scholarly journals Coordinated outreach for veterans in long-term care facilities by an integrated Veterans Affairs healthcare system during the COVID-19 pandemic

2020 ◽  
pp. 1-2
Author(s):  
Alexander Winnett ◽  
Lauren P. Jatt ◽  
Linda Sohn ◽  
Marcia Lysaght ◽  
Thomas Yoshikawa ◽  
...  
Keyword(s):  
Healthcare System ◽  
Long Term Care ◽  
Veterans Affairs ◽  
Term Care ◽  
Care Facilities

scholarly journals 1238. A National Comparison of Antibiograms Between Veterans Affairs Long-Term Care Facilities and Affiliated Hospitals

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S376-S377 ◽  
Author(s):  
Maria-Stephanie Tolg ◽  
Aisling Caffrey ◽  
Haley Appaneal ◽  
Robin Jump ◽  
Vrishali Lopes ◽  
...  
Keyword(s):  
Long Term Care ◽  
Veterans Affairs ◽  
Self Report ◽  
Chi Square ◽  
Term Care ◽  
E Coli ◽  
Care Facilities ◽  
National Comparison ◽  
Research Grant

Abstract Background Long-term care facilities (LTCFs) face several barriers to creating antibiograms. Here, we evaluate if LTCFs can use antibiograms from affiliated hospitals as their own antibiogram. Methods Facility-specific antibiograms were created for all Veterans Affairs (VA) LTCFs and VA Medical Centers (VAMCs) for 2017. LTCFs and affiliated VAMCs were paired and classified as being on the same campus or geographically distinct campuses based on self-report. For each pair, Escherichia coli susceptibility rates (%S) to cefazolin, ceftriaxone, cefepime, ciprofloxacin, nitrofurantoin, sulfamethoxazole/trimethoprim, ampicillin/sulbactam, piperacillin/tazobactam, and imipenem were compared. As guidelines discourage empiric use of antibiotics if susceptibility rates are <80%, we assessed clinical discordance between each LTCF and affiliated VAMC antibiogram at a threshold of 80% susceptible. The proportions of concordant susceptibilities between LTCFs and VAMCs on the same campus vs. geographically distinct campuses were compared using Chi-square tests. Results A total of 119 LTCFs and their affiliated VAMCs were included in this analysis, with 70.6% (n = 84) of facilities located on the same campus and 29.4% (n = 35) on geographically distinct campuses. The table below shows the overall clinical concordance (agreement) of LTCFs with their affiliated VAMC in regards to E. coli %S to the compared antibiotics. No significant differences were found when comparing LTCFs on the same campus vs. geographically distinct campuses. Conclusion Antibiograms between LTCFs and affiliated VAMCs had a high concordance, except for sulfamethoxazole/trimethoprim, cefazolin and ceftriaxone in regards to susceptibility rates of E. coli. Facilities on the same campus were found to have similar concordance rates to geographically distinct facilities. Future studies are needed to investigate how the various approaches to creating LTCF-specific antibiograms are associated with clinical outcomes. Disclosures M. S. Tolg, Veterans Affairs: Investigator, Research grant. A. Caffrey, Veterans Affairs: Investigator, Research grant. H. Appaneal, Veterans Affairs: Grant Investigator, Research grant. R. Jump, Veterans Affairs: Investigator, Research grant. V. Lopes, Veterans Affairs: Investigator, Research grant. D. Dosa, Veterans Affairs: Grant Investigator, Research grant. K. LaPlante, Veterans Affairs: Investigator, Research grant.

scholarly journals Utility of Healthcare System-Based Interventions in Improving the Uptake of Influenza Vaccination in Healthcare Workers at Long-Term Care Facilities: A Systematic Review

Vaccines ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 165 ◽  
Author(s):  
Angela Bechini ◽  
Chiara Lorini ◽  
Patrizio Zanobini ◽  
Francesco Mandò Tacconi ◽  
Sara Boccalini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Healthcare System ◽  
Vaccination Coverage ◽  
Healthcare Workers ◽  
Long Term Care ◽  
The Elderly ◽  
Term Care ◽  
Vaccination Uptake ◽  
Care Facilities

Healthcare workers (HCWs) in long-term care facilities (LTCFs) can represent a source of influenza infection for the elderly. While flu vaccination coverage (VC) is satisfactory in the elderly, HCWs are less likely to be vaccinated. There is no definitive evidence on which types of healthcare system-based interventions at LTCFs would be more useful in improving the vaccination uptake among HCWs. We performed a systematic review in different databases (Pubmed, Cochrane Database of Systematic Reviews, Health Evidence, Web of Science, Cinahl) to provide a synthesis of the available studies on this topic. Among the 1177 articles screened by their titles and abstracts, 27 were included in this review. Most of the studies reported multiple interventions addressed to improve access to vaccination, eliminate individual barriers, or introduce policy interventions. As expected, mandatory vaccinations seem to be the most useful intervention to increase the vaccination uptake in HCWs. However, our study suggests that better results in the vaccination uptake in HCWs were obtained by combining interventions in different areas. Educational campaigns alone could not have an impact on vaccination coverage. LTCFs represent an ideal setting to perform preventive multi-approach interventions for the epidemiological transition toward aging and chronicity.

Acquisition of Clostridium difficile Colonization and Infection After Transfer From a Veterans Affairs Hospital to an Affiliated Long-Term Care Facility

2017 ◽  
Vol 38 (9) ◽  
pp. 1070-1076 ◽  
Author(s):  
Suresh Ponnada ◽  
Dubert M. Guerrero ◽  
Lucy A. Jury ◽  
Michelle M. Nerandzic ◽  
Jennifer L. Cadnum ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Long Term Care ◽  
Care Facility ◽  
Veterans Affairs ◽  
Term Care ◽  
Long Term Care Facility ◽  
Asymptomatic Patients ◽  
Care Facilities

BACKGROUNDClostridium difficile infection (CDI) and asymptomatic carriage of toxigenic C. difficile are common in long-term care facilities (LTCFs). However, whether C. difficile is frequently acquired in the LTCF versus during acute-care admissions remains unknown.OBJECTIVETo test the hypothesis that LTCF residents often acquire C. difficile colonization and infection in the LTCFDESIGNThis 5-month cohort study was conducted to determine the incidence of acquisition of C. difficile colonization and infection in asymptomatic patients transferred from a Veterans Affairs hospital to an affiliated LTCF.METHODSRectal swabs were cultured for toxigenic C. difficile at the time of transfer to the LTCF and weekly for up to 6 weeks. We calculated the proportion of LTCF-onset CDI cases within 1 month of transfer that occurred in residents colonized on admission versus those with new acquisition in the LTCF.RESULTSOf 110 patients transferred to the LTCF, 12 (11%) were asymptomatically colonized with toxigenic C. difficile upon admission, and 4 of these 12 patients (33%) developed CDI within 1 month, including 3 recurrent and 1 initial CDI episode. Of 82 patients with negative cultures on transfer and at least 1 follow-up culture, 22 (27%) acquired toxigenic C. difficile colonization, and 4 developed CDI within 1 month, including 1 recurrent and 3 initial CDI episodes.CONCLUSIONLTCF residents frequently acquired colonization with toxigenic C. difficile after transfer from the hospital, and 3 of 4 initial CDI cases with onset within 1 month of transfer occurred in residents who acquired colonization in the LTCF.Infect Control Hosp Epidemiol 2017;38:1070–1076

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