Admission Surveillance for Carbapenamase-Producing Enterobacteriaceae at a Long-Term Acute Care Hospital

2013 ◽  
Vol 34 (8) ◽  
pp. 832-834 ◽  
Author(s):  
Jessica D. Lewis ◽  
Matthew Bishop ◽  
Brenda Heon ◽  
Amy J. Mathers ◽  
Kyle B. Enfield ◽  
...  
Keyword(s):  
United States ◽  
Prospective Study ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Acute Care Hospitals ◽  
The United States ◽  
Routine Screening ◽  
Care Hospital ◽  
High Prevalence

Carbapenemase-producing Enterobacteriaceae (CPE) are of increasing prevalence worldwide, and long-term acute care hospitals (LTACHs) have been implicated in several outbreaks in the United States. This prospective study of routine screening for CPE on admission to a LTACH demonstrates a high prevalence of CPE colonization in central Virginia.

Acute Emergence of Elizabethkingia meningoseptica Infection among Mechanically Ventilated Patients in a Long-Term Acute Care Facility

2010 ◽  
Vol 31 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Kingsley N. Weaver ◽  
Roderick C. Jones ◽  
Rosemary Albright ◽  
Yolanda Thomas ◽  
Carlos H. Zambrano ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Care Facility ◽  
Acute Care Hospitals ◽  
Care Hospital ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Elizabethkingia Meningoseptica ◽  
Ventilated Patients

Objective.To describe an outbreak of infection associated with an infrequently implicated pathogen, Elizabethkingia meningoseptica, in an increasingly prominent setting for health care of severely ill patients, the long-term acute care hospital.Design.Outbreak investigation.Setting.Long-term acute care hospital with 55 patients, most of whom were mechanically ventilated.Methods.We defined a case as E. meningoseptica isolated from any patient specimen source from December 2007 through April 2008, conducted an investigation of case patients, obtained environmental specimens, and performed microbiologic testing.Results.Nineteen patients had E. meningoseptica infection, and 8 died. All case patients had been admitted with respiratory failure that required mechanical ventilation. Among the 8 individuals who died, the time from collection of the first specimen positive for E. meningoseptica to death ranged from 6 to 43 days (median, 16 days). Environmental sampling was performed on 106 surfaces; E. meningoseptica was isolated from only one swab. Three related pulsed-field gel electrophoresis patterns were identified in patient isolates; the environmental isolate yielded a fourth, unrelated pattern.Conclusion.Long-term acute care hospitals with mechanically ventilated patients could serve as an important transmission setting for E. meningoseptica. This multidrug-resistant bacterium could pose additional risk when patients are transferred between long-term acute care hospitals and acute care hospitals.

scholarly journals Long-term acute care hospitals and Georgia Medicaid: Utilization, outcomes, and cost

2016 ◽  
Vol 4 ◽  
pp. 205031211667092
Author(s):  
Evan S. Cole ◽  
Carla Willis ◽  
William C Rencher ◽  
Mei Zhou
Keyword(s):  
Acute Care ◽  
Diagnosis Related Groups ◽  
Acute Care Hospital ◽  
Acute Care Hospitals ◽  
Risk Scores ◽  
Average Risk ◽  
Care Hospital ◽  
Hospital Patients ◽  
Medicaid Population

Objectives: Because most research on long-term acute care hospitals has focused on Medicare, the objective of this research is to describe the Georgia Medicaid population who received care at a long-term acute care hospital, the type and volume of services provided by these long-term acute care hospitals, and the costs and outcomes of these services. For those with select respiratory conditions, we descriptively compare costs and outcomes to those of patients who received care for the same services in acute care hospitals. Methods: We describe Georgia Medicaid recipients admitted to a long-term acute care hospital between 2011 and 2012. We compare them to a population of Georgia Medicaid recipients admitted to an acute care hospital for one of five respiratory diagnosis-related groups. Measurements used include patient descriptive information, admissions, diagnosis-related groups, length of stay, place of discharge, 90-day episode costs, readmissions, and patient risk scores. Results: We found that long-term acute care hospital admissions for Medicaid patients were fairly low (470 90-day episodes) and restricted to complex cases. We also found that the majority of long-term acute care hospital patients were blind or disabled (71.2%). Compared to patients who stayed at an acute care hospital, long-term acute care hospital patients had higher average risk scores (13.1 versus 9.0), lengths of stay (61 versus 38 days), costs (US$143,898 versus US$115,056), but fewer discharges to the community (28.4% versus 51.8%). Conclusion: We found that the Medicaid population seeking care at long-term acute care hospitals is markedly different than the Medicare populations described in other long-term acute care hospital studies. In addition, our study revealed that Medicaid patients receiving select respiratory care at a long-term acute care hospital were distinct from Medicaid patients receiving similar care at an acute care hospital. Our findings suggest that state Medicaid programs should carefully consider reimbursement policies for long-term acute care hospitals, including bundled payments that cover both the original hospitalization and long-term acute care hospital admission.

Medicaid Threats on the Horizon

2020 ◽  
Vol 35 (3) ◽  
pp. 145-145
Author(s):  
Paul Baldwin
Keyword(s):  
United States ◽  
Long Term Care ◽  
Acute Care Hospital ◽  
The United States ◽  
Care Hospital ◽  
Short Term ◽  
Term Care ◽  
Episodes Of Care ◽  
Primary Payer

Those of you who have been around for a while understand that Medicaid is the primary payer for long-term care in the United States. While Medicare pays for the short-term episodes of care associated with rehabilitation following a three-day stay in an acute-care hospital, it?s Medicaid that foots the bill for live-in residents who are unable to afford it themselves.

Sharp-Device Injuries to Hospital Staff Nurses in 4 Countries

2007 ◽  
Vol 28 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Sean P. Clarke ◽  
Maria Schubert ◽  
Thorsten Körner
Keyword(s):  
United States ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Hospital Staff ◽  
The United States ◽  
Staff Nurses ◽  
Care Hospital ◽  
Injury Rates ◽  
The Past ◽  
Hospital Staff Nurses

Objective.To compare sharp-device injury rates among hospital staff nurses in 4 Western countries.Design.Cross-sectional survey.Setting.Acute-care hospital nurses in the United States (Pennsylvania), Canada (Alberta, British Columbia, and Ontario), the United Kingdom (England and Scotland), and Germany.Participants.A total of 34,318 acute-care hospital staff nurses in 1998-1999.Results.Survey-based rates of retrospectively-reported needlestick injuries in the previous year for medical-surgical unit nurses ranged from 146 injuries per 1,000 full-time equivalent positions (FTEs) in the US sample to 488 injuries per 1,000 FTEs in Germany. In the United States and Canada, very high rates of sharp-device injury among nurses working in the operating room and/or perioperative care were observed (255 and 569 injuries per 1,000 FTEs per year, respectively). Reported use of safety-engineered sharp devices was considerably lower in Germany and Canada than it was in the United States. Some variation in injury rates was seen across nursing specialties among North American nurses, mostly in line with the frequency of risky procedures in the nurses' work.Conclusions.Studies conducted in the United States over the past 15 years suggest that the rates of sharp-device injuries to front-line nurses have fallen over the past decade, probably at least in part because of increased awareness and adoption of safer technologies, suggesting that regulatory strategies have improved nurse safety. The much higher injury rate in Germany may be due to slow adoption of safety devices. Wider diffusion of safer technologies, as well as introduction and stronger enforcement of occupational safety and health regulations, are likely to decrease sharp-device injury rates in various countries even further.

Bricolage: Making Do With What Is at Hand

2009 ◽  
Vol 15 (2) ◽  
pp. 82-84 ◽  
Author(s):  
Magdeline Aagard
Keyword(s):  
United States ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Midwestern United States

While researching and writing her dissertation, the author discovers the concept of bricolage. She describes its application in Tanzania and in a long-term acute care hospital in the Midwestern United States.

The First New Delhi Metallo-β-lactamase (NDM-1) Pseudomonas Aeruginosa Outbreak Identified in the United States in an Acute Care Hospital

2015 ◽  
Vol 43 (6) ◽  
pp. S67
Author(s):  
Kathleen Lucente ◽  
Kathleen Francis ◽  
Olarae Giger ◽  
Hillary Cooper ◽  
Connie Cutler ◽  
...  
Keyword(s):  
United States ◽  
Pseudomonas Aeruginosa ◽  
Acute Care ◽  
Acute Care Hospital ◽  
The United States ◽  
New Delhi ◽  
Care Hospital

scholarly journals Estimated number of N95 respirators needed for healthcare workers in acute-care hospitals during the coronavirus disease 2019 (COVID-19) pandemic

2021 ◽  
pp. 1-9
Author(s):  
Patrick T. Wedlock ◽  
Kelly J. O’Shea ◽  
Madellena Conte ◽  
Sarah M. Bartsch ◽  
Samuel L. Randall ◽  
...  
Keyword(s):  
United States ◽  
Resource Allocation ◽  
Acute Care ◽  
Healthcare Workers ◽  
Acute Care Hospital ◽  
The United States ◽  
Care Hospital ◽  
Single Use ◽  
N95 Respirators ◽  
Admission Prevalence

Abstract Objective: Due to shortages of N95 respirators during the coronavirus disease 2019 (COVID-19) pandemic, it is necessary to estimate the number of N95s required for healthcare workers (HCWs) to inform manufacturing targets and resource allocation. Methods: We developed a model to determine the number of N95 respirators needed for HCWs both in a single acute-care hospital and the United States. Results: For an acute-care hospital with 400 all-cause monthly admissions, the number of N95 respirators needed to manage COVID-19 patients admitted during a month ranges from 113 (95% interpercentile range [IPR], 50–229) if 0.5% of admissions are COVID-19 patients to 22,101 (95% IPR, 5,904–25,881) if 100% of admissions are COVID-19 patients (assuming single use per respirator, and 10 encounters between HCWs and each COVID-19 patient per day). The number of N95s needed decreases to a range of 22 (95% IPR, 10–43) to 4,445 (95% IPR, 1,975–8,684) if each N95 is used for 5 patient encounters. Varying monthly all-cause admissions to 2,000 requires 6,645–13,404 respirators with a 60% COVID-19 admission prevalence, 10 HCW–patient encounters, and reusing N95s 5–10 times. Nationally, the number of N95 respirators needed over the course of the pandemic ranges from 86 million (95% IPR, 37.1–200.6 million) to 1.6 billion (95% IPR, 0.7–3.6 billion) as 5%–90% of the population is exposed (single-use). This number ranges from 17.4 million (95% IPR, 7.3–41 million) to 312.3 million (95% IPR, 131.5–737.3 million) using each respirator for 5 encounters. Conclusions: We quantified the number of N95 respirators needed for a given acute-care hospital and nationally during the COVID-19 pandemic under varying conditions.

scholarly journals Investigation of a Group A Streptococcal Outbreak Among Residents of a Long-term Acute Care Hospital

2011 ◽  
Vol 52 (8) ◽  
pp. 988-994 ◽  
Author(s):  
M. Deutscher ◽  
S. Schillie ◽  
C. Gould ◽  
J. Baumbach ◽  
M. Mueller ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Group A
Sign in / Sign up

Export Citation Format

Share Document