Decreasing Polypharmacy in a Long-Term Care Setting with the Use of the STOPP Tool

Polypharmacy is the use of five or more medications. Polypharmacy in older adults can increase fall risk, decrease quality of life, increase adverse reactions and cause a more rapid decline in cognitive function. A literature review revealed that there is benefit to a reduced number of medications taken in the older adult population. This quality improvement project was completed at a long-term care facility in Central Minnesota. The STOPP tool was implemented with the leadership team at the facility which included the Director of Nursing, nursing manager, the PIPP Grant team and the staff development nurse. The project provided education on the use of the Screening Tool of Older People’s Prescriptions (STOPP) with the goal of lowering the overall number of medications that were prescribed to residents in the facility. This screening tool assisted staff in determining unnecessary medications prescribed and aided in conversations with nursing staff and providers to help them determine which medications could be discontinued. The STOPP tool will be used by the leadership staff upon new resident admission to help determine the presence of unnecessary medications that will be reviewed by the provider to be considered for discontinuation

Social comparison processes in organizations

We systematically analyze the role of social comparison processes in organizations. Specifically, we describe how social comparison processes have been used to explain six key areas of organizational inquiry: (1) organizational justice, (2) performance appraisal, (3) virtual work environments, (4) affective behavior in the workplace, (5) stress, and (6) leadership. Additionally, we describe how unique contextual factors in organizations offer new insight into two widely studied sub-processes of social comparison, acquiring social information and thinking about that information. Our analyses underscore the merit of integrating organizational phenomena and social comparison processes in future research and theory

Specific serum IgG at diagnosis of Staphylococcus aureus bloodstream invasion is correlated with disease progression.

Although Staphylococcus aureus is a prominent cause of infections, no vaccine is currently available. Active vaccination relies on immune memory, a core competence of the adaptive immune system. To elucidate whether adaptive immunity can provide protection from serious complications of S. aureus infection, a prospective observational study of 44 patients with S. aureus infection complicated by bacteremia was conducted. At diagnosis, serum IgG binding to S. aureus extracellular proteins was quantified on immunoblots and with Luminex-based FLEXMAP 3D™ assays comprising 64 recombinant S. aureus proteins. Results were correlated with the course of the infection with sepsis as the main outcome variable. S. aureus-specific serum IgG levels at diagnosis of S. aureus infection were lower in patients developing sepsis than in patients without sepsis (P<0.05). The pattern of IgG binding to eight selected S. aureus proteins correctly predicted the disease course in 75% of patients. Robust immune memory of S. aureus was associated with protection from serious complications of bacterial invasion. Serum IgG binding to eight conserved S. aureus proteins enabled stratification of patients with high and low risk of sepsis early in the course of S. aureus infections complicated by bacteremia

A preliminary study of negative appraisals and dysfunctional coping associated with post-traumatic stress disorder symptoms following myocardial infarction

OBJECTIVES: To investigate associations between post-traumatic stress disorder (PTSD) symptoms following myocardial infarction (MI) and subjective experience of MI, negative perception of consequences, negative appraisals of symptoms, and use of dysfunctional coping strategies, as described by Ehlers and Clark's (2000) model of PTSD