Reinforcement of an infection control bundle targeting prevention practices for Clostridioides difficile in Veterans Health Administration nursing homes

2020 ◽  
Vol 48 (6) ◽  
pp. 626-632 ◽  
Author(s):  
Jeanmarie Mayer ◽  
Nimalie D. Stone ◽  
Molly Leecaster ◽  
Nan Hu ◽  
Warren Pettey ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Infection Control ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Clostridioides Difficile

scholarly journals Longitudinal Pressure Ulcer Rates After Adoption of Culture Change in Veterans Health Administration Nursing Homes

2016 ◽  
Vol 64 (1) ◽  
pp. 151-155 ◽  
Author(s):  
Christine W. Hartmann ◽  
Michael Shwartz ◽  
Shibei Zhao ◽  
Jennifer A. Palmer ◽  
Dan R. Berlowitz
Keyword(s):  
Nursing Homes ◽  
Pressure Ulcer ◽  
Culture Change ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration

scholarly journals Incidence of Clostridioides difficile infections among young and middle-aged adults: Veterans Health Administration

2019 ◽  
Vol 40 (9) ◽  
pp. 997-1005 ◽  
Author(s):  
Ellyn M. Russo ◽  
Jennifer Kuntz ◽  
Holly Yu ◽  
Jeremy Smith ◽  
Ronald George Hauser ◽  
...  
Keyword(s):  
Veterans Health Administration ◽  
Health Concern ◽  
Charlson Comorbidity Index Score ◽  
Veterans Health ◽  
Health Administration ◽  
Middle Aged ◽  
Clostridioides Difficile ◽  
Using Data ◽  
Middle Aged Adult

AbstractObjective:Clostridioides difficile infection (CDI) remains a significant public health concern, resulting in excess morbidity, mortality, and costs. Additional insight into the burden of CDI in adults aged <65 years is needed.Design/Setting:A 6-year retrospective cohort study was conducted using data extracted from United States Veterans Health Administration electronic medical records.Patients/Methods:Patients aged 18–64 years on January 1, 2011, were followed until incident CDI, death, loss-to-follow-up, or December 31, 2016. CDI was identified by a diagnosis code accompanied by metronidazole, vancomycin, or fidaxomicin therapy, or positive laboratory test. The clinical setting of CDI onset was defined according to 2017 SHEA-IDSA guidelines.Results:Of 1,073,900 patients, 10,534 had a CDI during follow-up. The overall incidence rate was 177 CDIs per 100,000 person years, rising steadily from 164 per 100,000 person years in 2011 to 189 per 100,000 person years in 2016. Those with a CDI were slightly older (55 vs 51 years) and sicker, with a higher baseline Charlson comorbidity index score (1.4 vs 0.5) than those without an infection. Nearly half (48%) of all incident CDIs were community associated, and this proportion rose from 41% in 2011 to 56% in 2016.Conclusions:The findings from this large retrospective study indicate that CDI incidence, driven primarily by increasing community-associated infection, is rising among young and middle-aged adult Veterans with high service-related disability. The increasing burden of community associated CDI in this vulnerable population warrants attention. Future studies quantifying the economic and societal burden of CDI will inform decisions surrounding prevention strategies.

Characterizing Wandering Behaviors in Persons With Traumatic Brain Injury Residing in Veterans Health Administration Nursing Homes

2008 ◽  
Vol 89 (2) ◽  
pp. 244-250 ◽  
Author(s):  
Heather G. Belanger ◽  
Bellinda King-Kallimanis ◽  
Audrey L. Nelson ◽  
Lawrence Schonfeld ◽  
Steven G. Scott ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Nursing Homes ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration

scholarly journals Is Variation in Resident-Centered Care and Quality Performance Related to Health System Factors in Veterans Health Administration Nursing Homes?

2018 ◽  
Vol 55 ◽  
pp. 004695801878703 ◽  
Author(s):  
Jennifer L. Sullivan ◽  
Ryann L. Engle ◽  
Denise Tyler ◽  
Melissa K. Afable ◽  
Katelyn Gormley ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Health System ◽  
Veterans Health Administration ◽  
Community Living ◽  
Veterans Health ◽  
Health Administration ◽  
Staff Members ◽  
Centered Care ◽  
Community Living Centers ◽  
System Factors

The purpose of this research was to explore and compare common health system factors for 5 Community Living Centers (ie Veterans Health Administration nursing homes) with high performance on both resident-centered care and clinical quality and for 5 Community Living Centers (CLC) with low performance on both resident-centered care and quality. In particular, we were interested in “how” and “why” some Community Living Centers were able to deliver high levels of resident-centered care and high quality of care, whereas others did not demonstrate this ability. Sites were identified based on their rankings on a composite quality measure calculated from 28 Minimum Data Set version 2.0 quality indicators and a resident-centered care summary score calculated from 6 domains of the Artifacts of Culture Change Tool. Data were from fiscal years 2009-2012. We selected high- and low-performing sites on quality and resident-centered care and conducted 12 in-person site visits in 2014-2015. We used systematic content analysis to code interview transcripts for a priori and emergent health system factor domains. We then assessed variations in these domains across high and low performers using cross-site summaries and matrixes. Our final sample included 108 staff members at 10 Veterans Health Administration CLCs. Staff members included senior leaders, middle managers, and frontline employees. Of the health system factors identified, high and low performers varied in 5 domains, including leadership support, organizational culture, teamwork and communication, resident-centered care recognition and awards, and resident-centered care training. Organizations must recognize that making improvements in the factors identified in this article will require dedicated resources from leaders and support from staff throughout the organization.

Assessing a National Collaborative Program To Prevent Catheter-Associated Urinary Tract Infection in a Veterans Health Administration Nursing Home Cohort

2018 ◽  
Vol 39 (07) ◽  
pp. 820-825 ◽  
Author(s):  
Sarah L. Krein ◽  
M. Todd Greene ◽  
Beth King ◽  
Deborah Welsh ◽  
Karen E. Fowler ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Nursing Homes ◽  
Tract Infection ◽  
Incidence Rate ◽  
Urine Culture ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Community Based

OBJECTIVECollaborative programs have helped reduce catheter-associated urinary tract infection (CAUTI) rates in community-based nursing homes. We assessed whether collaborative participation produced similar benefits among Veterans Health Administration (VHA) nursing homes, which are part of an integrated system.SETTINGThis study included 63 VHA nursing homes enrolled in the “AHRQ Safety Program for Long-Term Care,” which focused on practices to reduce CAUTI.METHODSChanges in CAUTI rates, catheter utilization, and urine culture orders were assessed from June 2015 through May 2016. Multilevel mixed-effects negative binomial regression was used to derive incidence rate ratios (IRRs) representing changes over the 12-month program period.RESULTSThere was no significant change in CAUTI among VHA sites, with a CAUTI rate of 2.26 per 1,000 catheter days at month 1 and a rate of 3.19 at month 12 (incidence rate ratio [IRR], 0.99; 95% confidence interval [CI], 0.67–1.44). Results were similar for catheter utilization rates, which were 11.02% at month 1 and 11.30% at month 12 (IRR, 1.02; 95% CI, 0.95–1.09). The numbers of urine cultures per 1,000 residents were 5.27 in month 1 and 5.31 in month 12 (IRR, 0.93; 95% CI, 0.82–1.05).CONCLUSIONSNo changes in CAUTI rates, catheter use, or urine culture orders were found during the program period. One potential reason was the relatively low baseline CAUTI rate, as compared with a cohort of community-based nursing homes. This low baseline rate is likely related to the VHA’s prior CAUTI prevention efforts. While broad-scale collaborative approaches may be effective in some settings, targeting higher-prevalence safety issues may be warranted at sites already engaged in extensive infection prevention efforts.Infect Control Hosp Epidemiol 2018;820–825

An Intervention With Meaning

Crisis ◽  
2017 ◽  
Vol 38 (6) ◽  
pp. 376-383 ◽  
Author(s):  
Brooke A. Levandowski ◽  
Constance M. Cass ◽  
Stephanie N. Miller ◽  
Janet E. Kemp ◽  
Kenneth R. Conner
Keyword(s):  
High Risk ◽  
Qualitative Methodology ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Safety Planning ◽  
Health Administration ◽  
Suicide Method ◽  
Treatment Providers ◽  
Interactive Nature ◽  
Behavioral Health Treatment

Abstract. Background: The Veterans Health Administration (VHA) health-care system utilizes a multilevel suicide prevention intervention that features the use of standardized safety plans with veterans considered to be at high risk for suicide. Aims: Little is known about clinician perceptions on the value of safety planning with veterans at high risk for suicide. Method: Audio-recorded interviews with 29 VHA behavioral health treatment providers in a southeastern city were transcribed and analyzed using qualitative methodology. Results: Clinical providers consider safety planning feasible, acceptable, and valuable to veterans at high risk for suicide owing to the collaborative and interactive nature of the intervention. Providers identified the types of veterans who easily engaged in safety planning and those who may experience more difficulty with the process. Conclusion: Additional research with VHA providers in other locations and with veteran consumers is needed.

Sign in / Sign up

Export Citation Format

Share Document