scholarly journals Care of Peripheral Venous Catheter Sites: Advantages of Transparent Film Dressings Over Tape and Gauze

2014 ◽  
Vol 19 (4) ◽  
pp. 256-261 ◽  
Author(s):  
Stéphanie F. Bernatchez
Keyword(s):  
Bloodstream Infections ◽  
Venous Catheter ◽  
The United States ◽  
Central Venous ◽  
Term Care ◽  
Peripheral Venous Catheter ◽  
Care Facilities ◽  
Review Current ◽  
Peripheral Venous Line

AbstractPeripheral intravenous (PIV) catheters are the most commonly used catheters in hospitals, with up to 70% of patients requiring a peripheral venous line during their hospital stay. This represents 200 million PIV catheters used per year in acute-care hospitals in the United States alone. These medical devices are also used in other health care settings, such as long-term care facilities and nursing homes, and common indications include the administration of medications, nutrients, and fluids. These catheters require proper maintenance and care to avoid complications such as phlebitis, infiltration, occlusion, local infection, and bloodstream infection. Recently it has been suggested that PIV catheter use may lead to a higher rate of complications than previously thought. This is important because some studies have claimed that the rate of bloodstream infections due to PIV catheters is actually comparable to the rates observed with central venous catheters, rather than much lower as previously thought. Moreover, catheter-related infections are now seen as largely preventable. Our goal was to review the current literature and provide an overview of the various approaches used to manage PIV catheter sites as well as review current recommendations.

scholarly journals FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
Rebecca L Mauldin ◽  
Kathy Lee ◽  
Antwan Williams
Keyword(s):  
Long Term Care ◽  
Federal Policy ◽  
Care Facility ◽  
Well Being ◽  
The United States ◽  
Term Care ◽  
Long Term Care Facility ◽  
Care Facilities

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

scholarly journals The Effectiveness of Contact Precautions on Methicillin-Resistant Staphylococcus aureus in Long-term Care Across the United States

2019 ◽  
Vol 71 (7) ◽  
pp. 1676-1683 ◽  
Author(s):  
Daniel J Morgan ◽  
Min Zhan ◽  
Michihiko Goto ◽  
Carrie Franciscus ◽  
Bruce Alexander ◽  
...  
Keyword(s):  
United States ◽  
Staphylococcus Aureus ◽  
Long Term Care ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
The United States ◽  
Standard Precautions ◽  
Term Care ◽  
Contact Precautions ◽  
Care Facilities

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) is a common cause of health care–associated infections in long-term care facilities (LTCFs). The Centers for Disease Control and Prevention recommends contact precautions for the prevention of MRSA within acute care facilities, which are being used within the United States Department of Veterans Affairs (VA) for LTCFs in a modified fashion. The impact of contact precautions in long-term care is unknown. Methods To evaluate whether contact precautions decreased MRSA acquisition in LTCFs, compared to standard precautions, we performed a retrospective effectiveness study (pre-post, with concurrent controls) using data from the VA health-care system from 1 January 2011 until 31 December 2015, 2 years before and after a 2013 policy recommending a more aggressive form of contact precautions. Results Across 75 414 patient admissions from 74 long-term care facilities in the United States, the overall unadjusted rate of MRSA acquisition was 2.6/1000 patient days. Patients were no more likely to acquire MRSA if they were cared for using standard precautions versus contact precautions in a multivariable, discrete time survival analysis, controlling for patient demographics, risk factors, and year of admission (odds ratio, 0.97; 95% confidence interval, .85–1.12; P = .71). Conclusions MRSA acquisition and infections were not impacted by the use of active surveillance and contact precautions in LTCFs in the VA.

scholarly journals Diagnosis and management of catheter-related bloodstream infections in patients on home parenteral nutrition

2019 ◽  
Vol 11 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Ashley Bond ◽  
Paul Chadwick ◽  
Trevor R Smith ◽  
Jeremy M D Nightingale ◽  
Simon Lal
Keyword(s):  
Parenteral Nutrition ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Nutrition Support ◽  
Central Venous ◽  
Short Term ◽  
Qualitative And Quantitative ◽  
Central Venous Catheter Removal ◽  
Support Team

Catheter-related bloodstream infections (CRBSIs) commonly arise from a parenteral nutrition catheter hub. A target for a Nutrition Support Team is to have a CRBSI rate of less than 1 per 1000. The diagnosis of CRBSI is suspected clinically by a temperature shortly after setting up a feed, general malaise or raised blood inflammatory markers. It is confirmed by qualitative and quantitative blood cultures from the catheter and peripherally. Treatment of inpatients may involve central venous catheter removal and antibiotics for patients needing short-term parenteral nutrition, but catheter salvage is generally recommended for patients needing long-term parenteral nutrition, where appropriate.

scholarly journals Prevalence of advanced directives in the geriatric population with in long-term care facilities in the United States

2021 ◽  
Vol 12 (2) ◽  
pp. 173-178
Author(s):  
Ateequr Rahman ◽  
Druti Shukla ◽  
Lejla Cukovic ◽  
Kirstin Krzyzewski ◽  
Noopur Walia ◽  
...  
Keyword(s):  
United States ◽  
Long Term Care ◽  
The United States ◽  
Living Wills ◽  
Term Care ◽  
Advanced Directive ◽  
Advanced Directives ◽  
Significant Difference ◽  
Care Facilities

Advanced directives, such as Living Wills and Do Not Resuscitate (DNR) orders, provide the ability to identify, respect, and implement an individual's wishes for medical care during serious illness or end-of-life care. The aim of this study was to evaluate the prevalence of advanced directives amongst the residents of long-term care facilities in the United States. A total of 527 cases were extracted from 2018 National Study of Long-Term Care Providers, which was collected by the National Center for Health Statistics through the surveys of residential care communities and adult day services centers. Advanced directive rates were higher in patients 90 years of age and above as compared to other age groups. Nursing home residents were more likely to have advanced directives than other long term care facilities. There was no significant difference among males and females in the rate of advanced directives. Nursing home and Hospice residents had more advanced directives compared to other facilities. The Black population had the highest rate of advanced directive preparedness. Overall, the finding of this study revealed that there was a significant difference in the preparedness of DNR orders and Living Wills by patient demographics and the type of long-term care facility. Offering advanced directive services at public health/social services facilities can enhance the rate of advanced directive preparedness. Advanced directives ease the stress and anxiety of patients, family, and friends during difficult times.

Improving the Fate of Nursing Homes During the COVID-19 Pandemic: The Need for Policy

2021 ◽  
pp. e1-e3
Author(s):  
R. Tamara Konetzka
Keyword(s):  
Public Health ◽  
United States ◽  
New York ◽  
Nursing Homes ◽  
Long Term Care ◽  
New York Times ◽  
The United States ◽  
Term Care ◽  
Care Facilities

Approximately 40% of all COVID-19 deaths in the United States have been linked to long-term care facilities.1 Early in the pandemic, as the scope of the problem became apparent, the nursing home sector generated significant media attention and public alarm. A New York Times article in mid-April referred to nursing homes as “death pits”2 because of the seemingly uncontrollable spread of the virus through these facilities. This devastation continued during subsequent surges,3 but there is a role for policy to change this trajectory. (Am J Public Health. Published online ahead of print January 28, 2021: e1–e3. https://doi.org/10.2105/AJPH.2020.306107 )

scholarly journals Bundle Approach to Reduce Bloodstream Infections in Neutropenic Hematologic

2015 ◽  
Vol 28 (4) ◽  
pp. 474
Author(s):  
Jose Manuel Martinez ◽  
Luís Leite ◽  
Daniela França ◽  
Rita Capela ◽  
Luísa Viterbo ◽  
...  
Keyword(s):  
Relative Risk ◽  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Mechanical Valve ◽  
Venous Catheter ◽  
Positive Pressure ◽  
Control Group ◽  
Study Group ◽  
Central Venous

<p><strong>Introduction:</strong> The objective of the study was to reduce, by a bundle of interventions, the global bloodstream infections and catheterrelated bloodstream infections rates in neutropenic hematology patients with a long-term central venous catheter.<br /><strong>Material and Methods:</strong> This was a non-randomized prospective study. It was conducted in a 20-bed hematology oncology unit (Portuguese Institute of Oncology, Porto, Portugal) between 1st of August 2010 and 31st of January 2012. In this period we introduced a bundle of interventions (study group) and compared the results with the six months prior to implementation (control group). The interventions consisted in the use of a neutral pressure mechanical valve connector instead of a positive pressure mechanical valve connector, a more frequent change of this connector and a more efficient clean solution. One hundred and sixteen hematology patients with a long-term central venous catheter at time superior of 72 h, with 8 867 central venous catheter days [6 756 central venous catheter days in the study group and 2 111 central venous catheter days in the control group] were included in the study.<br /><strong>Results:</strong> A significant reduction in bloodstream infections rates and catheter-related bloodstream infections rates was achieved. Bloodstream infections rates: [32.69 (control group) vs. 9.43 (study group)], incidence reduction 71% [relative risk 0.2886, CI 95% (0.1793 – 0.4647), p &lt; 0.001] and catheter-related bloodstream infections rates: [17.53 (control group) vs. 4.73 (study group)], incidence reduction 71% [relative risk 0.2936, CI 95% (0.1793 – 0.5615), p &lt; 0.014]. No significant difference (p &gt; 0.05) was found in the neutrophil count at the time of blood culture samples between groups: 69% (&lt; 500 neutrophils/mm3) [71% (study group) vs. 68% (control group)].<br /><strong>Conclusions:</strong> The introduction of this bundle of interventions based on the variables of patient, product and practice, supported by the Healthcare and Technology Synergy framework, quickly resulted in a significant reduction of bloodstream infections and catheterrelated bloodstream infections rates.</p>

Characterizing healthcare delivery in the United States using Census Bureau’s County Business Patterns (2000–2016)

2020 ◽  
Vol 41 (6) ◽  
pp. 723-728
Author(s):  
Astha KC ◽  
Melissa K. Schaefer ◽  
Nimalie D. Stone ◽  
Joseph Perz
Keyword(s):  
Long Term Care ◽  
Healthcare Delivery ◽  
The United States ◽  
Healthcare Sector ◽  
Nursing Facilities ◽  
Term Care ◽  
The North ◽  
The Us ◽  
Care Facilities

AbstractBackground:The US Census Bureau’s County Business Patterns (CBP) series provides a unique opportunity to describe the healthcare sector using a single, national data source.Methods:We analyzed CBP data on business establishments in the healthcare industry for 2000–2016 for all 50 states and the District of Columbia. Setting and facility types were defined using the North American Industry Classification System.Results:In 2016, CBP enumerated 707,634 US healthcare establishments (a 34% increase from 2000); 86.5% were outpatient facilities and services followed by long-term care facilities (12.5%) and acute-care facilities (1.0%). Between 2000 and 2016, traditional facilities such as general medical surgical and surgical hospitals (−0.4%) and skilled nursing facilities (+0.1%) decreased or remained flat, while other long-term care and outpatient providers grew rapidly.Conclusion:This analysis highlights the steady growth and increased specialization of the US healthcare sector, particularly in long-term care and outpatient settings.

Long-term central venous catheter use among cancer patients in administrative claims data.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6101-6101
Author(s):  
Allison Nicole Lipitz Snyderman ◽  
Kent Sepkowitz ◽  
Elena B. Elkin ◽  
Laura C Pinheiro ◽  
Crystal Son ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Claims Data ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Population Based ◽  
Multivariable Logistic Regression Analysis ◽  
Administrative Claims ◽  
Central Venous

6101 Background: This study’s objective was to examine administrative claims data’s capacity to serve as a surveillance tool for long-term catheter use and related bloodstream infections among cancer patients. Population-based estimates and efforts to track catheter use and infections for this group are limited. As such, we sought to explore catheter use documentation using a cohort of colorectal cancer patients. Methods: We performed a retrospective analysis using the population-based SEER-Medicare dataset for patients 66 years or older diagnosed with colorectal cancer in 2005-2007 (n = 54,870). Insertions and removals of long-term central venous catheters (i.e., tunneled, ports/pumps, peripherally inserted central catheter [PICCs]) were identified by billing codes within 2 years of diagnosis. Factors associated with catheter use were identified in multivariable logistic regression analysis. Results: Findings were consistent with clinical expectations. A total of 11,775 patients (21%) had at least one documented long-term catheter insertion within 2 years of diagnosis, 19% within 6 months. Of those with catheters, approximately 25% had more than one insertion. Sixty-eight percent had at least one port/pump, 8% at least one tunneled catheter, and 33% at least one PICC. Seventy-four percent of catheterized patients had IV chemotherapy. Of patients stages I, II, III, and IV, 10%, 18%, 37%, and 39% had catheters, respectively. Adjusted for other factors, patients with catheters were significantly more likely to be younger, female, black (vs. white), and have comorbidities (vs. none documented in year prior to diagnosis), compared to patients without catheters. By the end of the study, 34% of patients with ports/pumps had documented removal and 42% died (for patients with tunneled catheters, 28% and 52%, respectively). Conclusions: Findings support the use of claims data to capture long-term catheter use in cancer patients, providing a foundation for exploration of its capacity to capture infections. Given extensive documented catheter use (21%), infections may be a significant problem. Claims data may offer a low-burden method for surveillance and study, aiding the development of targeted initiatives.

scholarly journals Nasal Carriage of Epidemic Methicillin-Resistant Staphylococcus aureus 15 (EMRSA-15) Clone Observed in Three Chicago-Area Long-Term Care Facilities

2013 ◽  
Vol 57 (9) ◽  
pp. 4551-4553 ◽  
Author(s):  
Sanchita Das ◽  
Christopher J. Anderson ◽  
Althea Grayes ◽  
Katherine Mendoza ◽  
Maureen Harazin ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Long Term Care ◽  
The United States ◽  
Health Concern ◽  
Term Care ◽  
Methicillin Resistant ◽  
Content Type ◽  
Chicago Area ◽  
Care Facilities

ABSTRACTThe spread of pandemic methicillin-resistantStaphylococcus aureus(MRSA) clones such as USA300 and EMRSA-15 is a global health concern. As a part of a surveillance study of three long-term care facilities in the Greater Chicago area, phenotypic and molecular characterization of nasal MRSA isolates was performed. We report a cluster of pandemic EMRSA-15, an MRSA clone rarely reported from the United States, detected during this study.

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