scholarly journals Transmission of Methicillin-Resistant Staphylococcus aureus (MRSA) to Healthcare Worker Gowns and Gloves During Care of Nursing Home Residents

2015 ◽  
Vol 36 (9) ◽  
pp. 1050-1057 ◽  
Author(s):  
Mary-Claire Roghmann ◽  
J. Kristie Johnson ◽  
John D. Sorkin ◽  
Patricia Langenberg ◽  
Alison Lydecker ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Nursing Home ◽  
Nursing Homes ◽  
Glucose Monitoring ◽  
Nursing Home Residents ◽  
Standards Of Care ◽  
Home Setting ◽  
Methicillin Resistant ◽  
Skin Breakdown ◽  
Nursing Home Setting

OBJECTIVETo estimate the frequency of methicillin-resistant Staphylococcus aureus (MRSA) transmission to gowns and gloves worn by healthcare workers (HCWs) interacting with nursing home residents to better inform infection prevention policies in this settingDESIGNObservational studySETTINGParticipants were recruited from 13 community-based nursing homes in Maryland and MichiganPARTICIPANTSResidents and HCWs from these nursing homesMETHODSResidents were cultured for MRSA at the anterior nares and perianal or perineal skin. HCWs wore gowns and gloves during usual care activities. At the end of each activity, a research coordinator swabbed the HCW’s gown and gloves.RESULTSA total of 403 residents were enrolled; 113 were MRSA colonized. Glove contamination was higher than gown contamination (24% vs 14% of 954 interactions; P<.01). Transmission varied greatly by type of care from 0% to 24% for gowns and from 8% to 37% for gloves. We identified high-risk care activities: dressing, transferring, providing hygiene, changing linens, and toileting the resident (OR >1.0; P<.05). We also identified low-risk care activities: giving medications and performing glucose monitoring (OR<1.0; P<.05). Residents with chronic skin breakdown had significantly higher rates of gown and glove contamination.CONCLUSIONSMRSA transmission from MRSA-positive residents to HCW gown and gloves is substantial; high-contact activities of daily living confer the highest risk. These activities do not involve overt contact with body fluids, skin breakdown, or mucous membranes, which suggests the need to modify current standards of care involving the use of gowns and gloves in the nursing home setting.Infect. Control Hosp. Epidemiol. 2015;36(9):1050–1057

Risk Factors for Methicillin-Resistant Staphylococcus Aureus Carriage in Residents of German Nursing Homes

2002 ◽  
Vol 23 (9) ◽  
pp. 511-515 ◽  
Author(s):  
H. von Baum ◽  
C. Schmidt ◽  
D. Svoboda ◽  
O. Bock-Hensley ◽  
Constanze Wendt
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Nursing Home ◽  
Nursing Homes ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Significant Risk ◽  
Nursing Home Residents ◽  
Medium Size ◽  
Prevalence Survey ◽  
Methicillin Resistant

Objectives:To determine the prevalence of and the risk factors for methicillin-resistant Staphylococcus aureus (MRSA) carriage in nursing home residents in the Rhine-Neckar region of southern Germany.Design:Point-prevalence survey.Setting:Forty-seven nursing homes in the region.Participants:All residents of the approached nursing homes who agreed to participate.Methods:After informed consent was obtained, all participants had their nares swabbed, some personal data collected, or both. All swabs were examined for growth of MRSA All S. aureus isolates underwent oxacillin susceptibility testing and polymerase chain reaction for demonstration of the meek gene. All MRSA isolates were typed using pulsed-field gel electrophoresis after digestion with SmaI.Results:Swabs from 3,236 nursing home residents yielded 36 MRSA strains, contributing to a prevalence rate of 1.1%. Significant risk factors for MRSA carriage in the multivariate analysis were the presence of wounds or urinary catheters, limited mobility, admission to a hospital during the preceding 3 months, or stay in a medium-size nursing home. One predominant MRSA strain could be detected in 30 of the 36 MRSA carriers.Conclusions:The prevalence of MRSA in German nursing homes is still low. These residents seemed to acquire their MRSA in the hospital and transfer it to their nursing home. Apart from well-known risk factors for the acquisition of MRSA we identified the size of the nursing home as an independent risk factor. This might be due to an increased use of antimicrobials in nursing homes of a certain size.

scholarly journals Prevalence and Molecular Genetics of Methicillin-Resistant Staphylococcus aureus Colonization in Nursing Homes in Saudi Arabia

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ahmed Albarrag ◽  
Ashwag Shami ◽  
Abrar Almutairi ◽  
Sara Alsudairi ◽  
Sumayh Aldakeel ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Saudi Arabia ◽  
Nursing Home ◽  
Nursing Homes ◽  
Multiplex Pcr ◽  
Nursing Home Residents ◽  
Toxin Gene ◽  
Methicillin Resistant ◽  
Multiplex Pcr Assay ◽  
Nasal Swabs

Objective. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the main causative agents of nosocomial infections that has posed a major threat to those with compromised immune systems such as nursing home residents. The aim of this study was to determine the rates of MRSA strains and the types of Staphylococcal Cassette Chromosome mec (SCCmec)in nursing homes in Saudi Arabia. Methods. A total of 188 nasal swabs were collected from the residents and nursing staff in two nursing homes in Riyadh, Saudi Arabia. All MRSA isolates were tested for antimicrobial susceptibility and analyzed for mecA and SCCmec typing by multiplex PCR assay. Detection of the Panton–Valentine leukocidin (PVL) gene was also tested in all positive MRSA isolates by multiplex PCR using specific primers. Results. Among the 188 collected nasal swabs (105 males and 83 females), MRSA colonization rate was 9.04% (11 (5.85%) females and 6 (5.71%) males). About 47% of MRSA were multidrug resistant (MDR) as acquired resistance to beta-lactam, macrolide, and aminoglycoside antibiotics. However, all the MRSA isolates showed susceptibility to vancomycin, tigecycline, and linezolid. All the MRSA isolates (n = 17) were mecA-positive with the SCCmec IVc (n = 7, 41.18%) as the most common SCCmec type followed by SCCmec V (n = 5, 29.41%) and SCCmec IVa (n = 2, 11.76%). The remaining isolates (n = 3) were nontypeable (17.65%). In addition, the PVL toxin gene was only detected in four of the male samples. Conclusion. MRSA nasal colonization is a common incident among nursing home residents. The prevalence of community-associated (CA) MRSA (SCCmec IV and V) was more common than hospital-associated (HA) MRSA in our study samples. It is crucial to investigate such rate of incidence, which is a key tool in preventive medicine and would aid in determining health policy and predict emergent outbreaks.

scholarly journals Between Social Inclusion and Exclusion: Integration of Daycare Guests in the Nursing Home Setting

2020 ◽  
Author(s):  
Kerstin Hämel ◽  
Gundula Röhnsch
Keyword(s):  
Nursing Home ◽  
Social Inclusion ◽  
Nursing Home Residents ◽  
Community Dwelling ◽  
Cognitive Capacity ◽  
Home Setting ◽  
Residential Care Facilities ◽  
Care Approach ◽  
Nursing Home Setting ◽  
Close Relatives

Abstract Background and Objectives In integrated daycare, community-dwelling older people in need of care join existing groups in residential care facilities during the day. This study focuses on how nursing home residents experience the integrative care approach, exploring opportunities for social inclusion and mechanisms of exclusion. Research Design and Methods A purposive sample of residents differing in cognitive capacity and level of (non)conflictual interaction with daycare guests was selected. Episodic interviews with residents (N = 10) and close relatives (N = 2) were conducted in 3 pilot facilities in Germany and analyzed using thematic coding. Results The analysis revealed different orientation patterns towards the presence of daycare guests: respondents (a) demonstrated indifference to the daycare guests, (b) saw bonding with guests as a means to connect to the outside world, and (c) perceived incompatibility between in-group and out-group. Criticisms included disruption of daily routines and loss of privacy. Most interviewees came to terms with the care situation using rational and moral arguments. Discussion and Implications The study reveals the importance of residents’ participation when integrating daycare guests. Institutional procedures are required to prevent exclusion of daycare guests and avoid overtaxing residents.

Double-swab 5% versus single-swab 10% iodophor for reducing methicillin-resistant Staphylococcus aureus with routine chlorhexidine bathing

2021 ◽  
pp. 1-3
Author(s):  
Lauren T. Heim ◽  
Loren G. Miller ◽  
Raveena D. Singh ◽  
James A. McKinnell ◽  
Tabitha D. Catuna ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Nursing Home ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Nursing Home Residents ◽  
Nasal Carriage ◽  
Methicillin Resistant ◽  
Chlorhexidine Bathing

Abstract In a prospective cohort study, we compared a 2-swabs-per-nostril 5% iodophor regimen with a 1-swab-per-nostril 10% iodophor regimen on methicillin-resistant Staphylococcus aureus carriage in nursing-home residents. Compared with baseline, both single-swab and double-swab regimens resulted in an identical 40% reduction in nasal carriage and 60% reduction in any carriage, skin or nasal.

The Grief Experiences of Certified Nursing Assistants: Personal Growth and Complicated Grief

2007 ◽  
Vol 54 (4) ◽  
pp. 301-318 ◽  
Author(s):  
Keith A. Anderson ◽  
Joseph E. Gaugler
Keyword(s):  
Nursing Home ◽  
Personal Growth ◽  
Complicated Grief ◽  
Nursing Home Residents ◽  
Past Research ◽  
Nursing Assistants ◽  
Certified Nursing Assistants ◽  
Disenfranchised Grief ◽  
Home Setting ◽  
Nursing Home Setting

The grief that certified nursing assistants (CNAs) experience following the deaths of nursing home residents has received scant attention in past research, particularly from an empirical standpoint. The purpose of this quantitative study was to investigate the grief experiences of CNAs in the nursing home setting and to identify and evaluate factors that may mediate or exacerbate grief. Participants ( N = 136) from 12 nursing homes completed self-administered surveys. Regression analyses revealed that CNAs with lower levels of perceived disenfranchised grief reported higher levels of personal growth, while CNAs with greater fear of death and those who experienced fewer deaths on the job reported higher levels of complicated grief. Practitioners and future researchers may benefit from these findings through the construction and implementation of interventions aimed at effectively enfranchising the grief experiences of this important group of healthcare workers.

Managing the Secrets of Dying Backstage: The Voices of Nursing Home Staff

2006 ◽  
Vol 53 (3) ◽  
pp. 193-207 ◽  
Author(s):  
Debra Parker Oliver ◽  
Davina Porock ◽  
David B. Oliver
Keyword(s):  
Nursing Home ◽  
End Of Life Care ◽  
Interaction Analysis ◽  
Nursing Home Residents ◽  
Home Setting ◽  
Licensed Practical Nurses ◽  
Practical Nurses ◽  
Interview Guide ◽  
Nursing Home Setting ◽  
Staff Experiences

The project analyzed staff descriptions of undocumented care given to dying nursing home residents. Registered nurses, licensed practical nurses, certified nurse aids, and social service designees were interviewed using an unstructured interview guide. Transcripts were coded by two members of the team and a thematic analysis was guided with the theoretical framework of Erving Goffman's dramaturgical model of social interaction. Analysis of interview transcripts revealed practices related to end of life care that went undocumented. Viewed through the lens of Goffman's theoretical model, this undocumented care revealed “secrets” related to socialization processes, communication, tension, superstitions, and interactions between staff and dying residents. Findings show that while dying is not formally acknowledged in the nursing home setting, staff experiences the reality of death and informally responds to the special needs of residents.

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