scholarly journals Monitoring polypharmacy in healthcare systems through a multi-setting survey: should we put more attention on long term care facilities?

2016 ◽  
Vol 5 (3) ◽  
Author(s):  
Luca Arnoldo ◽  
Giovanni Cattani ◽  
Piergiorgio Cojutti ◽  
Federico Pea ◽  
Silvio Brusaferro
Keyword(s):  
Long Term Care ◽  
Beers Criteria ◽  
Regional Health ◽  
Term Care ◽  
Point Prevalence Study ◽  
Healthcare Settings ◽  
Care Facilities ◽  
Acute Hospitals ◽  
Design And Methods

<em>Background</em>. Polypharmacy is a main issue of patient safety in all healthcare settings (<em>i.e.</em> increase adverse drug reactions and incidence of drug-drug interactions, etc.). The main object of the study was to evaluate the prevalence of polypharmacy and the appropriateness of drugs prescriptions in the regional health system (RHS) of Friuli Venezia-Giulia Region, Italy. <br /><em>Design and methods</em>. We carried out a point prevalence study in May 2014; 1582 patients ≥65 years were included from: 14 acute hospitals, 46 Long Term Care Facilities (LTCFs) and 42 general practitioners’ (GPs) clinics. Data analysis included the evaluation of potentially inappropriate prescriptions (PIPs) taking Beers criteria as a reference. <br /><em>Results</em>. Patients in therapy with 10 drugs or more were 13.5%: 15.2% in hospitals, 9.7% in GPs’ clinics and 15.6% in LTCFs. According to Beers criteria we identified 1152 PIPs that involved globally almost half of patients (46.0%): 41.9% in hospitals, 59.6% in LTCFs and 37.0% in GP’s clinics. The 53.9% of patients received at least one mainly kidney excreted drug; for these patients the evaluation of serum creatinine was overall present in the 87.7% (747/852): 96.4% in hospital ones, 87.5% in GPs’ clinics and 77.8% in LTCFs. LTCFs residents were significantly (P&lt;0.05) more exposed to PIPs and less monitored for the renal function. <br /><em>Conclusions</em>. A reliable estimation of the phenomenon in all the main healthcare settings is a necessary prerequisite to set tailored policies for facing polypharmacy within a RHS; the results showed the necessity to put a special attention on LTCFs.

Commentary: The Broader Context of Long-Term Care Ethics

2016 ◽  
Vol 25 (3) ◽  
pp. 554-556
Author(s):  
Jason Lesandrini ◽  
Carol O’Connell
Keyword(s):  
Care Setting ◽  
Long Term Care ◽  
Ethical Issues ◽  
Term Care ◽  
Ethical Concerns ◽  
Healthcare Settings ◽  
Care Facilities ◽  
Ethics Program ◽  
Made In

Ethical issues in long-term care settings, although having received attention in the literature, have not in our opinion received the appropriate level they require. Thus, we applaud the Cambridge Quarterly for publishing this case. We can attest to the significance of ethical issues arising in long-term care facilities, as Mr. Hope’s case is all too familiar to those practicing in these settings. What is unique about this case is that an actual ethics consult was made in a long-term care setting. We have seen very little in the published literature on the use of ethics structures in long-term care populations. Our experience is that these healthcare settings are ripe for ethical concerns and that providers, patients, families, and staff need/desire ethics resources to actively and preventively address ethical concerns. The popular press has begun to recognize the ethical issues involved in long-term care settings and the need for ethics structures. Recently, in California a nurse refused to initiate CPR for an elderly patient in a senior residence. In that case, the nurse was quoted as saying that the facility had a policy that nurses were not to start CPR for elderly patients.1 Although this case is not exactly the same as that of Mr. Hope, it highlights the need for developing robust ethics program infrastructures in long-term care settings that work toward addressing ethical issues through policy, education, and active consultation.

Low prevalence of Clostridium difficile colonization in patients in long-term care facilities in Graz, Austria: A point-prevalence study

2020 ◽  
Vol 48 (10) ◽  
pp. 1144-1147
Author(s):  
Eva Leitner ◽  
Elisabeth Schreiner ◽  
Maria Neuhold ◽  
Michael Bozic ◽  
Christian Pux ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Long Term Care ◽  
Point Prevalence ◽  
Prevalence Study ◽  
Term Care ◽  
Point Prevalence Study ◽  
Care Facilities ◽  
Low Prevalence

Bacterial flora in residents of long-term care facilities: a point prevalence study

2009 ◽  
Vol 71 (4) ◽  
pp. 385-387 ◽  
Author(s):  
K. Kanellakopoulou ◽  
V. Grammelis ◽  
F. Baziaka ◽  
A. Volonaki ◽  
M. Gika ◽  
...  
Keyword(s):  
Long Term Care ◽  
Bacterial Flora ◽  
Point Prevalence ◽  
Prevalence Study ◽  
Term Care ◽  
Point Prevalence Study ◽  
Care Facilities

scholarly journals Antimicrobial prescribing in long-term care facilities: a nationwide point-prevalence study, Slovenia, 2016

2018 ◽  
Vol 23 (46) ◽  
Author(s):  
Dora Stepan ◽  
Lea Ušaj ◽  
Marija Petek Šter ◽  
Marjetka Smolinger Galun ◽  
Hermina Smole ◽  
...  
Keyword(s):  
Long Term Care ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
Prevalence Study ◽  
Resistant Bacteria ◽  
Antibiotic Prescribing ◽  
Term Care ◽  
Point Prevalence Study ◽  
Care Facilities

Residents in long-term care are at high risk of infections because of their old age and many related health problems that lead to frequent antibiotic prescribing. The aim of the study was to assess antibiotic use in Slovenian long-term care facilities (LTCFs). The point-prevalence study was conducted between April and June 2016. Online questionnaires were sent to all Slovenian LTCFs. Eighty (68.4%) of the 117 LTCFs contacted, caring for 13,032 residents (70.6% of all Slovenian LTCF residents), responded to the survey. On the day of the study, the mean antibiotic prevalence per LTCF was 2.4% (95% confidence interval: 1.94–2.66). Most (70.2%) of the residents taking antibiotics were female. Most residents were being treated for respiratory tract (42.7%) or urinary tract (33.3%) infections. Co-amoxiclav and fluoroquinolones were the most frequently prescribed antibiotics (41.0% and 22.3% respectively). Microbiological tests were performed for 5.2% of residents receiving antibiotics. Forty nine (19.8%) residents receiving antibiotics were colonised with multidrug-resistant bacteria (MDR). Antibiotic use in Slovenian LTCFs is not very high, but most prescribed antibiotics are broad-spectrum. Together with low use of microbiological testing and high prevalence of colonisation with MDR bacteria the situation is worrisome and warrants the introduction of antimicrobial stewardship interventions.

scholarly journals Infection control: point prevalence study versus incidence study in Polish long-term care facilities in 2009–2010 in the Małopolska Region

Infection ◽  
2012 ◽  
Vol 41 (1) ◽  
pp. 1-8 ◽  
Author(s):  
J. Wójkowska-Mach ◽  
B. Gryglewska ◽  
J. Czekaj ◽  
P. Adamski ◽  
T. Grodzicki ◽  
...  
Keyword(s):  
Infection Control ◽  
Incidence Study ◽  
Long Term Care ◽  
Control Point ◽  
Point Prevalence ◽  
Prevalence Study ◽  
Term Care ◽  
Point Prevalence Study ◽  
Care Facilities
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