An Outbreak of Norovirus Infection in a Long-Term-Care Unit in Spain

2005 ◽  
Vol 26 (3) ◽  
pp. 259-262 ◽  
Author(s):  
Gemma Navarro ◽  
Rosa M. Sala ◽  
Ferran Segura ◽  
César Arias ◽  
Pilar Varela ◽  
...  
Keyword(s):  
Long Term Care ◽  
Clinical Symptoms ◽  
Care Facility ◽  
Care Hospital ◽  
Term Care ◽  
Long Term Care Facility ◽  
Staff Members ◽  
Genotype 2 ◽  
Stool Cultures

AbstractBackground:Norovirus belongs to the Caliciviridae family and causes outbreaks of infectious enteritis by fecal-oral transmission. In Spain, there have been few outbreaks reported due to this virus. We describe an outbreak on a long-term-care hospital ward.Methods:Cases were classified as probable, confirmed, and secondary. Stool cultures were performed. Polymerase chain reaction detection of norovirus was also performed.Results:The outbreak occurred from December 7 to 28, 2001, involving 60 cases (32 patients, 19 staff members, 8 patients' relatives, and 1 relative of a staff member). Most (82%) of the cases were female. The most frequently involved ages were 20 to 39 years for staff members and 70 to 89 years for patients. The incubation period of secondary cases in patients' families had a median of 48 hours (range, 1 to 7 days). Clinical symptoms included diarrhea (85%), vomiting (75%), fever (37%), nausea (23%), and abdominal pain (12%). Median duration of the disease was 48 hours (range, 1 to 7 days). All cases resolved and the outbreak halted with additional hygienic measures. Stool cultures were all negative for enteropathogenic bacteria and rotaviruses. In 16 of 23 cases, the norovirus genotype 2 antigen was detected.Conclusion:This outbreak of gastroenteritis due to norovirus genotype 2 affected patients, staff members, and their relatives in a long-term-care facility and was controlled in 21 days.

“They don't just disappear”: Acknowledging death in the long-term care setting

2012 ◽  
Vol 10 (4) ◽  
pp. 241-247 ◽  
Author(s):  
Janine Maitland ◽  
Kevin Brazil ◽  
Bill James-Abra
Keyword(s):  
Long Term Care ◽  
Emotional Health ◽  
Family Members ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
Qualitative Research Study ◽  
Staff Members

AbstractObjective:The purpose of this study was to describe the value of a formal room blessing ritual held within a long-term care facility, from the perspectives of staff, residents, and family members.Method:A qualitative research study involving interviews with staff, residents, and family members was conducted to examine the perceived value of a room blessing ritual.Results:Twenty-four room blessing attendees participated in the study (nine staff, eight residents, and seven family members). Attendees felt that the room blessing provided an opportunity to formally acknowledge the death of the resident and their grief; the majority felt that this was a positive experience and that it provided an element of closure. Staff members and residents expressed their appreciation for the opportunity to connect with family members of the deceased to express their condolences during the ritual. Participants also identified the inclusivity of the ritual (i.e., an open invitation to all staff, residents, and family members) as a positive aspect that served as a reminder that others shared in their grief. Staff members felt that blessing the room for the new resident was an important component of the ritual, helping to bridge the gap between mourning and welcoming a new person. Staff, residents, and family members felt that the room blessing positively reflected the mission and values of the facility. The most highly valued aspect of the ritual for all attendees was the sharing of stories about the deceased to celebrate that person's life.Significance of results:Long-term care facilities need to recognize that formal supports to manage the bereavement needs of staff and residents, such as a room blessing ritual, should be incorporated into their model for managing end-of-life care, given the relationship between the emotional health of staff and the quality of care provided for residents.

scholarly journals Adaptations for TAP in a Long-Term Care Setting

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 631-631
Author(s):  
Katherine Marx ◽  
Lauren Parker ◽  
Laura Gitlin
Keyword(s):  
Behavioral Interventions ◽  
Long Term Care ◽  
Clinical Symptoms ◽  
Functional Decline ◽  
Care Facility ◽  
Direct Care ◽  
Care Staff ◽  
Term Care ◽  
Long Term Care Facility

Abstract One of the most difficult aspects of caring for people living with dementia is managing neuropsychologic symptoms and functional decline. Although there are hundreds of efficacious non-pharmacologic interventions tested in homes, few are adapted for and tested in long-term care. The purpose of this pilot study was to identify the adaptations needed for the Tailored Activity Program (TAP) to make it feasible and acceptable in a long-term care facility. TAP provides tailored activities matched to interests and abilities to address dementia-related clinical symptoms. Two sites, under the umbrella of one company, participated. A total of five persons living with dementia, their family caregivers, two direct care staff and an interventionist participated, and occupational therapist who contracts with the site on a regular basis. Adaptations included shorter sessions and changes to forms to fit with workflows and documentation. Additional considerations challenging implementation of TAP included staff turn-over and training. Part of a symposium sponsored by the Behavioral Interventions for Older Adults Interest Group.

Clostridium difficileInfection in a Long-Term Care Facility: Hospital-Associated Illness Compared with Long-Term Care-Associated Illness

2011 ◽  
Vol 32 (7) ◽  
pp. 656-660 ◽  
Author(s):  
Jong Hun Kim ◽  
Diana Toy ◽  
Robert R. Muder
Keyword(s):  
Acute Care ◽  
Long Term Care ◽  
Acute Care Hospital ◽  
Care Facility ◽  
Optimal Strategies ◽  
Care Hospital ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

Background.Controversy exists over whetherClostridium difficileinfection (CDI) commonly occurs in long-term care facility residents who have not been recently transferred from an acute care hospital.Objective.To assess the incidence and outcome of CDI in a long-term care facility.Methods.Retrospective cohort study in a 262-bed long-term care Veterans Affairs facility in Pittsburgh, Pennsylvania, for the period January 2004 through June 2010. CDI was identified by positive stoolC. difficiletoxin assay and acute diarrhea. Patients were categorized as hospital-associated CDI (HACDI) or long-term care facility–associated CDI (LACDI) and followed for 6 months.Results.The annual rate of CDI varied between 0.11 and 0.23 per 1,000 resident-days for HACDI patients and between 0.04 and 0.28 per 1,000 resident-days for LACDI patients. We identified 162 patients, 96 patients (59.3%) with HACDI and 66 patients (40.7%) with LACDI. Median age was 74 and 77 years, respectively, for HACDI and LACDI (P= .055) patients. There were more patients with at least 1 relapse of CDI during 6 months of follow up in LACDI patients (32/66, 48.5%) than in HACDI patients (28/96, 29.2%;P= .009). Logistic regression showed that ages of at least 75 years (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.07–5.07;P= .033), more than 2 transfers to an acute care hospital (OR, 7.88; 95% CI, 1.88–32.95;P= .005), and LACDI (OR, 3.15; 95% CI, 1.41–7.05;P= .005) were associated with relapse of CDI.Conclusions.Forty percent of CDI cases were acquired within the long-term care facility, indicating a substantial degree of transmission. Optimal strategies to prevent CDI in the long-term care facility are needed.

Abnormal behavior of residents in a long-term care facility and the associated stress of care staff members

2001 ◽  
Vol 33 (3) ◽  
pp. 203-210 ◽  
Author(s):  
Itsugi Nagatomo ◽  
Yasuaki Akasaki ◽  
Masataka Tominaga ◽  
Wataru Hashiguchi ◽  
Masahiro Uchida ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Care Staff ◽  
Abnormal Behavior ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Staff Members

Namaste Care™: A Person-Centered Care Approach for Alzheimer’s and Advanced Dementia

2016 ◽  
Vol 40 (1) ◽  
pp. 37-51 ◽  
Author(s):  
Paula McNiel ◽  
Judith Westphal
Keyword(s):  
Long Term Care ◽  
Hospital Readmissions ◽  
Care Facility ◽  
The United States ◽  
Term Care ◽  
Long Term Care Facility ◽  
Staff Members ◽  
People With Dementia ◽  
The Impact

New methods of care are required to meet the needs of people with dementia and their caregivers. The Namaste Care™ program provides a person-centered approach through meaningful activities and loving touch. The purpose of this qualitative study was to explore the experiences of residents, staff, and family involved in the Namaste Care™ program at a long-term care facility in the United States. A descriptive approach was used to interview 14 staff members. The findings revealed six themes: peaceful sanctuary, relating their way, transforming experiences, connections and community, positive moments, and awakened to the possibilities. Results suggest that Namaste Care™ may be useful for individuals no longer able to participate in traditional long-term care setting activities. Further studies are indicated to confirm the impact on hospital readmissions, therapy enhancement, and medication use in relationship to Namaste Care™ program participation.

scholarly journals Comparative Effectiveness of Standard and Contingency-based Cleaning in Acute and Long-Term Care Facilities amidst Staff Shortages and a COVID-19 Surge

2021 ◽  
Author(s):  
Emil Lesho ◽  
Donna Newhart ◽  
Lisa Reno ◽  
Scott Sleeper ◽  
Julia Nary ◽  
...  
Keyword(s):  
Long Term Care ◽  
Acute Care Hospital ◽  
Care Facility ◽  
Care Hospital ◽  
Term Care ◽  
Long Term Care Facility ◽  
Residential Units ◽  
Before And After ◽  
Uv C

Background: Cleanliness of hospital surfaces helps prevent healthcare-associated infections, but larger evaluations of the effectiveness of various cleaning strategies during SARS-CoV-2 surges and worker shortages are scarce. Methods: In an acute care hospital (ACH) and a long-term care facility (LTCF), 417 surfaces were tested for SARS-CoV-2 and adenosine triphosphate before and after various cleaning strategies, including ultraviolet light (UV-C), electrostatic spraying, and room fogging. Results: ACH surface contamination differed among outbreak and non-outbreak wards (p = 0.001). RNA was detected on 66% of surfaces before cleaning and on 23% of those surfaces immediately after terminal cleaning, for a 65% post-cleaning reduction (p = 0.001). UV-C resulted in an 87% reduction (p = 0.023), while spraying with electrostatic bleach resulted in a 47% reduction (p = 0.010). LTCF contamination rates differed between the dementia, rehabilitation, and the residential units (p = 0.005). 67% of surfaces had RNA after room fogging without terminal-style wiping. Fogging with wiping led to an 11% reduction in the proportion of positive surfaces. Discussion: Baseline contamination varied by type of unit and outbreak conditions, but not facility type. Removal of viral RNA varied according to strategy. Unlike previous reports, time spent cleaning was associated with cleaning thoroughness.

Coping with the Intermingling of the Lucid and Confused

1988 ◽  
Vol 1 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Louis J. Novick
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Professional Staff ◽  
Term Care ◽  
Homogeneous Groups ◽  
Long Term Care Facility ◽  
Staff Members ◽  
Before And After ◽  
Staff Psychiatrist

The issue of intermingling mentally lucid individuals and confused patients with behaviour problems has been a serious concern for the long-term care facility from the standpoints of the resident, relatives and staff. Efforts at Maimonides Hospital Geriatric Centre in Montreal have included “relationship therapy” (i.e., the relationship between the resident and staff members) to preserve the resident's self-esteem. Also, homogeneous groups of lucid and confused residents have been formed to help each take part in appropriate social activities. Lucid residents also are encouraged to attend weekly meetings with both professional and non-professional staff working on their floor. A staff psychiatrist experienced in psycho-pharmacology has significantly improved the problems created by intermingling these two groups. The psychiatrist also has helped staff reduce the stress caused by intermingling. In addition, staff members meet with relatives before and after admission of applicants to alleviate and discuss their concerns. Nevertheless, Maimonides and other long-term care institutions face the problem of how to reduce the damage of intermingling these two groups of residents.

Efficacy of a stewardship intervention focused on reducing unnecessary use of non–Clostridioides difficile antibiotics in patients with Clostridioides difficile infection

2019 ◽  
pp. 1-3
Author(s):  
Michelle T. Hecker ◽  
Andrea H. Son ◽  
Heba Alhmidi ◽  
Brigid M. Wilson ◽  
Peter M. Wiest ◽  
...  
Keyword(s):  
Long Term Care ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Facility ◽  
Care Hospital ◽  
Term Care ◽  
Long Term Care Facility ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection

Abstract In a tertiary-care hospital and affiliated long-term care facility, a stewardship intervention focused on patients with Clostridioides difficile infection (CDI) was associated with a significant reduction in unnecessary non-CDI antibiotic therapy. However, there was no significant reduction in total non-CDI therapy or in the frequency of CDI recurrence.

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