The burden of gastroenteritis outbreaks in long-term care settings in Philadelphia, 2009–2018

2020 ◽  
Vol 41 (11) ◽  
pp. 1310-1314
Author(s):  
Hansol Kang ◽  
Yvette Khachadourian ◽  
Dana Perella ◽  
Tiina M. Peritz ◽  
Kristen A. Feemster ◽  
...  
Keyword(s):  
Long Term Care ◽  
Gastrointestinal Symptoms ◽  
Care Facility ◽  
The United States ◽  
Cross Sectional Study ◽  
Quality Data ◽  
Cross Sectional ◽  
Term Care ◽  
Outbreak Management

AbstractObjective:Gastroenteritis causes significant morbidity and mortality in long-term care facility (LTCF) residents, a growing population within the United States. We set out to better understand gastroenteritis outbreaks in LTCF by identifying outbreak and facility characteristics associated with outbreak incidence as well as outbreak duration and size.Design:We conducted a retrospective cross-sectional study on LTCFs in Philadelphia County from 2009 to 2018. Outbreak characteristics and interventions were extracted from Philadelphia Department of Public Health (PDPH) database and quality data on all LTCFs was extracted from Centers for Medicare and Medicaid Services Nursing Home Compare database.Results:We identified 121 gastroenteritis outbreaks in 49 facilities. Numbers of affected patients ranged from 2 to 211 patients (median patient illness rate, 17%). Staff were reported ill in 94 outbreaks (median staff illness rate, 5%). Outbreak facilities were associated with higher occupancy rates (91% vs 88%; P = .033) and total bed numbers (176 vs 122; P = .071) compared to nonoutbreak facilities. Higher rates of staff illness were associated with prolonged outbreaks (13% vs 4%; P < .001) and higher patient illness rates (9% vs 4%; P = .012). Prolonged outbreaks were associated with lower frequency of cohorting for outbreak management (13% vs 41%; P = .046).Conclusion:This study is the largest published analysis of gastroenteritis outbreaks in LTCFs. Facility characteristics and staff disease activity were associated with more severe outbreaks. Heightened surveillance for gastrointestinal symptoms among staff and increased use of cohorting might reduce the risk of prolonged gastroenteritis outbreaks in LTCF.

scholarly journals The Burden of Gastroenteritis Outbreaks in Long-Term Care Settings in Philadelphia, 2009–2018

2020 ◽  
Vol 41 (S1) ◽  
pp. s404-s404
Author(s):  
Hansol Kang ◽  
Susan Coffin ◽  
Tiina Peritz
Keyword(s):  
Attack Rate ◽  
Long Term Care ◽  
Gastrointestinal Symptoms ◽  
Care Facility ◽  
The United States ◽  
Quality Data ◽  
Cross Sectional ◽  
Term Care ◽  
Outbreak Management

Background: Gastroenteritis causes significant morbidity and mortality in long-term care facility (LTCF) residents, a growing population within the United States. Methods: We conducted a retrospective cross-sectional study in LTCFs in Philadelphia County from 2009 to 2018. Outbreak characteristics and interventions were extracted from Philadelphia Department of Public Health’s (PDPH) database, and quality data on all LTCFs was extracted from the CMS Nursing Home Compare database. Results: We identified 121 gastroenteritis outbreaks in 49 facilities. Numbers of affected patients ranged from 2 to 211 patients (median patient attack rate, 17%). Staff were reported ill in 94 outbreaks (median staff attack rate, 5%). Outbreak facilities were associated with higher occupancy rates (91% vs 88%; P = .033) and total bed numbers (176 vs 122; P = .071) when compared to nonoutbreak facilities. Higher rates of staff illness were associated with prolonged outbreaks (13% vs 4%; P < .001) and higher patient illness rates (9% vs 4%; P = .012). Prolonged outbreaks were associated with lower frequency of cohorting for outbreak management (13% vs 41%; P = .046). Conclusions: This study is the largest published analysis of gastroenteritis outbreaks in LTCFs. Facility characteristics and staff disease 20 activity were associated with more severe outbreaks. Heightened surveillance for gastrointestinal symptoms among staff and increased 21 use of cohorting might reduce the risk of prolonged gastroenteritis outbreaks in LTCF.Funding: NoneDisclosures: None

scholarly journals A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

2021 ◽  
Vol 18 (2) ◽  
pp. 476
Author(s):  
Bum Jung Kim ◽  
Sun-young Lee
Keyword(s):  
Social Support ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Hierarchical Regression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

scholarly journals FEDERAL POLICY SUPPORTS AND GAPS IN ADDRESSING RACIAL-ETHNIC HEALTH DISPARITIES IN U.S. LONG-TERM CARE FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S161-S161
Author(s):  
Rebecca L Mauldin ◽  
Kathy Lee ◽  
Antwan Williams
Keyword(s):  
Long Term Care ◽  
Federal Policy ◽  
Care Facility ◽  
Well Being ◽  
The United States ◽  
Term Care ◽  
Long Term Care Facility ◽  
Care Facilities

Abstract Older adults from racial and ethnic minority groups face health inequities in long-term care facilities such as nursing homes and assisted living facilities just as they do in the United States as a whole. In spite of federal policy to support minority health and ensure the well-being of long-term care facility residents, disparities persist in residents’ quality of care and quality of life. This poster presents current federal policy in the United States to reduce racial and ethnic health disparities and to support long-term care facility residents’ health and well-being. It includes legislation enacted by the Patient Protection and Affordable Care Act of 2010 (ACA), regulations of the U.S. Department of Health and Human Services (DHHS) for health care facilities receiving Medicare or Medicare funds, and policies of the Long-term Care Ombudsman Program. Recommendations to address threats to or gaps in these policies include monitoring congressional efforts to revise portions of the ACA, revising DHHS requirements for long-term care facilities staff training and oversight, and amending requirements for the Long-term Care Ombudsman Program to mandate collection, analysis, and reporting of resident complaint data by race and ethnicity.

scholarly journals Will the demands by the covid-19 pandemic increase the intent to quit the profession of long-term care managers? A repeated cross-sectional study in Germany

2021 ◽  
Author(s):  
Timo-Kolja Pförtner ◽  
Holger Pfaff ◽  
Kira Isabel Hower
Keyword(s):  
Online Survey ◽  
Long Term Care ◽  
Intention To Leave ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
Care Managers ◽  
Care Facilities ◽  
Inpatient Nursing

Abstract The Corona pandemic poses major demands for long-term care, which might have impacted the intention to quit the profession among managers of long-term care facilities. We used cross-sectional data of an online survey of long-term care managers from outpatient and inpatient nursing and palliative care facilities surveyed in April 2020 (survey cycle one; n = 532) and between December 2020 and January 2021 (survey cycle two; n = 301). The results show a significant association between the perceived pandemic-specific and general demands and the intention to leave the profession. This association was significantly stronger for general demands in survey cycle two compared with survey cycle one. The results highlight the pandemic’s immediate impact on long-term care. In view of the increasing number of people in need of care and the already existing scarcity of specialized nursing staff, the results highlight the need for initiatives to ensure the provision of long-term care, also and especially in such times of crisis.

The Effects of the Opioid Epidemic on Prescribing Practices in Long-Term Care Residents

2019 ◽  
Vol 34 (4) ◽  
pp. 258-267
Author(s):  
Lisa Yamagishi ◽  
Olivia Erickson ◽  
Kelly Mazzei ◽  
Christine O'Neil ◽  
Khalid M. Kamal
Keyword(s):  
Severe Pain ◽  
Long Term Care ◽  
Care Facility ◽  
The United States ◽  
Self Report ◽  
Prescribing Practices ◽  
Term Care ◽  
Data Set ◽  
Opioid Prescribing

OBJECTIVE: Evaluate opioid prescribing practices for older adults since the opioid crisis in the United States.<br/> DESIGN: Interrupted time-series analysis on retrospective observational cohort study.<br/> SETTING: 176-bed skilled-nursing facility (SNF).<br/> PARTICIPANTS: Patients admitted to a long-term care facility with pain-related diagnoses between October 1, 2015, and March 31, 2017, were included. Residents discharged prior to 14 days were excluded. Of 392 residents, 258 met inclusion criteria with 313 admissions.<br/> MAIN OUTCOME MEASURE: Changes in opioid prescribing frequency between two periods: Q1 to Q3 (Spring 2016) and Q4 to Q6 for pre- and postgovernment countermeasure, respectively.<br/> RESULTS: Opioid prescriptions for patients with pain-related diagnoses decreased during period one at -0.10% per quarter (95% confidence interval [CI] -0.85-0.85; P = 0.99), with the rate of decline increasing at -3.8% per quarter from period 1 and 2 (95% CI -0.23-0.15; P = 0.64). Opioid prescribing from top International Classification of Diseases, Ninth Revision category, "Injury and Poisoning" decreased in prescribing frequency by -3.0% per quarter from Q1 to Q6 (95% CI -0.16-0.10; P = 0.54). Appropriateness of pain-control was obtained from the Minimum Data Set version 3.0 "Percent of Residents Who Self-Report Moderate to Severe Pain (Short Stay)" measure; these results showed a significant increase in inadequacy of pain relief by 0.28% per quarter (95% CI 0.12-0.44; P = 0.009).<br/> CONCLUSION: Residents who self-report moderate- to severe pain have significantly increased since October 2015. Opioid prescriptions may have decreased for elderly patients in SNFs since Spring 2016. Further investigation with a larger population and wider time frame is warranted to further evaluate significance.

scholarly journals Correction: Technical-efficiency analysis of end-of-life care in long-term care facilities within Europe: A cross-sectional study of deceased residents in 6 EU countries (PACE)

PLoS ONE ◽  
2018 ◽  
Vol 13 (11) ◽  
pp. e0208199 ◽  
Author(s):  
Anne B. Wichmann ◽  
Eddy M. M. Adang ◽  
Kris C. P. Vissers ◽  
Katarzyna Szczerbińska ◽  
Marika Kylänen ◽  
...  
Keyword(s):  
End Of Life Care ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Efficiency Analysis ◽  
Life Care ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
Care Facilities

scholarly journals Depression and empathy in health professionals who work in the long-term care institutions for older adults

2021 ◽  
Vol 15 (3) ◽  
pp. 381-386
Author(s):  
Marina Miranda Borges ◽  
Ana Julia de Lima Bomfim ◽  
Marcos Hortes Nisihara Chagas
Keyword(s):  
Older Adults ◽  
Health Professionals ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Reactivity Index ◽  
Cross Sectional ◽  
Term Care ◽  
Patient Health ◽  
The Relationship

ABSTRACT Empathy is an important factor to guarantee the quality of care provided in the long-term care institutions (LTCIs) for older adults, and depression is a factor that affects the health of the professional and, consequently, the care. Thus, it is important that studies are conducted on the relationship of these variables in this context. Objective: The aim of this study is to verify the relationship between empathy and depressive symptoms among health professionals working in the LTCIs. Methods: A cross-sectional study was carried out at LTCIs in the state of São Paulo, Brazil. The final sample was constituted by 101 health professionals (i.e., caregivers and nursing technicians) with direct participation in the care of institutionalized older adults. The instruments were used as follows: the Interpersonal Reactivity Index (IRI) to assess empathy and the Patient Health Questionnaire-9 (PHQ-9) for the diagnosis of depression. For the analyses, the patients were divided into groups with and without depression, according to the score of the PHQ-9. Results: The prevalence of depression among health professionals was 19.8%. Significant statistical differences were found between the groups for the total score of the IRI (p=0.029), for the emotional domain (p=0.023), and for the personal distress (p=0.009). Conclusions: The findings indicate that the presence of depression among health professionals at LTCIs is related to the higher levels of empathy, especially in the emotional domain. Thus, future studies that contribute to understanding how care must be provided with empathy, but without harming the health of the professional, should be carried out.

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