Risks and Benefits of Bladder Antimuscarinics Among Elderly Residents of Veterans Affairs Community Living Centers

2013 ◽  
Vol 14 (10) ◽  
pp. 749-760 ◽  
Author(s):  
Daniela C. Moga ◽  
Ryan M. Carnahan ◽  
Brian C. Lund ◽  
Jane F. Pendergast ◽  
Robert B. Wallace ◽  
...  
Keyword(s):  
Veterans Affairs ◽  
Community Living ◽  
Risks And Benefits ◽  
Community Living Centers ◽  
Bladder Antimuscarinics

scholarly journals National trends in the treatment of urinary tract infections among Veterans’ Affairs Community Living Center residents

2019 ◽  
Vol 40 (10) ◽  
pp. 1087-1093 ◽  
Author(s):  
Haley J. Appaneal ◽  
Aisling R. Caffrey ◽  
Vrishali V. Lopes ◽  
Christopher J. Crnich ◽  
David M. Dosa ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antibiotic Use ◽  
Veterans Affairs ◽  
Community Living ◽  
Days Of Therapy ◽  
Community Living Centers ◽  
Tract Infections ◽  
National Trends ◽  
Culture Positive ◽  
Culture Negative

AbstractObjective:To describe urinary tract infection (UTI) treatment among Veterans’ Affairs (VA) Community Living Centers (CLCs) nationally and to assess related trends in antibiotic use.Design:Descriptive study.Setting and participants:All UTI episodes treated from 2013 through 2017 among residents in 110 VA CLCs. UTI episodes required collection of a urine culture, antibiotic treatment, and a UTI diagnosis code. UTI episodes were stratified into culture-positive and culture-negative episodes.Methods:Frequency and rate of antibiotic use were assessed for all UTI episodes overall and were stratified by culture-positive and culture-negative episodes. Joinpoint software was used for regression analyses of trends over time.Results:We identified 28,247 UTI episodes in 14,983 Veterans. The average age of Veterans was 75.7 years, and 95.9% were male. Approximately half of UTI episodes (45.7%) were culture positive and 25.7% were culture negative. Escherichia coli was recovered in 34.1% of culture-positive UTI episodes, followed by Proteus mirabilis and Klebsiella spp, which were recovered in 24.5% and 17.4% of culture-positive UTI episodes, respectively. The rate of total antibiotic use in days of therapy (DOT) per 1,000 bed days decreased by 10.1% per year (95% CI, −13.6% to −6.5%) and fluoroquinolone use (ciprofloxacin or levofloxacin) decreased by 14.5% per year (95% CI, −20.6% to −7.8%) among UTI episodes overall. Similar reductions in rates of total antibiotic use and fluoroquinolone use were observed among culture-positive UTI episodes and among culture-negative UTI episodes.Conclusion:Over a 5-year period, antibiotic use for UTIs significantly decreased among VA CLCs, as did use of fluoroquinolones. Antibiotic stewardship efforts across VA CLCs should be applauded, and these efforts should continue.

Budget Impact Analysis of Veterans Affairs Medical Foster Homes versus Community Living Centers

2017 ◽  
Vol 20 (1) ◽  
pp. 48-54
Author(s):  
Bryce S. Sutton ◽  
Étienne Pracht ◽  
Arthur R. Williams ◽  
Farrokh Alemi ◽  
Allison E. Williams ◽  
...  
Keyword(s):  
Impact Analysis ◽  
Budget Impact ◽  
Veterans Affairs ◽  
Budget Impact Analysis ◽  
Community Living ◽  
Foster Homes ◽  
Community Living Centers

Measuring Use of Psychotropic Drugs in Veterans Affairs Community Living Centers

2014 ◽  
Vol 29 (9) ◽  
pp. 588-601 ◽  
Author(s):  
Michael Harvey ◽  
Dawn Currie ◽  
Amy Furman ◽  
Scott Mambourg
Keyword(s):  
Psychotropic Drugs ◽  
Veterans Affairs ◽  
Community Living ◽  
Community Living Centers

scholarly journals 2012. Trends in Microbiological Culture Collection Across Veterans Affairs Medical Centers and Community Living Centers, 2010 to 2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S675-S675
Author(s):  
Haley Appaneal ◽  
Aisling Caffrey ◽  
Stephanie Hughes ◽  
Vrishali Lopes ◽  
Robin L Jump ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Culture Collection ◽  
Veterans Affairs ◽  
Community Living ◽  
Term Care ◽  
Medical Centers ◽  
Community Living Centers ◽  
Veterans Affairs Medical Centers ◽  
Tract Infections ◽  
Over Time

Abstract Background Microbiological cultures are critical in the diagnosis of infection, identification of pathogenic organisms, and tailoring antibiotic use. However, unnecessary collection of cultures, particularly from the urine, may lead to overuse of antibiotics. There have been no national studies to evaluate trends in the collection of cultures in acute and long-term care settings. Here we describe changes in the collection of cultures nationally across Veterans Affairs medical centers (VAMCs) and Community Living Centers (CLCs). Methods All positive and negative cultures collected from 2010 to 2017 among Veterans admitted to VAMCs or CLCs were included. Cultures were categorized by specimen source (urine, blood, skin and soft tissue, or lung). Joinpoint software was used for regression analyses of trends over time and to estimate annual average percent changes with 95% confidence intervals (CI). Results A total of 5,089,640 cultures from 158 VAMCS and 342,850 cultures from 146 CLCs were identified. The number of cultures collected for all culture types in VAMCs and CLCs decreased significantly. The number of cultures collected per admission decreased significantly by 5.5% annually among VAMCs (95% CI −7.0 to −4.0%) and by 8.4% annually among CLCs (95% CI −10.1 to −6.6%). The proportion of positive cultures decreased 1.6% annually among VAMCs (95% CI −2.3 to −0.9%) and remained stable among CLCs (-0.4% annually, 95% CI, −1.1 to 0.4%). The most common culture source among VAMCs was blood (36.2%), followed by urine (31.8%), and among CLCs was urine (56.9%), followed by blood (16.0%). Urine cultures decreased by 4.5% annually among VAMCs (95% CI −5.4 to −3.6%) and 7.0% annually among CLCs (95% CI −7.6 to −6.4%). Conclusion Our study demonstrates a significant reduction in the number of cultures collected over time. Positive cultures decreased significantly in VAMCs, possibly indicating fewer culture-positive infections.In both VAMCs and CLCs, decreases in cultures taken may represent an important reduction in the collection of unnecessary cultures nationally driven by increased awareness about over-testing and over-treatment of presumed infection, particularly urinary tract infections. Disclosures All authors: No reported disclosures.

Nursing home-associated infections in Department of Veterans Affairs community living centers

2010 ◽  
Vol 38 (6) ◽  
pp. 461-466 ◽  
Author(s):  
Linda Tsan ◽  
Robert Langberg ◽  
Chester Davis ◽  
Yancy Phillips ◽  
John Pierce ◽  
...  
Keyword(s):  
Nursing Home ◽  
Veterans Affairs ◽  
Community Living ◽  
Department Of Veterans Affairs ◽  
Community Living Centers
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