Predicting 3-year mortality and admission to acute-care hospitals, skilled nursing facilities, and long-term care facilities in Medicare beneficiaries

ABSTRACT Objectives: To estimate the SARS-CoV-2 infection rate and the secondary attack rate among healthcare workers (HCWs) in Quebec, the most affected province of Canada during the first wave; to describe the evolution of work-related exposures and infection prevention and control (IPC) practices in infected HCWs; and to compare the exposures and practices between acute care hospitals (ACHs) and long-term care facilities (LTCFs). Design: Survey of cases Participants: Quebec HCWs from private and public institutions with laboratory-confirmed COVID-19 diagnosed between 1st March and 14th June 2020. HCWs ≥18 years old, having worked during the exposure period and survived their illness were eligible for the survey. Methods: After obtaining consent, 4542 HCWs completed a standardized questionnaire. COVID-19 rates and proportions of exposures and practices were estimated and compared between ACHs and LTCFs. Results: HCWs represented 25% (13,726/54,005) of all reported COVID-19 cases in Quebec and had an 11-times greater rate than non-HCWs. Their secondary household attack rate was 30%. Most affected occupations were healthcare support workers, nurses and nurse assistants, working in LTCFs (45%) and ACHs (30%). Compared to ACHs, HCWs of LTCFs had less training, higher staff mobility between working sites, similar PPE use but better self-reported compliance with at-work physical distancing. Sub-optimal IPC practices declined over time but were still present at the end of the first wave. Conclusion: Quebec HCWs and their families were severely affected during the first wave of COVID-19. Insufficient pandemic preparedness and suboptimal IPC practices likely contributed to high transmission in both LTCFs and ACHs.

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Evaluation of Infections in Long-Term Care Facilities Versus Acute Care Hospitals

Infection Management for Geriatrics in Long-Term Care Facilities ◽

10.1201/9780824744311-8 ◽

2002 ◽

pp. 35-46

Keyword(s):

Acute Care ◽

Long Term Care ◽

Acute Care Hospitals ◽

Term Care ◽

Care Facilities

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Health problems and violence experiences of nurses working in acute care hospitals, long-term care facilities, and home-based long-term care in Germany: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0260050 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0260050

Author(s):

Andrea Schaller ◽

Teresa Klas ◽

Madeleine Gernert ◽

Kathrin Steinbeißer

Keyword(s):

Mental Health ◽

Acute Care ◽

Long Term Care ◽

Mental Health Problems ◽

Acute Care Hospitals ◽

Health Problems ◽

Term Care ◽

Home Based ◽

Care Facilities

Background Working in the nursing sector is accompanied by great physical and mental health burdens. Consequently, it is necessary to develop target-oriented, sustainable profession-specific support and health promotion measures for nurses. Objectives The present review aims to give an overview of existing major health problems and violence experiences of nurses in different settings (acute care hospitals, long-term care facilities, and home-based long-term care) in Germany. Methods A systematic literature search was conducted in PubMed and PubPsych and completed by a manual search upon included studies’ references and health insurance reports. Articles were included if they had been published after 2010 and provided data on health problems or violence experiences of nurses in at least one care setting. Results A total of 29 studies providing data on nurses health problems and/or violence experience were included. Of these, five studies allowed for direct comparison of nurses in the settings. In addition, 14 studies provided data on nursing working in acute care hospitals, ten on nurses working in long-term care facilities, and four studies on home-based long-term care. The studies either conducted a setting-specific approach or provided subgroup data from setting-unspecific studies. The remaining studies did not allow setting-related differentiation of the results. The available results indicate that mental health problems are the highest for nurses in acute care hospitals. Regarding violence experience, nurses working in long-term care facilities appear to be most frequently affected. Conclusion The state of research on setting-specific differences of nurses’ health problems and violence experiences is insufficient. Setting-specific data are necessesary to develop target-group specific and feasible interventions to support the nurses’ health and prevention of violence, as well as dealing with violence experiences of nurses.

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COVID-19 Across the Landscape of Long-Term Care in Alameda County: Heterogeneity and Disparities

Gerontology and Geriatric Medicine ◽

10.1177/23337214211073419 ◽

2022 ◽

Vol 8 ◽

pp. 233372142110734

Author(s):

Terry E. Hill ◽

David J. Farrell

Keyword(s):

Public Health ◽

Long Term Care ◽

The Elderly ◽

Population Based ◽

Nursing Facilities ◽

Term Care ◽

Skilled Nursing ◽

Data Infrastructure ◽

Care Facilities

Throughout the pandemic, public health and long-term care professionals in our urban California county have linked local and state COVID-19 data and performed observational exploratory analyses of the impacts among our diverse long-term care facilities (LTCFs). Case counts from LTCFs through March 2021 included 4309 (65%) in skilled nursing facilities (SNFs), 1667 (25%) in residential care facilities for the elderly (RCFEs), and 273 (4%) in continuing care retirement communities (CCRCs). These cases led to 582 COVID-19 resident deaths and 12 staff deaths based on death certificates. Data on decedents’ age, race, education, and country of birth reflected a hierarchy of wealth and socioeconomic status from CCRCs to RCFEs to SNFs. Mortality rates within SNFs were higher for non-Whites than Whites. Staff accounted for 42% of LTCF-associated COVID-19 cases, and over 75% of these staff were unlicensed. For all COVID-19 deaths in our jurisdiction, both LTCF and community, 82% of decedents were age 65 or over. Taking a comprehensive, population-based approach across our heterogenous LTCF landscape, we found socioeconomic disparities within COVID-19 cases and deaths of residents and staff. An improved data infrastructure linking public health and delivery systems would advance our understanding and potentiate life-saving interventions within this vulnerable ecosystem.

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Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017

Eurosurveillance ◽

10.2807/1560-7917.es.2018.23.46.1800516 ◽

2018 ◽

Vol 23 (46) ◽

Cited By ~ 79

Author(s):

Carl Suetens ◽

Katrien Latour ◽

Tommi Kärki ◽

Enrico Ricchizzi ◽

Pete Kinross ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Acute Care ◽

Long Term Care ◽

Acute Care Hospitals ◽

Point Prevalence ◽

Healthcare Associated Infections ◽

Term Care ◽

Care Facilities ◽

Healthcare Associated

Point prevalence surveys of healthcare-associated infections (HAI) and antimicrobial use in the European Union and European Economic Area (EU/EEA) from 2016 to 2017 included 310,755 patients from 1,209 acute care hospitals (ACH) in 28 countries and 117,138 residents from 2,221 long-term care facilities (LTCF) in 23 countries. After national validation, we estimated that 6.5% (cumulative 95% confidence interval (cCI): 5.4–7.8%) patients in ACH and 3.9% (95% cCI: 2.4–6.0%) residents in LTCF had at least one HAI (country-weighted prevalence). On any given day, 98,166 patients (95% cCI: 81,022–117,484) in ACH and 129,940 (95% cCI: 79,570–197,625) residents in LTCF had an HAI. HAI episodes per year were estimated at 8.9 million (95% cCI: 4.6–15.6 million), including 4.5 million (95% cCI: 2.6–7.6 million) in ACH and 4.4 million (95% cCI: 2.0–8.0 million) in LTCF; 3.8 million (95% cCI: 3.1–4.5 million) patients acquired an HAI each year in ACH. Antimicrobial resistance (AMR) to selected AMR markers was 31.6% in ACH and 28.0% in LTCF. Our study confirmed a high annual number of HAI in healthcare facilities in the EU/EEA and indicated that AMR in HAI in LTCF may have reached the same level as in ACH.

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A Comparison of Emergency Preparedness Policies by Long-Term Care Setting Type in Ohio: Assisted Living Settings Lag Behind Nursing Homes in Key Areas

Journal of Applied Gerontology ◽

10.1177/0733464820902010 ◽

2020 ◽

pp. 073346482090201

Author(s):

Katherine A. Kennedy ◽

Cassandra L. Hua ◽

Ian Nelson

Keyword(s):

Assisted Living ◽

Emergency Preparedness ◽

Disaster Preparedness ◽

Long Term Care ◽

Nursing Facilities ◽

Community Based ◽

Term Care ◽

Skilled Nursing ◽

Care Facilities

Skilled nursing facilities (SNFs) have received regulatory attention in relation to their emergency preparedness. Yet, assisted living settings (ALs) have not experienced such interest due to their classification as a state-regulated, home- and community-based service. However, the growth in the number of ALs and increased resident acuity levels suggest that existing disaster preparedness policies, and therefore, plans, lag behind those of SNFs. We examined differences in emergency preparedness policies between Ohio’s SNFs and ALs. Data were drawn from the 2015 wave of the Ohio Biennial Survey of Long-Term Care Facilities. Across setting types, most aspects of preparedness were similar, such as written plans, specifications for evacuation, emergency drills, communication procedures, and preparations for expected hazards. Despite these similarities, we found SNFs were more prepared than large ALs in some key areas, most notably being more likely to have a backup generator and 7 days of pharmacy stocks and generator fuel.

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The Care of Irreversible Dementia Sufferers in the Toronto and Peel Regions: Perceptions of Service Providers

Canadian Journal on Aging / La Revue canadienne du vieillissement ◽

10.1017/s071498080000756x ◽

1987 ◽

Vol 6 (4) ◽

pp. 271-289 ◽

Cited By ~ 3

Author(s):

S. Lynne MacFadgen

Keyword(s):

Acute Care ◽

Community Service ◽

Long Term Care ◽

Service Providers ◽

Acute Care Hospitals ◽

Service Planning ◽

Term Care ◽

Service Staff ◽

Care Facilities

ABSTRACTIn this study, the system of care for 4907 irreversible dementia (ID) sufferers in Metropolitan Toronto and the Region of Peel was investigated. Mail survey data were compiled from senior administrative personnel (data include observation ratings by clinical and direct service staff) within 41 long-term care facilities, 15 acute care hospitals, and 30 community services. Consistent with the results of other descriptive studies, the findings reveal that: 1) long-term care facilities had the highest average proportion of ID sufferers; 2) the majority of ID sufferers were 75 years and older and predominantly female; and 3) ID sufferers on community service caseloads were less impaired than those in long-term care facilities. The study findings also indicate that the following factors may be important in assessing the care and management of ID sufferers within long-term care facilities and acute care hospitals: type of facility, admission criteria, arrangements for accommodation, number and nature of special programs, extent of inservice training, levels of staffing, and number and nature of family support services. In addition to these variables, the location and size of the catchment area and eligibility criteria may be important factors in similar community service assessments. The findings pertaining to the frequently used inpatient and community resources, additional resources required, and unmet needs of ID sufferers and family are discussed with respect to health care and senior support service planning and implementation within the outlined regions.

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Adapting Mindfulness-Based Interventions for Residents of Long-Term Care Facilities

Gerontology and Geriatric Medicine ◽

10.1177/23337214211057703 ◽

2021 ◽

Vol 7 ◽

pp. 233372142110577

Author(s):

Christian Terry ◽

Michael Penland ◽

Devon Garland ◽

Wendy Wang ◽

Taylor Burton ◽

...

Keyword(s):

Long Term Care ◽

Nursing Facilities ◽

Traditional Group ◽

Term Care ◽

Skilled Nursing ◽

Healthy Older Adults ◽

Care Facilities ◽

States Data ◽

Full Day

Mindfulness-based interventions (MBIs) have received increased clinical attention in recent years. While some MBI research has focused on healthy older adults, research with more emotionally and physically vulnerable populations, such as residents of long-term care facilities (LTCFs), is lacking. The current paper presents quantitative and qualitative results from a pilot study of an individual MBI designed for residents of LTCFs. Participants included 8 residents from two skilled nursing facilities in the southeastern United States. Data were collected between October 2016 through June 2017. A modified MBI is proposed with specific adaptations for LTCF residents. Recommended adaptations for LTCFs include a shift from a group to an individual format, individual weekly instructor–participant meetings, removal of the yoga and full-day silent retreat and shortening the duration of the formal practices. The current study found that these adaptations result in an individual MBI that is accessible to most LTCF residents while still providing the associated benefits of traditional group MBIs.

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