Improving the Care of Older Adults with Infections and Promoting Antimicrobial Stewardship: Preliminary Outcomes from an Online Course for Long-Term Care Facility Nursing Staff

2015 ◽  
Vol 16 (3) ◽  
pp. B13
Author(s):  
Robin L. Jump ◽  
Barbara M. Heath ◽  
Sue S. Shick ◽  
Patricia A. Higgins ◽  
Curtis J. Donskey ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Staff ◽  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Care Facility ◽  
Online Course ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals Clinical features and risk factors for mortality among long-term care facility residents hospitalized due to COVID-19 in Spain

2021 ◽  
Author(s):  
José-Manuel Ramos-Rincón ◽  
Máximo Bernabeu-Whittel ◽  
Isabel Fiteni-Mera ◽  
Almudena López-Sampalo ◽  
Carmen López-Ríos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Long Term Care ◽  
Functional Dependence ◽  
Care Facility ◽  
Community Dwelling ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

Abstract Background COVID-19 severely impacted older adults and long-term care facility (LTCF) residents. Our primary aim was to describe differences in clinical and epidemiological variables, in-hospital management, and outcomes between LTCF residents and community-dwelling older adults hospitalized with COVID-19. The secondary aim was to identify risk factors for mortality due to COVID-19 in hospitalized LTCF residents. Methods This is a cross-sectional analysis within a retrospective cohort of hospitalized patients≥75 years with confirmed COVID-19 admitted to 160 Spanish hospitals. Differences between groups and factors associated with mortality among LTCF residents were assessed through comparisons and logistic regression analysis. Results Of 6,189 patients≥75 years, 1,185 (19.1%) were LTCF residents and 4,548 (73.5%) were community-dwelling. LTCF residents were older (median: 87.4 vs. 82.1 years), mostly female (61.6% vs. 43.2%), had more severe functional dependence (47.0% vs 7.8%), more comorbidities (Charlson Comorbidity Index: 6 vs 5), had dementia more often (59.1% vs. 14.4%), and had shorter duration of symptoms (median: 3 vs 6 days) than community-dwelling patients (all, p<.001). Mortality risk factors in LTCF residents were severe functional dependence (aOR:1.79;95%CI:1.13-2.83;p=.012), dyspnea (1.66;1.16-2.39;p=.004), SatO2<94% (1.73;1.27-2.37;p=.001), temperature≥37.8ºC (1.62;1.11-2.38; p=.013); qSOFA index≥2 (1.62;1.11-2.38;p=.013), bilateral infiltrates (1.98;1.24-2.98;p<.001), and high C-reactive protein (1.005;1.003-1.007;p<.001). In-hospital mortality was initially higher among LTCF residents (43.3% vs 39.7%), but lower after adjusting for sex, age, functional dependence, and comorbidities (aOR:0.74,95%CI:0.62-0.87;p<.001). Conclusion Basal functional status and COVID-19 severity are risk factors of mortality in LTCF residents. The lower adjusted mortality rate in LTCF residents may be explained by earlier identification, treatment, and hospitalization for COVID-19.

Oral health assessment by nursing staff of Alzheimer's patients in a long-term-care facility

1999 ◽  
Vol 19 (2) ◽  
pp. 64-71 ◽  
Author(s):  
Christopher Y. Lin ◽  
David B. Jones ◽  
Karen Godwin ◽  
R. Kenneth Godwin ◽  
Janice A. Knebl ◽  
...  
Keyword(s):  
Oral Health ◽  
Nursing Staff ◽  
Long Term Care ◽  
Health Assessment ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals Effective Antimicrobial Stewardship in a Long-Term Care Facility through an Infectious Disease Consultation Service: Keeping a LID on Antibiotic Use

2012 ◽  
Vol 33 (12) ◽  
pp. 1185-1192 ◽  
Author(s):  
Robin L. P. Jump ◽  
Danielle M. Olds ◽  
Nasim Seifi ◽  
Georgios Kypriotakis ◽  
Lucy A. Jury ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Care Facility ◽  
Antimicrobial Use ◽  
Consultation Service ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

Design.We introduced a long-term care facility (LTCF) infectious disease (ID) consultation service (LID service) that provides on-site consultations to residents of a Veterans Affairs (VA) LTCF. We determined the impact of the LID service on antimicrobial use and Clostridium difficile infections at the LTCF.Setting.A 160-bed VA LTCF.Methods.Systemic antimicrobial use and positive C. difficile tests at the LTCF were compared for the 36 months before and the 18 months after the initiation of the ID consultation service through segmented regression analysis of an interrupted time series.Results.Relative to that in the preintervention period, total systemic antibiotic administration decreased by 30% (P<.001), with significant reductions in both oral (32%; P<.001) and intravenous (25%; P = .008) agents. The greatest reductions were seen for tetracyclines (64%; P<.001), clindamycin (61%; P<.001), sulfamethoxazole/trimethoprim (38%; P<.001), fluoroquinolones (38%; P<.001), and β lactam/β-lactamase inhibitor combinations (28%; P<.001). The rate of positive C. difficile tests at the LTCF declined in the postintervention period relative to preintervention rates (P = .04).Conclusions.Implementation of an LTCF ID service led to a significant reduction in total antimicrobial use. Bringing providers with ID expertise to the LTCF represents a new and effective means to achieve antimicrobial stewardship.

scholarly journals Antibiotic Use and Need for Antimicrobial Stewardship in Long-Term Care

2015 ◽  
Vol 68 (6) ◽  
Author(s):  
Lisa Dong-Ying Wu ◽  
Sandra A N Walker ◽  
Marion Elligsen ◽  
Lesley Palmay ◽  
Andrew Simor ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Care Facility ◽  
Antibiotic Use ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Longue Duree ◽  
Longue Durée

<p><strong>ABSTRACT</strong></p><p><strong>Background:</strong> Antimicrobial stewardship may be important in long-term care facilities because of unnecessary or inappropriate antibiotic use observed in these residents, coupled with their increased vulnerability to health care–associated infections.</p><p><strong>Objectives:</strong> To assess antibiotic use in a long-term care facility in order to identify potential antimicrobial stewardship needs.</p><p><strong>Methods:</strong> A retrospective descriptive study was conducted at the Veterans Centre, a long-term care facility at Sunnybrook Health Sciences Centre, Toronto, Ontario. All residents taking one or more antibiotics (n = 326) were included as participants. Antibiotic-use data for patients residing in the facility between April 1, 2011, and March 31, 2012, were collected and analyzed.</p><p><strong>Results:</strong> Totals of 358 patient encounters, 835 antibiotic prescriptions, and 193 positive culture results were documented during the study period. For 36% (302/835) of antibiotic prescriptions, the duration was more than 7 days. Cephalosporins (30%; 251/835) and fluoroquinolones (28%; 235/835) were the most frequently prescribed antibiotic classes. Urine was the most common source of samples for culture (60%; 116/193).</p><p><strong>Conclusions:</strong> Characteristics of antimicrobial use at this long-term care facility that might benefit from further evaluation included potentially excessive use of fluoroquinolones and cephalosporins and potentially excessive duration of antibiotic use for individual patients.</p><p><strong>RÉSUMÉ</strong></p><p><strong></strong><strong>Contexte :</strong> La gérance des antibiotiques peut s’avérer importante au sein des établissements de soins de longue durée à cause d’une utilisation inutile ou inappropriée des antibiotiques chez les résidents de ces établissements et de leur vulnérabilité aux infections nosocomiales. </p><p><strong>Objectifs :</strong> Évaluer l’utilisation des antibiotiques dans un établissement de soins de longue durée afin de déterminer si une gérance des antimicrobiens peut être nécessaire.</p><p><strong>Méthodes :</strong> Une étude descriptive rétrospective a été réalisée au Veterans Centre, un établissement de soins de longue durée au sein du Sunnybrook Health Sciences Centre, à Toronto en Ontario. Tous les résidents prenant au moins un antibiotique (n = 326) ont été admis à l’étude. Des données sur les antibiothérapies pour des patients résidant dans l’établissement entre le 1er avril 2011 et le 31 mars 2012 ont été recueillies et analysées.</p><p><strong>Résultats :</strong> Pendant l’étude, on a consigné en tout 358 séjours de patients, 835 prescriptions d’antibiotiques et 193 résultats positifs de culture. Pour 36 % (302/835) des prescriptions d’antibiotiques, le traitement était de plus de 7 jours. Les céphalosporines (30 % [251/835]) et les fluoroquinolones (28 % [235/835]) étaient les antibiotiques les plus souvent prescrits. Les cultures étaient le plus souvent obtenues à partir d’urines (60 % [116/193]).</p><p><strong>Conclusions :</strong> L’utilisation possiblement excessive de fluoroquinolones et de céphalosporines ainsi que la durée potentiellement exagérée des antibiothérapies font partie des caractéristiques de l’emploi des antimicrobiens dans cet établissement de soins de longue durée qui pourraient mériter de plus amples évaluations.</p>

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