scholarly journals 517 - Informal and Formal Depression Care in Nursing Homes (InFormeD): Study protocol of a six month cohort study to better match treatment with residents

2021 ◽  
Vol 33 (S1) ◽  
pp. 66-67
Author(s):  
Ine Declercq ◽  
Ruslan Leontjevas ◽  
Inge Knippenberg ◽  
Susan Van Hooren ◽  
Patricia De Vriendt ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Nursing Homes ◽  
Informal Care ◽  
Depression Scale ◽  
Nursing Home Residents ◽  
Comprehensive Approach ◽  
Formal Care ◽  
Depression Care ◽  
Positive Effects

AbstractBackground:Depression is common among nursing home residents and has a considerable impact on their quality of life. Therefore, there has been an increased interest in interventions aiming at the reduction of depression among nursing home residents. These interventions could be categorized into formal and informal depression care. Formal care includes psychosocial, psychotherapeutic and/or (neuro-)biological interventions. Informal care can be provided by nursing home staff, alongside the formal care (e.g., letting sunlight into the room when one believes in the positive effects of daylight). Although many studies have been done about depression treatment in nursing homes, there is still a lack of insight into the effectiveness of interventions and how they differ among specific target groups (e.g., residents with cognitive impairment versus residents with physical disabilities). Moreover, research into informal care is rather rare. More insight is needed into the effect of formal and informal depression care and the mutually reinforcing effects of those strategies on nursing home residents. This insight is essential to better match treatments with residents and to provide a more comprehensive approach to counter depression.Objectives:The aim of this study is to gain insight in the use of formal and informal depression care and their associations with depression among nursing home residents.Design:A six month cohort study will be conducted.Method:Residents will be recruited in nursing homes across the Netherlands and Flanders (Belgium). To measure formal and informal care, newly developed tools will be cross-culturally validated: one to assess the provided formal care in nursing homes, two tools for measuring the used informal strategies. Depression outcomes will be measured with the Geriatric Depression Scale, Cornell Scale for Depression in Dementia, and the Nijmegen-Observer-Rated Depression-scale). Baseline measurements and cross- sectional analyses will be performed and repeated after six months. The intended associations will be assessed using multiple regression analysis.Conclusion:To develop a good depression care policy, a more comprehensive approach is needed and may benefit both residents and staff.

scholarly journals Is there any correlation between Magnesium status and depression in elderly people? A descriptive-analytical study among Tehran-nursing home residents

2021 ◽  
Vol 12 (2) ◽  
pp. 632-639
Author(s):  
Lyly Nazemi ◽  
Ingmar Skoog ◽  
Ingvar Karlsson ◽  
Margda Waern ◽  
Agneta Yngve ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Elderly Population ◽  
Analytical Study ◽  
Depression Scale ◽  
Nursing Home Residents ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Flame Atomic Absorption ◽  
Significant Difference

Background: Very few studies have shown the possible relationship between magnesium (Mg) status and depression. In the present study, the intracellular Mg status of the elderly population living in nursing homes (NHs) was assessed to determine its relationship with depression. Methods: A descriptive-analytical study was conducted on the elderly population living in nursing homes (Tehran-Iran; 2010-2012). Participants' demographic and clinical characteristics were collected and recorded in a checklist. Evaluating the participants’ nutritional status, Mini Nutritional Assessment Method was implemented. Determining participant's depressive symptoms, 15-item Geriatric Depression Scale was used. Final scores were classified into4 categories not depressed, mild, moderate, and severe depression. Mg level in leukocytes was also measured by flame atomic absorption spectrometry. Results: Totally 113 elderly were included and only 9.8% of subjects were not depressed. About 21% of the subjects were well nourished. Of participants who suffered from heart disease, 80.2% were depressed (p=0.03). Regarding correlations between Mg status and depression, results showed no significant difference in Mg levels of two depressed and non-depressed participants (p=0.73). Conclusion: The results of the present study showed notable prevalence rates of depression and malnutrition among nursing home residents. It was also found that the relationship between intracellular Mg levels and depression was not significant. Further studies are needed to determine the major factors related to these preventable psychological and nutritional disorders among elderly NH residents.

scholarly journals A Tablet ‐ Based Intervention for Activating Nursing Home Residents with Dementia: Results from a Cluster-Randomised Controlled Trial

2021 ◽  
Author(s):  
Julie Lorraine O'Sullivan ◽  
Sonia Lech ◽  
Paul Gellert ◽  
Ulrike Grittner ◽  
Jan-Niklas Voigt-Antons ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Psychotropic Medication ◽  
Controlled Trial ◽  
Depression Scale ◽  
Nursing Home Residents ◽  
Pharmacological Intervention ◽  
People With Dementia

Abstract Objectives: To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia.Design: Cluster-randomized controlled trial.Setting: Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units).Participants: N = 162 residents with dementia. Intervention: Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for eight weeks.Measurements: Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer’s Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until collection of baseline data was completed. Data was analyzed with linear mixed-effects models.Results: Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95%CI: -3.54 to 2.33 for TBI and .36 points, 95%CI: -3.27 to 2.55 for CAS). Group difference in change of apathy was not statistically significant (B = .25; 95%CI: -3.89 to 4.38, p = .91). This corresponds to a standardized effect size (Cohen’s d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group.Conclusions: Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states. Funding: German National Association of Statutory Health Insurance Funds. Registry: ISRCTN98947160.

Preconceptions about institutionalisation at public nursing homes in Spain: views of residents and family members

2012 ◽  
Vol 34 (4) ◽  
pp. 547-568 ◽  
Author(s):  
BEATRIZ RODRÍGUEZ-MARTÍN ◽  
MARÍA MARTÍNEZ-ANDRÉS ◽  
BEATRIZ CERVERA-MONTEAGUDO ◽  
BLANCA NOTARIO-PACHECO ◽  
VICENTE MARTÍNEZ-VIZCAÍNO
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Nursing Homes ◽  
Informal Care ◽  
Nursing Home Residents ◽  
Care Systems ◽  
Points Of View ◽  
Home Placement ◽  
Social Causes ◽  
Depth Interviews

ABSTRACTThe aim of this article was to ascertain nursing home residents' preconceptions about institutionalisation and analyse the causes and circumstances of and the justification for their admission. Grounded theory was used to design and analyse a qualitative study based on in-depth interviews in a theoretical sampling of 20 persons aged over 65 years with no cognitive impairment, and eight proxy informants of residents with cognitive impairment, institutionalised at a public nursing home in Spain. Our analysis revealed that preconceptions about nursing homes differ between residents and relatives, and are strongly influenced by the views held by society about such centres and by previous experiences. Regarding the causes and circumstances underlying nursing home placement, while the principal cause of institutionalisation among residents with cognitive impairment was the ineffectiveness of informal care systems, in the case of residents without cognitive impairment reasons tended to revolve around two main themes: social causes (loneliness, not be a burden to the others, household-related, comfort and absence of relatives in the vicinity), and limitations in physical functioning, with the former predominating. This study shows society's perception of such centres and the circumstances surrounding admission. These points of view are useful for analysing why informal care systems prove inadequate, and are crucial for designing programmes targeted at acceptance and successful adaptation to institutionalisation when this becomes necessary.

scholarly journals Associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 in nursing homes and healthcare workers in Catalonia: prospective cohort study

BMJ ◽  
2021 ◽  
pp. n1868
Author(s):  
Carmen Cabezas ◽  
Ermengol Coma ◽  
Nuria Mora-Fernandez ◽  
Xintong Li ◽  
Montse Martinez-Marcos ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Nursing Homes ◽  
Hospital Admission ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Nursing Home Residents ◽  
Nursing Home Staff ◽  
Hazard Ratios

Abstract Objective To determine associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 among nursing home residents, nursing home staff, and healthcare workers. Design Prospective cohort study. Setting Nursing homes and linked electronic medical record, test, and mortality data in Catalonia on 27 December 2020. Participants 28 456 nursing home residents, 26 170 nursing home staff, and 61 791 healthcare workers. Main outcome measures Participants were followed until the earliest outcome (confirmed SARS-CoV-2 infection, hospital admission or death with covid-19) or 26 May 2021. Vaccination status was introduced as a time varying exposure, with a 14 day run-in after the first dose. Mixed effects Cox models were fitted to estimate hazard ratios with index month as a fixed effect and adjusted for confounders including sociodemographics, comorbidity, and previous medicine use. Results Among the nursing home residents, SARS-CoV-2 infection was found in 2482, 411 were admitted to hospital with covid-19, and 450 died with covid-19 during the study period. In parallel, 1828 nursing home staff and 2968 healthcare workers were found to have SARS-CoV-2 infection, but fewer than five were admitted or died with covid-19. The adjusted hazard ratio for SARS-CoV-2 infection after two doses of vaccine was 0.09 (95% confidence interval 0.08 to 0.11) for nursing home residents, 0.20 (0.17 to 0.24) for nursing home staff, and 0.13 (0.11 to 0.16) for healthcare workers. Adjusted hazard ratios for hospital admission and mortality after two doses of vaccine were 0.05 (0.04 to 0.07) and 0.03 (0.02 to 0.04), respectively, for nursing home residents. Nursing home staff and healthcare workers recorded insufficient events for mortality analysis. Conclusions Vaccination was associated with 80-91% reduction in SARS-CoV-2 infection in all three cohorts and greater reductions in hospital admissions and mortality among nursing home residents for up to five months. More data are needed on longer term effects of covid-19 vaccines.

Lessons learned from the statewide implementation of the Music & Memory program in nursing homes in Wisconsin in the USA

Dementia ◽  
2020 ◽  
pp. 147130122096223
Author(s):  
Jung Kwak ◽  
Jung-Hwa Ha ◽  
Katharine O’Connell Valuch
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Behavioral Problems ◽  
Nursing Home Residents ◽  
Lessons Learned ◽  
Direct Care ◽  
Care Staff ◽  
Memory Training ◽  
Positive Effects ◽  
The Usa

The movement of evidence-based interventions into institutional settings such as nursing homes is challenging. Among ecopsychosocial interventions to address behavioral problems of nursing home residents with dementia, Music and Memory, a popular intervention that provides individualized music listening, has shown potential to improve residents’ quality of life. In Wisconsin in the USA, the Music and Memory program has been implemented in nursing home facilities statewide. In the present study, to examine facilitators and barriers related to implementation and sustainability of the Music and Memory program, all nursing homes in Wisconsin were invited to participate in a survey (online or mail). A total of 161 facilities participated, representing a response rate of 41%. Descriptive statistics and content analysis were conducted. Over 80% of responding facilities were providing the Music and Memory program, and 86% of those facilities planned to continue its use. The majority of respondents found Music and Memory to be beneficial to residents, but they also reported that the program was not equally effective for everyone and that it was time and labor intensive. Barriers to sustainability included lack of buy-in by direct care staff, use of technology, costs of equipment, inconsistency of volunteers, and families not supportive or helpful. Facilitators included support of facility personnel, family, and volunteers; observing positive effects of program; Music and Memory training provision and support; and accessibility of equipment. For the program to be successful, facilities must identify the residents most likely to benefit from it, realistically estimate its costs and required labor, and ensure staff buy-in.

scholarly journals Cancer events in Belgian nursing home residents (NHR): An EORTC prospective cohort study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13066-e13066
Author(s):  
Hans Wildiers ◽  
Monique Elseviers ◽  
Murielle E. Mauer ◽  
Jonas de Wolf ◽  
Edith Bastiaens ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nursing Home ◽  
Skin Cancer ◽  
Nursing Homes ◽  
Head And Neck ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Nursing Home Residents ◽  
Clinical Suspicion ◽  
Local Staff

e13066 Background: A large prospective cohort study was designed to describe cancer events, referral patterns, anticancer treatments and outcome in NHR. Methods: The study was set up in 39 nursing homes from the Armonea network in Belgium, covering 4262 nursing home beds. Cancer events were defined as a new cancer event (new cancer or progressive disease of a previously known cancer) where a diagnostic/treatment decision had to be taken; and patients with strong clinical suspicion (physician’s judgement) of a new cancer event, but where the decision was made not to take further diagnostic/therapeutic steps. Cancer events in NHR were collected during a 1y-period in these 39 nursing homes. After training, each site’s local staff identified patients with cancer events in collaboration with the treating general practitioner (GP). NHR were included after informed consent, and relevant data, including a questionnaire for the GP at baseline, were recorded at least every 3 months up to 2 years. Results: The study was open from 3-2015 till 3-2016 in 37 nursing homes (and 2 pilot nursing homes started and stopped 6 months earlier). In only 9 NHR (median age 87y, range 72-92), cancer events were recorded during this period (incidence rate = 222/100,000 NHR per year). The 9 tumor cases were: one strong clinical suspicion of new prostate cancer, and one undefined cancer; a strong clinical suspicion of breast cancer progression; 3 newly diagnosed cancers (angiosarcoma of the breast, head and neck plus gingiva cancer, and one undefined) ; 3 cases with diagnosed progression of a previously known tumor (skin cancer, head and neck cancer plus skin cancer, bladder cancer). During follow-up, 6/9 NHR died, with a median overall survival of 5 Mo (range 2-16 Mo). Further details on diagnostic/therapeutic approach and outcome are pending. Conclusions: This study evaluated for the first time cancer events prospectively in a large nursing home population. Clinically relevant cancer events occur at a much lower frequency in NHR than expected from cancer incidence data in the general older population, supporting several previous retrospective observations that cancer events are much less frequent and problematic in very frail older persons than previously expected. Clinical trial information: NCT01910376.

scholarly journals A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial

2021 ◽  
pp. 1-13
Author(s):  
Julie L. O’Sullivan ◽  
Sonia Lech ◽  
Paul Gellert ◽  
Ulrike Grittner ◽  
Jan-Niklas Voigt-Antons ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Nursing Homes ◽  
Psychotropic Medication ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Randomized Controlled ◽  
Cluster Randomized

Abstract Objectives: To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia. Design: Cluster-randomized controlled trial. Setting: Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units). Participants: N = 162 residents with dementia. Intervention: Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks. Measurements: Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer’s Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models. Results: Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI −3.54, 2.33 for TBI and .36 points, 95% CI −3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen’s d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group. Conclusions: Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.

scholarly journals Impact of Roommates on MDRO Spread in Nursing Homes

2020 ◽  
Vol 41 (S1) ◽  
pp. s66-s67
Author(s):  
Gabrielle M. Gussin ◽  
Ken Kleinman ◽  
Raveena D. Singh ◽  
Raheeb Saavedra ◽  
Lauren Heim ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Multidrug Resistant ◽  
Healthcare Intervention ◽  
Odds Ratios ◽  
Care Needs ◽  
Environmental Cleaning ◽  
The Impact

Background: Addressing the high burden of multidrug-resistant organisms (MDROs) in nursing homes is a public health priority. High interfacility transmission may be attributed to inadequate infection prevention practices, shared living spaces, and frequent care needs. We assessed the contribution of roommates to the likelihood of MDRO carriage in nursing homes. Methods: We performed a secondary analysis of the SHIELD OC (Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, CA) Project, a CDC-funded regional decolonization intervention to reduce MDROs among 38 regional facilities (18 nursing homes, 3 long-term acute-care hospitals, and 17 hospitals). Decolonization in participating nursing homes involved routine chlorhexidine bathing plus nasal iodophor (Monday through Friday, twice daily every other week) from April 2017 through July 2019. MDRO point-prevalence assessments involving all residents at 16 nursing homes conducted at the end of the intervention period were used to determine whether having a roommate was associated with MDRO carriage. Nares, bilateral axilla/groin, and perirectal swabs were processed for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CRE). Generalized linear mixed models assessed the impact of maximum room occupancy on MDRO prevalence when clustering by room and hallway, and adjusting for the following factors: nursing home facility, age, gender, length-of-stay at time of swabbing, bedbound status, known MDRO history, and presence of urinary or gastrointestinal devices. CRE models were not run due to low counts. Results: During the intervention phase, 1,451 residents were sampled across 16 nursing homes. Overall MDRO prevalence was 49%. In multivariable models, we detected a significant increasing association of maximum room occupants and MDRO carriage for MRSA but not other MDROs. For MRSA, the adjusted odds ratios for quadruple-, triple-, and double-occupancy rooms were 3.5, 3.6, and 2.8, respectively, compared to residents in single rooms (P = .013). For VRE, these adjusted odds ratios were 0.3, 0.3, and 0.4, respectively, compared to residents in single rooms (P = NS). For ESBL, the adjusted odds ratios were 0.9, 1.1, and 1.5, respectively, compared to residents in single rooms (P = nonsignificant). Conclusions: Nursing home residents in shared rooms were more likely to harbor MRSA, suggesting MRSA transmission between roommates. Although decolonization was previously shown to reduce MDRO prevalence by 22% in SHIELD nursing homes, this strategy did not appear to prevent all MRSA transmission between roommates. Additional efforts involving high adherence hand hygiene, environmental cleaning, and judicious use of contact precautions are likely needed to reduce transmission between roommates in nursing homes.Funding: NoneDisclosures: Gabrielle M. Gussin, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

scholarly journals Antibiotic Susceptibility of Common Organisms Isolated from Urine Cultures of Nursing Home Residents

2020 ◽  
Vol 41 (S1) ◽  
pp. s118-s120
Author(s):  
Austin R. Penna ◽  
Taniece R. Eure Eure ◽  
Nimalie D. Stone ◽  
Grant Barney ◽  
Devra Barter ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Antibiotic Susceptibility ◽  
Clinical Decision Making ◽  
Service Providers ◽  
Urine Culture ◽  
Nursing Home Residents ◽  
Antibiotic Prescribing ◽  
E Coli ◽  
Susceptibility Data

Background: With the emergence of antibiotic resistant threats and the need for appropriate antibiotic use, laboratory microbiology information is important to guide clinical decision making in nursing homes, where access to such data can be limited. Susceptibility data are necessary to inform antibiotic selection and to monitor changes in resistance patterns over time. To contribute to existing data that describe antibiotic resistance among nursing home residents, we summarized antibiotic susceptibility data from organisms commonly isolated from urine cultures collected as part of the CDC multistate, Emerging Infections Program (EIP) nursing home prevalence survey. Methods: In 2017, urine culture and antibiotic susceptibility data for selected organisms were retrospectively collected from nursing home residents’ medical records by trained EIP staff. Urine culture results reported as negative (no growth) or contaminated were excluded. Susceptibility results were recorded as susceptible, non-susceptible (resistant or intermediate), or not tested. The pooled mean percentage tested and percentage non-susceptible were calculated for selected antibiotic agents and classes using available data. Susceptibility data were analyzed for organisms with ≥20 isolates. The definition for multidrug-resistance (MDR) was based on the CDC and European Centre for Disease Prevention and Control’s interim standard definitions. Data were analyzed using SAS v 9.4 software. Results: Among 161 participating nursing homes and 15,276 residents, 300 residents (2.0%) had documentation of a urine culture at the time of the survey, and 229 (76.3%) were positive. Escherichia coli, Proteus mirabilis, Klebsiella spp, and Enterococcus spp represented 73.0% of all urine isolates (N = 278). There were 215 (77.3%) isolates with reported susceptibility data (Fig. 1). Of these, data were analyzed for 187 (87.0%) (Fig. 2). All isolates tested for carbapenems were susceptible. Fluoroquinolone non-susceptibility was most prevalent among E. coli (42.9%) and P. mirabilis (55.9%). Among Klebsiella spp, the highest percentages of non-susceptibility were observed for extended-spectrum cephalosporins and folate pathway inhibitors (25.0% each). Glycopeptide non-susceptibility was 10.0% for Enterococcus spp. The percentage of isolates classified as MDR ranged from 10.1% for E. coli to 14.7% for P. mirabilis. Conclusions: Substantial levels of non-susceptibility were observed for nursing home residents’ urine isolates, with 10% to 56% reported as non-susceptible to the antibiotics assessed. Non-susceptibility was highest for fluoroquinolones, an antibiotic class commonly used in nursing homes, and ≥ 10% of selected isolates were MDR. Our findings reinforce the importance of nursing homes using susceptibility data from laboratory service providers to guide antibiotic prescribing and to monitor levels of resistance.Disclosures: NoneFunding: None

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