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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