magnetic-moment fluctuations and the electronic mean free path

Noise-based core monitoring and diagnostics: overview of the cortex project

This paper gives an overview of the CORTEX project, which is a Research and Innovation Action funded by the European Union in the Euratom 2016-2017 work program, under the Horizon 2020 framework. CORTEX, which stands for CORe monitoring Techniques and EXperimental validation and demonstration, aims at developing an innovative core monitoring technique that allows detecting anomalies in nuclear reactors, such as excessive vibrations of core internals, flow blockage, coolant inlet perturbations, etc. The technique is based on primarily using the inherent fluctuations in neutron flux recorded by in-core and ex-core instrumentation (often referred to as neutron noise), from which the anomalies will be differentiated depending on their type, location and characteristics. In addition to be non-intrusive and not requiring any external perturbation of the system, the method allows the detection of operational problems at a very early stage. Proper actions could thus be taken by utilities before such problems have any adverse effect on plant safety and reliability

A study of the dynamics of magnetic disaccommodation in amorphous ferromagnets. II. Theoretical considerations

The results obtained in part I are interpreted in terms of the viscosity field arising from independent processes of directional ordering for magnetic defects dispersed in the amorphous structure and interacting with the magnetization vector. A specific model is developed in order to take into account the changes in the ordering kinetics induced by the periodic magnetization rotations described in part I. This model, however, requires that the magnetic induction remain constant during the whole measurement; as a consequence, the model's predictions cannot be directly compared with the experimental results, obtained instead at constant applied field. This difficulty is overcome by deriving a general relationship between the magnetic‐induction decay and the viscosity field kinetics for an arbitrary number of half‐periods of the square‐wave field. The agreement of our theory with the experimental results turns out to be quite satisfactory. As consequence, the ordering processes responsible for the magnetic aftereffect in amorphous ferromagnets may be described as essentially uncorrelated

A study of the dynamics of magnetic disaccommodation in amorphous ferromagnets. I. Experimental results

Systematic room‐temperature measurements of the aftereffect of the ac magnetic permeability have been performed on a Fe81B13.5 Si3.5C2 amorphous ribbon in order to get detailed information about the nature of the atomic ordering processes responsible for the magnetic relaxation. The magnetic aftereffect related to 180° domain‐wall motion has been measured by means of a specific technique allowing periodic domain‐wall displacements to be induced between two fixed, neighboring equilibrium positions by applying a square‐wave field of proper amplitude and frequency. In this way, the average direction of the magnetization vector is cyclically modified in all points where the studied directional ordering processes may occur. As a consequence, the kinetics of ordering is modified in a characteristic way, giving rise to relevant variations in the intensity of the magnetic aftereffect measured between fixed times (t1=2×10−3 s and t2=10−1 s), and in the value of the magnetic induction at the time t2. All measurements have been performed at constant applied field. The degree of reliability of this experimental technique has been analyzed in detail. The magnetic aftereffect, ΔB=B(t1)−B(t2), and the magnetic induction B(t2) have been measured as functions of the number of domain‐wall cycles, and after removing the square‐wave field for a variable time t∗. The results of many independent measurements are reported and discussed

Magnetic hysteresis in granular CuCo alloys

Room-temperature hysteresis loops of granular Cu100-xCox alloys (5 less than or equal to x less than or equal to 15) obtained by planar flow casting in air and submitted to proper annealing treatments have been measured up to a field of 10 kOe by means of a vibrating sample magnetometer. In major loops (\H-vert\ = 10 kOe), the reduced remanence-to-saturation ratio m(r) = M-r/M-s and the coercivity H-c measured on all studied materials appear to be related by an almost linear law of the type m(r) approximate to 1/3 (mu H-c/kT), mu being the average magnetic moment on Co particles. A similar relation is also observed on minor symmetrical loops (100 Oe less than or equal to\H-vert\ less than or equal to 9 kOe). The observed results are accounted for by a model which considers the hysteresis as originating by magnetic interactions among nearly superparamagnetic Co particles. (C) 1999 American Institute of Physics. [S0021-8979(99)51408-4]

Magnetic Properties And Giant Magnetoresistance Of Magnetic Granular Co10cu90 Alloys Obtained By Direct-current Joule Heating

The direct-current (dc) joule heating technique was exploited to fabricate giant magnetoresistance (GMR) Co10Cu90 granular alloys. The Co cluster precipitation process was investigated by calorimetric and x-ray diffraction measurements. At T=10 K, the largest MR change of 25.0% has been observed for the melt-spun Co10Cu90 ribbon annealed at I=5 A. The magnetoresistance scales approximately as the inverse Co particle size. At room temperature, it was found that the dc joule-heated samples show relatively high GMR in comparison with furnace-annealed samples. Based on the phenomenological GMR model, we assumed that it is a consequence of smaller Co particles formed in dc joule-heated samples. © 1995 American Institute of Physics.7885062506