Influenza and Pneumococcal Vaccination and Tuberculin Skin Testing Programs in Long-Term Care Facilities: Where Do We Stand?

1995 ◽  
Vol 16 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Margaret A. McArthur ◽  
Andrew E. Simor ◽  
Beverly Campbell ◽  
Allison McGeer
Keyword(s):  
Long Term Care ◽  
Skin Testing ◽  
Pneumococcal Vaccination ◽  
Tuberculin Skin Testing ◽  
Term Care ◽  
Care Facilities

Tuberculin skin testing programs in long-term care facilities for th elderly

1994 ◽  
Vol 22 (2) ◽  
pp. 125
Author(s):  
M. McArthur ◽  
I.G. Naglie ◽  
A. Cheung ◽  
A. Simor ◽  
M. Naus ◽  
...  
Keyword(s):  
Long Term Care ◽  
Skin Testing ◽  
Tuberculin Skin Testing ◽  
Term Care ◽  
Care Facilities

Tuberculosis Surveillance Practices in Long-Term Care Institutions

1995 ◽  
Vol 16 (3) ◽  
pp. 148-151
Author(s):  
Gary Naglie ◽  
Margaret McArthur ◽  
Andrew Simor ◽  
Monika Naus ◽  
Angela Cheung ◽  
...  
Keyword(s):  
Skin Test ◽  
Long Term Care ◽  
Skin Testing ◽  
The Elderly ◽  
Positive Tuberculin Skin Test ◽  
Tuberculin Skin Testing ◽  
Term Care ◽  
Policies And Procedures ◽  
Testing Practices

AbstractObjecitves:To identify the tuberculosis (TB) skin-testing practices of long-term care facilities for the elderly in Toronto, Ontario.Design:A telephone survey using a 25-item questionnaire.Setting:Twenty-nine nursing homes (NHs) and 26 Homes for the Aged (HFAs) in metropolitan Toronto.Results:Thirty-one percent of facilities (17 of 55) had no formal tuberculin skin-testing program, including 52% of NHs (15 of 29) versus 8% of HFAs (2 of 26; P= 0.001). Ninety-two percent of HFAs (24 of 26) compared with 45% of NHs (13 of 29), obtained preadmission or admission skin-test status of residents (P= 0.0005). Annual testing was performed at 46% of HFAs (12 of 26) and 27% of NHs (8 of 29; P= 0.28). Of facilities that carried out any skin testing, 64% of HFAs (16 of 25) versus 32% of NHs (6 of 19) measured induration to establish test positivity (P=0.068). Fifty-two percent of HFAs (13 of 25), compared with 21% of NHs (4 of 19), recorded the actual size of induration in the patient record (P=0.085). Only 28% of HFAs (7 of 25) and 21% of NHs (4 of 19) correctly defined a positive tuberculin skin test.Conclusions:TB surveillance practices in long-term care institutions in Toronto are inadequate and often yield results that do not predict the risk of infection and cannot be used to investigate outbreaks. Tuberculin skin-testing practices were better at HFAs, which are subject to provincial legislation regarding TB surveillance, than at NHs, which are not subject to this legislation. Staff at HFAs and NHs require education regarding tuberculin skin-testing policies and procedures.

Increasing Pneumococcal Vaccination Rates Among Residents of Long-Term–Care Facilities: Provider-Based Improvement Strategies Implemented by Peer-Review Organizations in Four Western States

2000 ◽  
Vol 21 (11) ◽  
pp. 705-710 ◽  
Author(s):  
Kurt B. Stevenson ◽  
John W. McMahon ◽  
Jan Harris ◽  
J. Richard Hillman ◽  
Steven D. Helgerson
Keyword(s):  
Long Term Care ◽  
Pneumococcal Vaccination ◽  
Vaccination Rate ◽  
Term Care ◽  
Improvement Project ◽  
Vaccination Rates ◽  
Standing Order ◽  
Care Facilities ◽  
Collaborative Efforts

AbstractObjective:To evaluate collaborative efforts and intervention strategies by peer-review organizations (PROs) and long-term-care facilities (LTCFs) for improving pneumococcal vaccination rates among residents of LTCFs.Design:Prospective, before-after quality improvement project.Setting:133 LTCFs in Alaska, Idaho, Montana, and Wyoming.Patients:All residents of participating LTCFs.Methods:Baseline pneumococcal vaccination rates were determined by medical-record review, self-reporting by patient or family members, and review of Medicare claims information. Remeasurement of vaccination rates was accomplished from documentation of vaccination of eligible residents by each LTCF.Results:133 LTCFs with 7,623 residents from Alaska, Idaho, Montana, and Wyoming participated in this quality-improvement project. This accounted for 41% (133/321) of the potential nursing homes and resident population in the participating states. Baseline overall vaccination rates were 40% (3,050/7,589). The overall vaccination rate improved to 75% (5,720/7,623, P<.001). The number of facilities meeting the Healthy People 2000 vaccination goal of 80% improved from 18% (24/133) to 62% (83/133, P<.001). Initial use of chart stickers and implementation of standing orders led to similar increases in vaccination rates, but the standing-order strategy required commitment of fewer PRO resources at a statewide level. Remeasurement of vaccination rates in a subset of participating Idaho LTCFs 1 year after initial vaccination efforts demonstrated a sustained vaccination rate of 70% in facilities enforcing a standing-order policy.Conclusions:Simple and straightforward vaccination strategies implemented in LTCFs over a short period of time can have a significant impact on vaccination rates. Collaborative efforts between state PROs and LTCFs enhance implementation of these strategies and can result in the achievement of national vaccination objectives. Standing orders appear to be one intervention effective in sustaining successful vaccination efforts. Regardless of the specific interventions employed, PROs played a significant role in facilitating vaccination program development and intervention implementation.

Increasing Influenza and Pneumococcal Vaccination and Tuberculosis Screening among Residents of Colorado Long-Term Care Facilities

1999 ◽  
Vol 22 (4) ◽  
pp. 466-483 ◽  
Author(s):  
W. William Schluter ◽  
Debra L. Ralston ◽  
Richard J. Delaney ◽  
Angela Sauaia ◽  
Thomas R. Dunn
Keyword(s):  
Long Term Care ◽  
Pneumococcal Vaccination ◽  
Tuberculosis Screening ◽  
Term Care ◽  
Care Facilities

scholarly journals Influenza and Pneumococcal Vaccination in Long Term Care Facilities in Two Regions of Quebec

1996 ◽  
Vol 7 (5) ◽  
pp. 296-300 ◽  
Author(s):  
Philippe De Wals ◽  
Michel Carbonneau ◽  
Hélène Payette ◽  
Théophile Niyonsenga
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Random Sample ◽  
Pneumococcal Vaccine ◽  
Long Term Care ◽  
Pneumococcal Vaccination ◽  
Vaccination Rate ◽  
Term Care ◽  
Care Facilities

OBJECTIVES: To evaluate the use of influenza and pneumococcal vaccines in long term care facilities.DESIGN: Cross-sectional survey in a random sample of 30 facilities in two regions of Quebec. Information was collected from the general manager or the chief of nursing, all consultant physicians and a random sample of 20 residents in each facility.RESULTS: Twenty-nine centres agreed to participate. The mean influenza vaccination rate was 70%, and was not influenced by differences in the types of facilities or the organization of the programs for immunization. The main obstacle to influenza vaccination reported by physicians was nonacceptance by a significant proportion of residents. Of the residents who did not initially request influenza vaccine, only 64% accepted vaccination when it was offered. The vast majority of residents were satisfied with the information they had received and the respect shown for their freedom of choice. Forty per cent of residents were unfit to provide a valid consent and the vaccination rate was 76% in this group. Only one-third of the physicians regularly obtained authorization from a relative or the legal guardian before prescribing vaccination for incompetent residents. None of the facilities studied had an effective program for pneumococcal vaccination, only 43% of the physicians reported any use of pneumococcal vaccine and 98% of residents had never heard of the vaccine.CONCLUSIONS: The national objective of 95% coverage with influenza vaccine will be difficult to achieve in long term care facilities, mainly because a minority of residents are not likely to be convinced of the benefit of immunization. Much remains to be done to promote and administer pneumococcal vaccine in this setting.

Influenza and Pneumococcal Vaccination Coverage Levels Among Hawaii Statewide Long-Term-Care Facilities

2001 ◽  
Vol 22 (08) ◽  
pp. 519-521 ◽  
Author(s):  
Xiao Wei Cui ◽  
Marcia M. Nagao ◽  
Paul V. Effler
Keyword(s):  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Long Term Care ◽  
Pneumococcal Vaccination ◽  
Term Care ◽  
Vaccination Rates ◽  
Time Period ◽  
Care Facilities

Abstract Influenza and pneumococcal vaccination rates among Hawaii long-term-care facilities (LTCFs) statewide during the 1996/97 through the 1998/99 influenza seasons revealed that resident influenza vaccination rates remained over 89%, but pneumococcal vaccination was underutilized. LTCF staff influenza vaccination rates over the same time period were low.

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