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Infection in the Nursing Home Resident

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1. Oral health educational interventions for nursing home staff and residents. (PubMed)

Oral health educational interventions for nursing home staff and residents. Associations between nursing home residents' oral health status and quality of life, respiratory tract infections, and nutritional status have been reported. Educational interventions for nurses or residents, or both, focusing on knowledge and skills related to oral health management may have the potential to improve residents' oral health.To assess the effects of oral health educational interventions for nursing home (...) staff or residents, or both, to maintain or improve the oral health of nursing home residents.We searched the Cochrane Oral Health Trials Register (to 18 January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2015, Issue 12), MEDLINE Ovid (1946 to 18 January 2016), Embase Ovid (1980 to 18 January 2016), CINAHL EBSCO (1937 to 18 January 2016), and Web of Science Conference Proceedings (1990 to 18 January 2016). We searched ClinicalTrials.gov and the World

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2016 Cochrane

2. Resident safety practices in nursing home settings

, Carlo M, McPheeters ML. Resident safety practices in nursing home settings. Rockville: Agency for Healthcare Research and Quality (AHRQ). Technical Brief No. 24. 2016 Authors' objectives To describe the state of the science around nursing home safety in order to establish a research agenda for moving the field forward. Authors' conclusions Key safety issues as defined by Agency for Healthcare Research and Quality Common Format criteria are adverse events such as falls, pressure ulcers, infection (...) Resident safety practices in nursing home settings Resident safety practices in nursing home settings Resident safety practices in nursing home settings Simmons S, Schnelle J, Slagle J, Sathe NA, Stevenson D, Carlo M, McPheeters ML Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Simmons S, Schnelle J, Slagle J, Sathe NA, Stevenson D

2016 Health Technology Assessment (HTA) Database.

3. Vitamin D deficiency was common among nursing home residents and associated with dementia: a cross sectional study of 545 Swedish nursing home residents. (PubMed)

Vitamin D deficiency was common among nursing home residents and associated with dementia: a cross sectional study of 545 Swedish nursing home residents. Residents of nursing homes may have low 25-hydroxyvitamin D (25OHD) concentrations. Associations between vitamin D and cognitive performance, dementia and susceptibility to infections are not clearly established. The aim of this study was to investigate the prevalence of vitamin D deficiency and to identify associated factors among residents (...) of nursing homes for elderly.In this cross-sectional study blood samples for analysis of 25OHD were collected from all participating residents of Swedish nursing homes for the elderly from January to March 2012.dementia too severe to collect a blood test, terminally ill or refusing participation.Serum 25OHD concentrations. Logistic regression to evaluate factors associated with vitamin D deficiency (25OHD < 25 nmol/L).Blood samples were obtained from 545 of 901 residents of 22 nursing homes. Mean age 86

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2017 BMC Geriatrics

4. Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections in Nursing Home Residents. (PubMed)

Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections in Nursing Home Residents. To describe the epidemiology and incidence of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in nursing home (NH) residents, which has previously not been well characterized.Retrospective analysis of public health surveillance data.Healthcare facilities in 33 U.S. counties.Residents of the surveillance area.Counts of NH-onset and hospital-onset (HO) invasive MRSA (...) infections (cultured from sterile body sites) identified from the Centers for Disease Control and Prevention Emerging Infections Program (EIP) population-based surveillance from 2009 to 2013 were compared. Demographic characteristics and risk factors of NH-onset cases were analyzed. Using NH resident-day denominators from the Centers for Medicare and Medicaid Services Skilled Nursing Facility Cost Reports, incidence of NH-onset invasive MRSA infections from facilities in the EIP area was determined.A

2018 Journal of the American Geriatrics Society

5. Medication Exposure and Risk of Recurrent Clostridium difficile Infection in Community-Dwelling Older People and Nursing Home Residents. (PubMed)

Medication Exposure and Risk of Recurrent Clostridium difficile Infection in Community-Dwelling Older People and Nursing Home Residents. It is unclear how medication exposures differ in their association with recurrent Clostridium difficile infection (rCDI) in elderly nursing home (NH) residents and community-dwelling individuals. This study examined these exposures to determine whether the risk of rCDI differs according to living environment.Retrospective.Academic and community healthcare (...) settings.Individuals aged 65 and older with CDI (N = 616).Information on participant characteristics and medications was extracted from the electronic medical record (EMR). We used separate extended Cox models according to living environment to identify the association between medication use and risk of rCDI.Of the 616 elderly adults treated for CDI, 24.1% of those living in the community and 28.1% of NH residents experienced recurrence within 1 year. For community-dwelling participants, the risk of rCDI was 1.6

2017 Journal of the American Geriatrics Society

6. A National Implementation Project to Prevent Catheter-Associated Urinary Tract Infection in Nursing Home Residents. (PubMed)

A National Implementation Project to Prevent Catheter-Associated Urinary Tract Infection in Nursing Home Residents. Catheter-associated urinary tract infection (UTI) in nursing home residents is a common cause of sepsis, hospital admission, and antimicrobial use leading to colonization with multidrug-resistant organisms.To develop, implement, and evaluate an intervention to reduce catheter-associated UTI.A large-scale prospective implementation project was conducted in community-based nursing (...) care, 5-star rating, presence of an infection control committee, and an infection preventionist.In 4 cohorts over 30 months, 568 community-based nursing homes were recruited; 404 met inclusion criteria for analysis. The unadjusted catheter-associated UTI rates decreased from 6.78 to 2.63 infections per 1000 catheter-days. With use of the regression model and adjustment for facility characteristics, the rates decreased from 6.42 to 3.33 (incidence rate ratio [IRR], 0.46; 95% CI, 0.36-0.58; P < .001

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2017 JAMA Internal Medicine

7. Measuring Antibiotic Appropriateness for Urinary Tract Infections in Nursing Home Residents. (PubMed)

Measuring Antibiotic Appropriateness for Urinary Tract Infections in Nursing Home Residents. We assessed the appropriateness of initiating antibiotics in 49 nursing home (NH) residents receiving antibiotics for urinary tract infection (UTI) using 3 published algorithms. Overall, 16 residents (32%) received prophylaxis, and among the 33 receiving treatment, the percentage of appropriate use ranged from 15% to 45%. Opportunities exist for improving UTI antibiotic prescribing in NH. Infect Control

2017 Infection control and hospital epidemiology

8. Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents. (PubMed)

Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents. Urinary tract infections (UTIs) in nursing homes are common, costly, and morbid.Systematic literature review of strategies to reduce UTIs in nursing home residents.Ovid MEDLINE, Cochrane Library, CINAHL, Web of Science and Embase through June 22, 2015.Interventional studies with a comparison group reporting at least 1 outcome for: catheter-associated UTI (CAUTI), UTIs not identified as catheter (...) significantly).Studies were often underpowered to assess statistical significance; none were pooled given variety of interventions and outcomes.Several practices, often implemented in bundles, such as improving hand hygiene, reducing and improving catheter use, managing incontinence without catheters, and enhanced barrier precautions, appear to reduce UTI or CAUTI in nursing home residents. Journal of Hospital Medicine 2017;12:356-368.© 2017 Society of Hospital Medicine

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2017 Journal of Hospital Medicine

9. The Antibiotic Prescribing Pathway for Presumed Urinary Tract Infections in Nursing Home Residents. (PubMed)

The Antibiotic Prescribing Pathway for Presumed Urinary Tract Infections in Nursing Home Residents. Due to the high rates of inappropriate antibiotic prescribing for presumed urinary tract infections (UTIs) in nursing home (NH) residents, we sought to examine the antibiotic prescribing pathway and the extent to which it agrees with the Loeb criteria; findings can suggest strategies for antibiotic stewardship.Chart review of 260 randomly-selected cases from 247 NH residents treated

2017 Journal of the American Geriatrics Society

10. Epidemiology of Respiratory Pathogens among Elderly Nursing Home Residents with Acute Respiratory Infections in Corsica, France, 2013–2017 (PubMed)

Epidemiology of Respiratory Pathogens among Elderly Nursing Home Residents with Acute Respiratory Infections in Corsica, France, 2013–2017 The current study aims to describe the demographical and clinical characteristics of elderly nursing home (NH) residents with acute respiratory infections (ARIs) during four winter seasons (2013/2014-2016/2017), as well as the microbiological etiology of these infections.Seventeen NHs with at least one ARI resident in Corsica, France, were included. An ARI (...) %) for influenza B/Victoria. Axillary fever (≥38°C) was significantly more common among patients infected with influenza A(H3N2).The circulation of seasonal respiratory viruses other than influenza A(H3N2) seems to be sporadic among elderly NH residents. Investigating the circulation of respiratory viruses in nonwinter seasons seems to be important in order to understand better the dynamic of their year-round circulation in NHs.

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2017 BioMed research international

11. Appropriateness of transferring nursing home residents to emergency departments: a systematic review. (PubMed)

Appropriateness of transferring nursing home residents to emergency departments: a systematic review. Elderly living in a Nursing Home (NH) are frequently transferred to an Emergency Department when they need acute medical care. A proportion of these transfers may be considered inappropriate and may be avoidable.Systematic review. Literature search performed in September 2018 using PubMed, Web of Science, the Cochrane Library and the Cumulative Index to Nursing and Allied Health Literature (...) of NH residents to an ED, 4 to 55% were classified as inappropriate. The most common reasons for transfer were trauma after falling, altered mental status and infection. Transfers were associated with a high risk of complications and mortality, especially during out-of-hours. Advance directives (ADs) were usually not available and relatives often urge NH staff to transfer patients to an ED. The lack of availability of GPs was a barrier to organise acute care in the NH in order to prevent admission

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2019 BMC Geriatrics

12. Spread of ESBL-producing Escherichia coli in nursing home residents in Ireland and the Netherlands may reflect infrastructural differences. (PubMed)

and were part of the same cluster type by whole-genome sequencing. Four Irish residents on three different wards were colonized with an identical E. coli O89:H9, ST131, complex type 1478. Cross-transmission between three Irish wards may reflect differences in nursing home infrastructure, specifically communal areas and multi-bedded resident rooms.Copyright © 2019 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. (...) Spread of ESBL-producing Escherichia coli in nursing home residents in Ireland and the Netherlands may reflect infrastructural differences. A prevalence study in two nursing homes (one each in the Netherlands and Ireland) found four (11%) Dutch and six (9%) Irish residents colonized with 11 extended-spectrum beta-lactamase-producing Escherichia coli, 10 of which contained CTX-M-15. Four Dutch isolates, from three residents of the same ward, belonged to E. coli O25:H4, sequence type (ST) 131

2019 Journal of Hospital Infection

13. Adverse Events in Long-term Care Residents Transitioning From Hospital Back to Nursing Home. (PubMed)

Adverse Events in Long-term Care Residents Transitioning From Hospital Back to Nursing Home. Transition from hospital to nursing home is a high-risk period for adverse events in long-term care (LTC) residents. Adverse events include harms from medical care, including failure to provide appropriate care.To report the incidence, type, severity, and preventability of adverse events in LTC residents transitioning from hospital back to the same LTC facility.Prospective cohort study of LTC residents (...) discharged from hospital back to LTC from March 1, 2016, to December 31, 2017, and followed up for 45 days. In a random sample of 32 nursing homes located in 6 New England states, 555 LTC residents were selected, contributing 762 transitions from hospital back to the same LTC facility.The main outcome was an adverse event within the 45-day period after transition from hospital back to nursing home. Trained nurse abstractors reviewed nursing home records for the period, and then 2 physicians independently

2019 JAMA Internal Medicine

14. Evidence-based intervention to reduce avoidable hospital admissions in care home residents (the Better Health in Residents in Care Homes (BHiRCH) study): protocol for a pilot cluster randomised trial. (PubMed)

Evidence-based intervention to reduce avoidable hospital admissions in care home residents (the Better Health in Residents in Care Homes (BHiRCH) study): protocol for a pilot cluster randomised trial. Acute hospital admission is distressing for care home residents. Ambulatory care sensitive conditions, such as respiratory and urinary tract infections, are conditions that can cause unplanned hospital admission but may have been avoidable with timely detection and intervention in the community (...) . The Better Health in Residents in Care Homes (BHiRCH) programme has feasibility tested and will pilot a multicomponent intervention to reduce these avoidable hospital admissions. The BHiRCH intervention comprises an early warning tool for noting changes in resident health, a care pathway (clinical guidance and decision support system) and a structured method for communicating with primary care, adapted for use in the care home. We use practice development champions to support implementation and embed

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2019 BMJ open Controlled trial quality: uncertain

15. Infection in the Nursing Home Resident

Infection in the Nursing Home Resident Infection in the Nursing Home Resident Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Infection in the Nursing Home Resident Infection in the Nursing Home Resident Aka: Infection in the Nursing Home Resident , Signs of Infection in the Nursing Home Resident II. Symptoms Functional Decline Confusion or Decreased Appetite or reduced food intake Behavior Change Uncooperative with staff Falls III. Signs: Fever Single >100.0 F (37.8 C) Repeated s >99.0 F (37.2 C) Repeated s >99.5 F (37.5 C) Increase in > 2.0 F (1.1 C) IV. Labs: Initial Testing with platelets and differential >14,000 cells/mm3

2018 FP Notebook

16. Predicting mortality in patients treated differently: updating and external validation of a prediction model for nursing home residents with dementia and lower respiratory infections. (PubMed)

Predicting mortality in patients treated differently: updating and external validation of a prediction model for nursing home residents with dementia and lower respiratory infections. To evaluate whether a model that was previously developed to predict 14-day mortality for nursing home residents with dementia and lower respiratory tract infection who received antibiotics could be applied to residents who were not treated with antibiotics. Specifically, in this same data set, to update the model (...) using recalibration methods; and subsequently examine the historical, geographical, methodological and spectrum transportability through external validation of the updated model.1 cohort study was used to develop the prediction model, and 4 cohort studies from 2 countries were used for the external validation of the model.Nursing homes in the Netherlands and the USA.157 untreated residents were included in the development of the model; 239 untreated residents were included in the external validation

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2016 BMJ open

17. Comparing appropriateness of antibiotics for nursing home residents by setting of prescription initiation: a cross-sectional analysis (PubMed)

Comparing appropriateness of antibiotics for nursing home residents by setting of prescription initiation: a cross-sectional analysis The pervasive, often inappropriate, use of antibiotics in healthcare settings has been identified as a major public health threat due to the resultant widespread emergence of antibiotic resistant bacteria. In nursing homes (NH), as many as two-thirds of residents receive antibiotics each year and up to 75% of these are estimated to be inappropriate. The objective (...) of this study was to characterize antibiotic therapy for NH residents and compare appropriateness based on setting of prescription initiation.This was a retrospective, cross-sectional multi-center study that occurred in five NHs in southern Wisconsin between January 2013 and September 2014. All NH residents with an antibiotic prescribing events for suspected lower respiratory tract infections (LRTI), skin and soft tissue infections (SSTI), and urinary tract infections (UTI), initiated in-facility, from

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2018 Antimicrobial resistance and infection control

18. Communication and Compliance for Antibiotic Prescribing by General Practice to Nursing Home Residents With Suspected UTI

to guidelines. Condition or disease Urinary Tract Infections Communication Compliance, Medication Study Design Go to Layout table for study information Study Type : Observational Actual Enrollment : 459 participants Observational Model: Other Time Perspective: Prospective Official Title: Communication and Compliance With Guidelines for Antibiotic Prescribing by General Practice to Nursing Home Residents With Suspected Urinary Tract Infections -A Research Protocol for a Cross-Sectional Study in the Primary (...) Communication and Compliance for Antibiotic Prescribing by General Practice to Nursing Home Residents With Suspected UTI Communication and Compliance for Antibiotic Prescribing by General Practice to Nursing Home Residents With Suspected UTI - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum

2018 Clinical Trials

19. Indwelling Urethral versus Suprapubic Catheters in Nursing Home Residents: Determining the Safest Option for Long-Term Use. (PubMed)

Indwelling Urethral versus Suprapubic Catheters in Nursing Home Residents: Determining the Safest Option for Long-Term Use. The incidence of infectious complications has not been previously compared for two types of common urinary catheters used in the long-term care setting: indwelling urethral catheters and suprapubic catheters.To compare catheter-associated urinary tract infection (CAUTI) rates and multidrug-resistant organism (MDRO) colonization between nursing home residents (...) with indwelling urethral and suprapubic catheters.Participants included 418 nursing home residents with an indwelling device enrolled in a previously published prospective targeted infection prevention study conducted between 2010 and 2013. Resident age, gender, function, comorbidities, and information on infections, antibiotic use, and recent hospitalizations were obtained at study enrolment, day 14, and every 30 days thereafter for up to one year. Microbiological samples were obtained from several anatomic

2018 Journal of Hospital Infection

20. Differences in Molecular Epidemiology of Staphylococcus aureus and Escherichia coli in Nursing Home Residents and People in Unassisted Living Situations. (PubMed)

Differences in Molecular Epidemiology of Staphylococcus aureus and Escherichia coli in Nursing Home Residents and People in Unassisted Living Situations. The usefulness of colonization pressure as a working model and proxy for infection transmission is limited due to the inability to grade or quantify the specific risk within environments that are subject to change.To elaborate on the colonization pressure model by comparing the molecular epidemiology of two bacteria, Staphylococcus aureus (...) and Escherichia coli, among residents in a nursing home and people in unassisted living situations.A cross-sectional study of 73 elderly residents from a village in south-central Sweden was conducted. Of these, 35 were residents of a nursing home, and 34 lived in an own place of residence in the same geographical area. Samples of two representative bacterial species were collected from multiple body sites and analysed for molecular diversity.Combining all body sites, 47% of the participants were colonized

2018 Journal of Hospital Infection

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