Oral health champions in long-term care facilities-a pilot study

2013 ◽  
Vol 34 (4) ◽  
pp. 164-170 ◽  
Author(s):  
Carol Amerine ◽  
Linda Boyd ◽  
Denise M. Bowen ◽  
Karen Neill ◽  
Tara Johnson ◽  
...  
Keyword(s):  
Oral Health ◽  
Pilot Study ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities

scholarly journals The Impact of Enhanced Antimicrobial Stewardship Support on Antibiotic Starts in Long-Term Care Facilities

2020 ◽  
Vol 41 (S1) ◽  
pp. s527-s527
Author(s):  
Gabriela Andujar-Vazquez ◽  
Kirthana Beaulac ◽  
Shira Doron ◽  
David R Snydman
Keyword(s):  
Public Health ◽  
Pilot Study ◽  
Infection Control ◽  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Medical Center ◽  
Term Care ◽  
Care Facilities ◽  
The Impact

Background: The Tufts Medical Center Antimicrobial Stewardship (ASP) Team has partnered with the Massachusetts Department of Public Health (MDPH) to provide broad-based educational programs (BBEP) to long-term care facilities (LTCFs) in an effort to improve ASP and infection control practices. LTCFs have consistently expressed interest in individualized and hands-on involvement by ASP experts, yet they lack resources. The goal of this study was to determine whether “enhanced” individualized guidance provided by an ASP expert would lead to antibiotic start decreases in LTCFs participating in our pilot study. Methods: A pilot study was conducted to test the feasibility and efficacy of providing enhanced ASP and infection control practices to LTCFs. In total, 10 facilities already participating in MDPH BBEP and submitting monthly antibiotic start data were enrolled, were stratified by bed size and presence of dementia unit, and were randomized 1:1 to the “enhanced” group (defined as reviewing protocols and antibiotic start cases, providing lectures and feedback to staff and answering questions) versus the “nonenhanced” group. Antibiotic start data were validated and collected prospectively from January 2018 to July 2019, and the interventions began in April 2019. Due to staff turnover and lack of engagement, intervention was not possible in 2 of the 5 LTCFs randomized to the enhanced group, which were therefore analyzed as a nonenhanced group. An incidence rate ratios (IRRs) with 95% CIs were calculated comparing the antibiotic start rate per 1,000 resident days between periods in the pilot groups. Results: The average bed sizes for enhanced groups versus nonenhanced groups were 121 (±71.0) versus 108 (±32.8); the average resident days per facility per month were 3,415.7 (±2,131.2) versus 2,911.4 (±964.3). Comparatively, 3 facilities in the enhanced group had dementia unit versus 4 in the nonenhanced group. In the per protocol analysis, the antibiotic start rate in the enhanced group before versus after the intervention was 11.35 versus 9.41 starts per 1,000 resident days (IRR, 0.829; 95% CI, 0.794–0.865). The antibiotic start rate in the nonenhanced group before versus after the intervention was 7.90 versus 8.23 antibiotic starts per 1,000 resident days (IRR, 1.048; 95% CI, 1.007–1.089). Physician hours required for ASP for the enhanced group totaled 8.9 (±2.2) per facility per month. Conclusions: Although the number of hours required for intervention by an expert was not onerous, maintaining engagement proved difficult and in 2 facilities could not be achieved. A statistically significant 20% decrease in the antibiotic start rate was achieved in the enhanced group after interventions, potentially reflecting the benefit of enhanced ASP support by an expert.Funding: This study was funded by the Leadership in Epidemiology, Antimicrobial Stewardship, and Public Health (LEAP) fellowship training grant award from the CDC.Disclosures: None

scholarly journals Environmental screening for SARS-CoV-2 in long term care facilities: lessons from a pilot study

2021 ◽  
Vol 6 ◽  
pp. 235
Author(s):  
Rachel Kwiatkowska ◽  
Nicola Yaxley ◽  
Ginny Moore ◽  
Allan Bennett ◽  
Matthew Donati ◽  
...  
Keyword(s):  
Pilot Study ◽  
Long Term Care ◽  
Genetic Material ◽  
Infection Risk ◽  
Infection Prevention And Control ◽  
Term Care ◽  
Indirect Transmission ◽  
Care Facilities ◽  
The Impact

Background: The SARS-CoV-2 pandemic has highlighted the risk of infection transmission in long-term care facilities (LTCF) and the vulnerability of resident populations. It is essential to understand the environmental spread of the virus and risk of indirect transmission to inform Infection Prevention and Control (IPC) measures in these settings. Methods: Upon notification of SARS-CoV-2 outbreaks, LTCF within a local authority in the South West of England were approached to take part in this pilot study. Investigators visited to swab common touch-points and elevated ‘non-touch’ surfaces and samples were analysed for presence of SARS-CoV-2 genetic material (RNA). Data were collected regarding LTCF infrastructure, staff behaviours, clinical and epidemiological risk factors for infection (staff and residents), and IPC measures. Criteria for success were: recruitment of three LTCF; detection of SARS-COV-2 RNA; variation in proportion of SARS-CoV-2 positive surfaces by sampling zone; potential to assess infection risk from SARS-CoV-2 positive surfaces. Results: Three LTCFs were recruited, ranging in size and resident demographics. Outbreaks lasted 63, 50 and 30 days with resident attack rates of 53%, 40% and 8%, respectively. The proportion of sample sites on which SARS-CoV-2 was detected was highest in rooms occupied by infected residents and varied elsewhere in the LTCF, with low levels in a facility implementing enhanced IPC measures. The heterogeneity of settings and difficulty obtaining data made it difficult to assess association between environmental contamination and infection. Elevated surfaces were more likely to test positive for SARS-CoV-2 RNA than common touch-points. Conclusions: SARS-CoV-2 RNA can be detected in a variety of LTCF outbreak settings. We identified variation in environmental spread which could be associated with implementation of IPC measures, though we were unable to assess the impact on infection risk. Sampling elevated surfaces could add to ongoing public health surveillance for SARS-CoV-2 and other airborne pathogens in LTCF.

scholarly journals Reducing Dental Plaque Scores in Long-term Care Facilities Using a Checklist and Random Inspections: A Pilot Study

2019 ◽  
Vol 60 (3) ◽  
pp. 177-184
Author(s):  
Brian Laurence ◽  
India Rogers ◽  
Donna Grant-Mills ◽  
Dawn Smith ◽  
Eshetu Tefera ◽  
...  
Keyword(s):  
Pilot Study ◽  
Dental Plaque ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities

scholarly journals Implementation of Telemedicine Consultation to Assess Unplanned Transfers in Rural Long-Term Care Facilities, 2012–2015: A Pilot Study

2016 ◽  
Vol 17 (11) ◽  
pp. 1006-1010 ◽  
Author(s):  
Joshua Hofmeyer ◽  
Jonathon P. Leider ◽  
Jennifer Satorius ◽  
Erin Tanenbaum ◽  
David Basel ◽  
...  
Keyword(s):  
Pilot Study ◽  
Long Term Care ◽  
Term Care ◽  
Telemedicine Consultation ◽  
Care Facilities

Resident challenges with daily life in Chinese long-term care facilities: A qualitative pilot study

2018 ◽  
Vol 39 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Yuting Song ◽  
Kezia Scales ◽  
Ruth A. Anderson ◽  
Bei Wu ◽  
Kirsten N. Corazzini
Keyword(s):  
Pilot Study ◽  
Long Term Care ◽  
Daily Life ◽  
Term Care ◽  
Care Facilities

scholarly journals Oral disease burden of dentate older adults living in long-term care facilities: FINORAL study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lina Julkunen ◽  
Kaija Hiltunen ◽  
Hannu Kautiainen ◽  
Riitta K. T. Saarela ◽  
Kaisu H. Pitkälä ◽  
...  
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Disease Burden ◽  
Long Term Care ◽  
Clinical Signs ◽  
Oral Disease ◽  
Soft Or ◽  
Term Care ◽  
Care Facilities

Abstract Background A growing number of older adults have natural teeth and are at high risk of oral diseases, which are induced by oral bacterial accumulation and proceed unnoticed and quietly. Our aim was (1) to examine the association of oral disease burden (ODB) with health and functioning among dentate long-term care residents, and (2) to find easily detectable signs for nurses to identify residents’ poor oral health. Methods In this cross-sectional observational study dentists examined 209 residents’ oral status, and nurses assessed residents for their functioning and nutrition in long-term care facilities in Helsinki, Finland. ODB was defined by asymptotic dental score (ADS). Six clinical signs of residents’ poor oral health were considered as potentially easy for nurses to detect: lesions on lips, teeth with increased mobility, lesions on oral mucosa, eating soft or pureed food, unclear speech, and needing assistance in eating. The association of these was tested with high ODB as outcome. Results Participants were grouped according to their ADS scores: low (n = 39), moderate (n = 96) and high ODB (n = 74). ODB was linearly associated with coronary artery disease and poor cognitive and physical functioning: needing assistance in eating, poor ability to make contact, and unclear speech but not with other diseases including dementia or demographic characteristics. Furthermore, ODB was linearly associated with eating soft or pureed food. Of the six selected, easily detectable signs, having at least two positive signs gave 89% sensitivity to detecting high ODB. Conclusion Poor oral health was common and ODB accumulated among residents with poor functioning. Nurses may use a few easily detectable signs to screen residents’ oral health when considering a resident’s need for consultation with an oral health professional.

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