Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomized Control Trial of a Clinical Pathway for Nursing Home Pneumonia.
Brief Summary: Nursing home residents are frequently transferred to hospital for management of pneumonia. This often leads to hospital related complications and is a burden on the acute care health system. The purpose of this study is to assess whether managing residents with pneumonia and lower respiratory tract infection on site in the nursing home can reduce hospital admissions and can reduce complications and improve quality of life for residents. We have randomized residents with nursing home acquired pneumonia to on-site management, using a clinical pathway, versus usual care.


Options:
A: Inclusion Criteria:

* Symptoms or signs of lower respiratory tract infection as defined by standardized criteria.

Exclusion Criteria:

* Residents were excluded if they were not expected to live longer than 30 days from the date of enrollment, had a previous anaphylactic or serious allergic reaction to quinolones, had advanced directives that they are not be transferred to hospital for treatment.
B: Inclusion Criteria:

* \> 40 Beds
* MD, NP or PA available on-site at least 1/week
* Capable of Starting intravenous fluids
* Capable of Providing respiratory treatments
* Capable of Assessing oxygenation status by pulse oximetry
* \< 4 hrs turnaround time for STAT medications ("stat" is an abbreviation of the Latin word statim, meaning "immediately, without delay")
* \< 8 hrs. turnaround time for STAT laboratory tests
* \< 8 hrs. turnaround time for STAT X-rays
* Computers available for online staff training
* Strong support for participation from the facility administrator, director of nursing, and medical director, as well as corporate leadership (for NHs that are part of a corporate chain), as evidenced by a signed agreement before enrollment
* \> 10% 30-day readmission rates

Exclusion Criteria:

* Hospital based
* Having only private pay residents (no Medicare/Medicaid, no Medicare provider number).
* Participation in a project designed specifically to reduce acute care transfers or hospitalization rates (including federal demonstrations)
* Conducting more than one other major quality improvement or research project during the project period which would threaten their ability to fully participate in the trial.
* Specialize in Pediatrics (\> 30 % of patients in NHs are pediatric)
* Specialize in HIV (\> 30 % of patients in NHs are HIV)
* Specialize in Respiratory care with ventilator care (\>30% of patients in NH are in this category)
* Robust INTERACT implementation and/or very low hospitalization rate
* Located in a country outside USA
C: Inclusion Criteria:

* Inclusion criteria for nursing homes:

  1. the board of directors/the management express explicit motivation to participate in the study and agree to allocate at least a 0,10 FTE per week for at least two ACP Reference Person(s) per 30 to 40 nursing home beds, to carry out the tasks that are part of this project
  2. have at least 100 beds

Inclusion criteria for care staff in the nursing homes:

1. able to speak and understand Dutch.
2. work in a participating nursing home as either (head) nurse, care assistant, psychologist, physiotherapist, occupational therapist, social worker, animator, or reference person dementia/palliative care

Exclusion Criteria:

* Exclusion criteria for nursing homes:

  1. nursing homes have taken/are taking part in another research study that is evaluating palliative care services or communication strategies, currently or in the past 4 years
  2. they have - or are planning to develop during the foreseen duration of the trial - an extensive ACP policy, meaning that (i) all nursing home residents or their family (in principal) regularly receive ACP conversations (two conversations or more each year) or (ii) the nursing home is judged by the researchers as having explicit and detailed ACP guidelines available (corresponding to high-quality ACP procedures and practices)
  3. major organisational changes or physical changes to the facility (e.g. building activities or staff re-organisation) are planned or ongoing during the study period.
D: Inclusion Criteria:

* clinical diagnosis of hearing loss and low vision
* at least one sensory loss acquired after the age of 55
* living in a home for the elderly

Exclusion Criteria:

* congenital deaf persons
* a dual sensory loss before the age of 55

Answer: A