The Prevalence of Fecal Colonization With VRE Among Residents of Long-Term–Care Facilities in Melbourne, Australia

2001 ◽  
Vol 22 (9) ◽  
pp. 576-578 ◽  
Author(s):  
Alexander A. Padiglione ◽  
Elizabeth Grabsch ◽  
Rory Wolfe ◽  
Kimberly Gibson ◽  
M. Lindsay Grayson
Keyword(s):  
Nursing Homes ◽  
Confidence Interval ◽  
Acute Care ◽  
Long Term Care ◽  
Prevalence Survey ◽  
Term Care ◽  
Point Prevalence Survey ◽  
Care Facilities ◽  
General Community

AbstractA point-prevalence survey performed among residents of eight nursing homes in Melbourne, Australia, found a rate of fecal VRE colonization of 3.1% (9/292; 95% confidence interval, 1.1-5.1), allvanBEnterococcusfaecium.This is a higher rate than in the general community (3.1% vs 0.2%). Many residents (16%) had been inpatients in acute-care hospitals in the previous 3 months.

Methicillin-resistantStaphylococcus aureus(MRSA) in the institutionalized older patient

2009 ◽  
Vol 19 (1) ◽  
pp. 13-23 ◽  
Author(s):  
M Eveillard ◽  
ML Joly-Guillou
Keyword(s):  
Nursing Homes ◽  
Acute Care ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities ◽  
Surgical Antibiotic Prophylaxis ◽  
Cross Transmission ◽  
Mrsa Infection ◽  
Low Incidence

SummaryNursing homes and long-term care facilities are usually considered as reservoirs for methicillin-resistantStaphylococcus aureus(MRSA) carriers. Actually, there are major differences in MRSA carriage between institutions, with variations from 1% to more than 30%. Overall there is a low incidence of MRSA infection in these institutions, even though carriage is associated with a higher risk of subsequent MRSA infection, with high mortality rates. The main risk factors for carriage are well known: recent hospitalization in an acute-care ward, skin wounds and recent antimicrobial therapy. Age over 75 years is also a risk factor. Residents of nursing homes and long-term care facilities pose a risk of MRSA transfer to acute-care wards, with potential consequences in terms of infection control strategy or surgical antibiotic prophylaxis. No well-designed study has identified the best strategy for MRSA control in institutions for older people and strategies that have been proposed are controversial. Studies to elucidate this would be useful, as well as studies specifically designed to identify the relative importance of different ways of MRSA transmission in these institutions (cross-transmission via healthcare workers or the environment, or direct transmission from one resident to another). Finally, a first important step towards MRSA control is a strict application of standard precautions, particularly good compliance with hand hygiene.

scholarly journals Antimicrobial use in UK long-term care facilities: results of a point prevalence survey

2019 ◽  
Vol 74 (7) ◽  
pp. 2083-2090 ◽  
Author(s):  
Tracey Thornley ◽  
Diane Ashiru-Oredope ◽  
Elizabeth Beech ◽  
Philip Howard ◽  
Charlotte L Kirkdale ◽  
...  
Keyword(s):  
Long Term Care ◽  
Point Prevalence ◽  
Antimicrobial Use ◽  
Prevalence Survey ◽  
Term Care ◽  
Point Prevalence Survey ◽  
Care Facilities

Infections and use of antibiotics in residents of long-term care facilities in Hungary

2014 ◽  
Vol 155 (23) ◽  
pp. 911-917 ◽  
Author(s):  
Rita Szabó ◽  
Karolina Böröcz
Keyword(s):  
Urinary Tract ◽  
Long Term Care ◽  
Soft Tissues ◽  
Good Practice ◽  
Antibiotic Use ◽  
Prevalence Survey ◽  
Term Care ◽  
Care Facilities ◽  
Tract Infections

Introduction: Healthcare associated infections and antimicrobial use are common among residents of long-term care facilities. Faced to the lack of standardized data, the European Centre for Disease Prevention and Control funded a project with the aim of estimating prevalence of infections and antibiotic use in European long-term care facilities. Aim: The aim of the authors was to present the results of the European survey which were obtained in Hungary. Method: In Hungary, 91 long-term care facilities with 11,823 residents participated in the point-prevalence survey in May, 2013. Results: The prevalence of infections was 2.1%. Skin and soft tissues infections were the most frequent (36%), followed by infections of the respiratory (30%) and urinary tract (21%). Antimicrobials were mostly prescribed for urinary tract infections (40.3%), respiratory tract infections (38.4%) and skin and soft tissue infections (13.2%). The most common antimicrobials (97.5%) belonged to the ATC J01 class of “antibacterials for systemic use”. Conclusions: The results emphasise the need for a national guideline and education for good practice in long-term care facilities. Orv. Hetil., 2014, 155(23), 911–917.

Uitbraak COVID-19 in de verpleeghuiszorg

2020 ◽  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Nursing Homes ◽  
Long Term Care ◽  
Informal Caregivers ◽  
Rapid Review ◽  
Daily Routine ◽  
Term Care ◽  
Care Facilities

Long-term care for older adults is highly affect by the COVID-19 outbreak. The objective of this rapid review is to understand what we can learn from previous crises or disasters worldwide to optimize the care for older adults in long term care facilities during the outbreak of COVID-19. We searched five electronic databases to identify potentially relevant articles. In total, 23 articles were included in this study. Based on the articles, it appeared that nursing homes benefit from preparing for the situation as best as they can. For instance, by having proper protocols and clear division of tasks and collaboration within the organization. In addition, it is helpful for nursing homes to collaborate closely with other healthcare organizations, general practitioners, informal caregivers and local authorities. It is recommended that nursing homes pay attention to capacity and employability of staff and that they support or relieve staff where possible. With regard to care for the older adults, it is important that staff tries to find a new daily routine in the care for residents as soon as possible. Some practical tips were found on how to communicate with people who have dementia. Furthermore, behavior of people with dementia may change during a crisis. We found tips for staff how to respond and act upon behavior change. After the COVID-19 outbreak, aftercare for staff, residents, and informal caregivers is essential to timely detect psychosocial problems. The consideration between, on the one hand, acute safety and risk reduction (e.g. by closing residential care facilities and isolating residents), and on the other hand, the psychosocial consequences for residents and staff, were discussed in case of other disasters. Furthermore, the search of how to provide good (palliative) care and to maintain quality of life for older adults who suffer from COVID-19 is also of concern to nursing home organizations. In the included articles, the perspective of older adults, informal caregivers and staff is often lacking. Especially the experiences of older adults, informal caregivers, and nursing home staff with the care for older adults in the current situation, are important in formulating lessons about how to act before, during and after the coronacrisis. This may further enhance person-centered care, even in times of crisis. Therefore, we recommend to study these experiences in future research.

Predictors of Mortality in Board and Care Homes

1997 ◽  
Vol 36 (1) ◽  
pp. 77-87 ◽  
Author(s):  
Nicholas G. Castle
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Social Services ◽  
Long Term Care ◽  
Significant Proportion ◽  
The Elderly ◽  
Term Care ◽  
Care Facilities ◽  
Board And Care

Long-term care institutions have emerged as dominant sites of death for the elderly. However, studies of this trend have primarily examined nursing homes. The purpose of this research is to determine demographic, functional, disease, and facility predictors and/or correlates of death for the elderly residing in board and care facilities. Twelve factors are found to be significant: proportion of residents older than sixty-five years of age, proportion of residents who are chair- or bed-fast, proportion of residents with HIV, bed size, ownership, chain membership, affiliation with a nursing home, number of health services provided other than by the facility, the number of social services provided other than by the facility, the number of social services provided by the facility, and visits by Ombudsmen. These are discussed and comparisons with similar studies in nursing homes are made.

scholarly journals Reducing Morbidity and Mortality Rates from COVID-19, Influenza and Pneumococcal Illness in Nursing Homes and Long-Term Care Facilities by Vaccination and Comprehensive Infection Control Interventions

Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 48
Author(s):  
Roger E. Thomas
Keyword(s):  
Nursing Homes ◽  
Infection Control ◽  
Strong Evidence ◽  
Disease Transmission ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities ◽  
Meta Analyses ◽  
Tract Infections

The COVID-19 pandemic identifies the problems of preventing respiratory illnesses in seniors, especially frail multimorbidity seniors in nursing homes and Long-Term Care Facilities (LCTFs). Medline and Embase were searched for nursing homes, long-term care facilities, respiratory tract infections, disease transmission, infection control, mortality, systematic reviews and meta-analyses. For seniors, there is strong evidence to vaccinate against influenza, SARS-CoV-2 and pneumococcal disease, and evidence is awaited for effectiveness against COVID-19 variants and when to revaccinate. There is strong evidence to promptly introduce comprehensive infection control interventions in LCFTs: no admissions from inpatient wards with COVID-19 patients; quarantine and monitor new admissions in single-patient rooms; screen residents, staff and visitors daily for temperature and symptoms; and staff work in only one home. Depending on the vaccination situation and the current risk situation, visiting restrictions and meals in the residents’ own rooms may be necessary, and reduce crowding with individual patient rooms. Regional LTCF administrators should closely monitor and provide staff and PPE resources. The CDC COVID-19 tool measures 33 infection control indicators. Hand washing, social distancing, PPE (gowns, gloves, masks, eye protection), enhanced cleaning of rooms and high-touch surfaces need comprehensive implementation while awaiting more studies at low risk of bias. Individual ventilation with HEPA filters for all patient and common rooms and hallways is needed.

scholarly journals Characterization and evolution of infection control practices among SARS-CoV-2 infected healthcare workers of acute care hospitals and long-term care facilities in Quebec, Canada, Spring 2020

2021 ◽  
pp. 1-37
Author(s):  
Sara Carazo ◽  
Denis Laliberté ◽  
Jasmin Villeneuve ◽  
Richard Martin ◽  
Pierre Deshaies ◽  
...  
Keyword(s):  
Acute Care ◽  
Attack Rate ◽  
Healthcare Workers ◽  
Long Term Care ◽  
Acute Care Hospitals ◽  
Exposure Period ◽  
Infection Prevention And Control ◽  
Term Care ◽  
Care Facilities

ABSTRACT Objectives: To estimate the SARS-CoV-2 infection rate and the secondary attack rate among healthcare workers (HCWs) in Quebec, the most affected province of Canada during the first wave; to describe the evolution of work-related exposures and infection prevention and control (IPC) practices in infected HCWs; and to compare the exposures and practices between acute care hospitals (ACHs) and long-term care facilities (LTCFs). Design: Survey of cases Participants: Quebec HCWs from private and public institutions with laboratory-confirmed COVID-19 diagnosed between 1st March and 14th June 2020. HCWs ≥18 years old, having worked during the exposure period and survived their illness were eligible for the survey. Methods: After obtaining consent, 4542 HCWs completed a standardized questionnaire. COVID-19 rates and proportions of exposures and practices were estimated and compared between ACHs and LTCFs. Results: HCWs represented 25% (13,726/54,005) of all reported COVID-19 cases in Quebec and had an 11-times greater rate than non-HCWs. Their secondary household attack rate was 30%. Most affected occupations were healthcare support workers, nurses and nurse assistants, working in LTCFs (45%) and ACHs (30%). Compared to ACHs, HCWs of LTCFs had less training, higher staff mobility between working sites, similar PPE use but better self-reported compliance with at-work physical distancing. Sub-optimal IPC practices declined over time but were still present at the end of the first wave. Conclusion: Quebec HCWs and their families were severely affected during the first wave of COVID-19. Insufficient pandemic preparedness and suboptimal IPC practices likely contributed to high transmission in both LTCFs and ACHs.

A Comparison of Wandering Behavior in Nursing Homes and Assisted Living Facilities

2005 ◽  
Vol 19 (2) ◽  
pp. 181-196 ◽  
Author(s):  
Elizabeth R. A. Beattie ◽  
JunAh Song ◽  
Shane LaGore
Keyword(s):  
Nursing Homes ◽  
Assisted Living ◽  
Challenging Behavior ◽  
Long Term Care ◽  
Assisted Living Facilities ◽  
Term Care ◽  
Training Requirements ◽  
Care Facilities ◽  
Staffing And Training

Wandering, a challenging behavior associated with dementia, affects many residents of long-term care facilities and can result in elopement, injury, and death. Most studies of wandering have taken place in nursing homes (NH). Expansion of the long-term care sector over the last 2 decades has resulted in a surge in options such as assisted living facilities (ALF). This study compared wandering behavior of residents (N = 108) in 21 long-term care facilities (15 NH, 6 ALF). Staff used the Revised Algase Wandering Scale-Nursing Home Version (RAWS-NH) to quantify wandering. While there were some differences in demographic variables (i.e., race, motor ability) between NH and ALF participants, no significant differences were found in either RAWS-NH overall or any of the 6 subscale scores. This suggests that the expression of wandering is similar in long-term care residents across all dimensions of the RAWS-NH regardless of facility type. Findings are of concern for those involved in the safe management and protection of residents at risk for wandering, particularly in long-term care facilities with underregulated staffing and training requirements.

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