The impact of health care provider relationships and communication dynamics on urinary tract infection management and antibiotic utilization for long-term care facility residents treated in the emergency department: A qualitative study

Geriatric teams have emerged as an accepted method of health care delivery to the elderly patient in ambulatory and acute inpatient settings. As one model of specialized health care teams, geriatric teams vary in structure, membership, and type. The purposes may be diverse, ranging from providing primary care to multidimensional functional and diagnostic assessment. Geriatric teams have convincingly demonstrated benefit to the care of the elderly. Overcoming significant barriers to their formation, geriatric teams are beginning to develop in long-term care facilities as a result of economic and educational pressures. However, the unique environment and needs of the long-term care facility have resulted in differences in leadership, membership, and structure of long-term care teams. Pharmacist involvement in the long-term care geriatric team could benefit the facility, patient care, and the profession. The key to future involvement by pharmacists in teams appears to depend on their interest, ability to acquire necessary skills, and demonstration of unique professional contributions.

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Introduction of a Waterless Alcohol-Based Hand Rub in a Long-Term–Care Facility

Infection Control and Hospital Epidemiology ◽

10.1086/502185 ◽

2003 ◽

Vol 24 (3) ◽

pp. 165-171 ◽

Cited By ~ 56

Author(s):

Lona Mody ◽

Shelly A. McNeil ◽

Rongjun Sun ◽

Suzanne F. Bradley ◽

Carol A. Kauffman

Keyword(s):

Hand Hygiene ◽

Long Term Care ◽

Care Facility ◽

Microbial Colonization ◽

Term Care ◽

Term Care Facility ◽

Long Term Care Facility ◽

Hygiene Practices ◽

The Impact

AbstractObjective:To examine the impact of introduction of an alcohol-based hand rub on hand hygiene knowledge and compliance and hand colonization of healthcare workers (HCWs) in a long-term-care facility (LTCF).Methods:Two floors of an LTCF participated. Ward A used the hand rub as an adjunct to soap and water; ward B was the control. HCWs' hands were cultured using the bag-broth technique forStaphylococcus aureus,gram-negative bacilli (GNB),Candida,and vancomycin-resistant enterococci (VRE). HCWs completed a questionnaire at baseline and after an educational intervention and introduction of rub.Results:Hand hygiene practices, knowledge, and opinions did not change after the educational or rub intervention. Ward A HCWs thought that the rub was faster (P= .002) and less drying (P= .04) than soap. Hand hygiene frequency did not differ at baseline between the two floors, but increased on ward A by the end of the study (P= .04). HCWs were colonized frequently with GNB (66%),Candida(41%), S.aureus(20%), and VRE (9%). Although colonization did not change from baseline on either ward, the rub was more effective in clearing GNB (P= .03) and S.aureus(P= .003). Nosocomial infection rates did not change.Conclusion:The alcohol-based hand rub was a faster, more convenient, less drying method of hand hygiene for HCWs in an LTCF, and it improved compliance. Although microbial colonization did not change, the rub was more efficacious in removing pathogens already present on the hands of HCWs.

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Insights into the impact and use of research results in a residential long-term care facility: a case study

Implementation Science ◽

10.1186/1748-5908-7-90 ◽

2012 ◽

Vol 7 (1) ◽

Cited By ~ 3

Author(s):

Lisa A Cranley ◽

Judy M Birdsell ◽

Peter G Norton ◽

Debra G Morgan ◽

Carole A Estabrooks

Keyword(s):

Long Term Care ◽

Care Facility ◽

Term Care ◽

Term Care Facility ◽

Research Results ◽

Long Term Care Facility ◽

The Impact ◽

Residential Long Term Care

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COVID-19: first long-term care facility outbreak in the Netherlands following cross-border introduction from Germany, March 2020

10.21203/rs.3.rs-99503/v1 ◽

2020 ◽

Author(s):

Mitch van Hensbergen ◽

Casper D.J. den Heijer ◽

Petra Wolffs ◽

Volker Hackert ◽

Henriette L.G. ter Waarbeek ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

Long Term Care ◽

Care Facility ◽

Regional Hospital ◽

Term Care ◽

Long Term Care Facility ◽

Cross Border ◽

Care Workers

Abstract Background: The Dutch province of Limburg borders the German district of Heinsberg, which had a large cluster of COVID-19 cases linked to local carnival activities in February, before any cases were reported in the Netherlands. However, Heinsberg was not included as an area reporting local or community transmission per the national case definition at the time. In early March, two residents from a long-term care facility (LTCF) in Sittard, a Dutch town located in close vicinity to the district of Heinsberg, started experiencing respiratory symptoms and were admitted to the regional hospital at which they were tested for COVID-19. Introduction of the virus could have occurred following the carnival activities in the surrounding area by LTCF visitors or health care workers.Methods: Surveys and semi-structured oral interviews were conducted with all present residents by health care workers during regular points of care for information on new or unusual signs and symptoms of disease. Both throat and nasopharyngeal swabs were taken from residents suspect of COVID-19 for the detection of SARS-CoV-2 by Real-time Polymerase Chain Reaction and whole genome sequencing was performed using a SARS-CoV-2 specific amplicon-based Nanopore sequencing approach. Additionally, twelve random residents were sampled for possible asymptomatic infections.Results: Since the start of the outbreak, nineteen (19%) residents tested positive for COVID-19. Eleven samples were sequenced, along with three random samples from COVID-19 patients hospitalized in the regional hospital at the time of the LTCF outbreak. Conclusions: All samples were linked to COVID-19 cases from the cross-border region of Heinsberg, Germany. Symptoms were reported only in about two third of the cases, and tended to be generally mild. We therefore recommend low-level screening of HCWs and residents following a confirmed COVID-19 case, even in the absence of symptoms. Since the LTCF residents who tested positive did not meet the criteria for suspect cases of COVID-19 at the time, this highlights the importance of cooperation among cross-border partners in order to establish a coordinated implementation of infection control measures in the region on top of national guidelines to limit the spread of infectious diseases such as COVID-19.

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