Module 2: Direct Comprehensive Primary Care in the LTC Setting

25 2.2.7 Admission and Physical Assessments

Common Steps in Long Term Care Home Admissions:

  • Preadmission
  • Medication Reconciliation
  • Transfer in care communication
  • Admission day
  • NP/MD Admission Process
  • Admission RAI assessment[1][2][3][4][5][6]

Comprehensive LTC Admission Assessment:

  • Demographics
  • Advanced Care Planning
  • History of Presenting Illness (HPI)
  • Active Problems
  • Medical History
  • Surgical History
  • Social History
  • Review of System (ROS)
  • Geriatric Review of Systems
  • Functional Abilities
  • Medications
  • Physical Examination (PE)
  • Investigations
  • Problem List

Optional Reading

Complex admissions:

  • New admissions to LTC from hospital are medically complex
  • ~ 1 in 5 patients admitted to a LTC from the hospital setting are readmitted to hospital within 30 days
  • Strategies to prevent hospital admission after LTC admission
  • Increased patient monitoring for 7 days after admission
  • Early detection for chronic disease flares
  • More contact with MD/NP following admission
  • Increased specialist consultation
  • Effective communication and collaboration between LTC and hospital[7]

  1. Boltz et al., 2016a
  2. Boltz et al., 2016b
  3. CGA Toolkit Plus, 2023
  4. Health Standards Organization (HSO), 2023
  5. Outlander et al., 2016
  6. Public Health Agency of Canada, 2022
  7. Public Health Agency of Canada, 2022

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Nurse Practitioners Delivering Primary Care in the Long Term Care Setting Copyright © 2024 by Erin Ziegler, Carrie Heer and Adhiba Nilormi is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License, except where otherwise noted.

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