scholarly journals Correlation of long-term care facility vaccination practices between seasons and resident types

2021 ◽  
Author(s):  
Emily T O’Neill ◽  
Elliott Bosco ◽  
Erin Persico ◽  
Joe B Silva ◽  
Melissa R Riester ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Pearson Correlation ◽  
Care Facility ◽  
Correlation Coefficients ◽  
Source Population ◽  
Short Stay ◽  
Moderate Correlation ◽  
Term Care ◽  
Data Set ◽  
Median Proportion

ABSTRACTObjectivesInfluenza vaccination varies widely across LTCFs due to staff behaviors, LTCF practices, and patient factors. It is unclear how seasonal LTCF vaccination varies between cohabitating but distinct short-stay and long-stay residents. Thus, we assessed the correlation of LTCF vaccination between these populations and across seasons.DesignNational retrospective cohort using Medicare and Minimum Data Set (MDS) data.Setting and ParticipantsU.S. LTCFs. Short-stay and long-stay Medicare-enrolled residents age ≥65 in U.S. LTCFs from a source population of residents during October 1st-March 31st in 2013-2014 (3,042,881 residents; 15,683 LTCFs) and 2014-2015 (3,143,174, residents; 15,667 LTCFs).MethodsMDS-assessed influenza vaccination was the outcome. Pearson correlation coefficients were estimated to assess seasonal correlations between short-stay and long-stay resident vaccination within LTCFs.ResultsThe median proportion of short-stay residents vaccinated across LTCFs was 70.4% (IQR, 50.0-82.7%) in 2013-2014 and 69.6% (IQR, 50.0-81.6%) in 2014-2015. The median proportion of long-stay residents vaccinated across LTCFs was 85.5% (IQR, 78.0-90.9%) in 2013-2014 and 84.6% (IQR, 76.6-90.3%) in 2014-2015. Within LTCFs, there was a moderate correlation between short-stay and long-stay vaccination in 2013-2014 (r=0.50, 95%CI: 0.49-0.51) and 2014-2015 (r=0.53, 95%CI: 0.51-0.54). Across seasons, there was a moderate correlation for LTCFs with short-stay residents (r=0.54, 95%CI: 0.53-0.55) and a strong correlation for those with long-stay residents (r=0.68, 95%CI: 0.67-0.69).Conclusion and ImplicationsIn LTCFs with inconsistent influenza vaccination across seasons or between populations, targeted vaccination protocols for all residents, regardless of stay type, may improve successful vaccination in this vulnerable patient population.Brief summaryIn LTCFs, influenza vaccination was moderately correlated across all residents, but varied across seasons. Inconsistent vaccination among cohabitating residents may increase infection risk in LTCFs.

scholarly journals Long-term Care Facility Variation in the Incidence of Pneumonia and Influenza

2019 ◽  
Vol 6 (6) ◽  
Author(s):  
Elliott Bosco ◽  
Andrew R Zullo ◽  
Kevin W McConeghy ◽  
Patience Moyo ◽  
Robertus van Aalst ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Long Term Care ◽  
Care Facility ◽  
Physician Assistants ◽  
Incidence Rates ◽  
Short Stay ◽  
Term Care ◽  
Data Set ◽  
Facility Level

Abstract Background Pneumonia and influenza (P&I) increase morbidity and mortality among older adults, especially those residing in long-term care facilities (LTCFs). Facility-level characteristics may affect the risk of P&I beyond resident-level risk factors. However, the relationship between facility characteristics and P&I is poorly understood. To address this, we identified potentially modifiable facility-level characteristics that influence the incidence of P&I across LTCFs. Methods We conducted a retrospective cohort study using 2013–2015 Medicare claims linked to Minimum Data Set and LTCF-level data. Short-stay (<100 days) and long-stay (100+ days) LTCF residents were followed for the first occurrence of hospitalization, LTCF discharge, Medicare disenrollment, or death. We calculated LTCF risk-standardized incidence rates (RSIRs) per 100 person-years for P&I hospitalizations by adjusting for over 30 resident-level demographic and clinical covariates using hierarchical logistic regression. Results We included 1 767 241 short-stay (13 683 LTCFs) and 922 863 long-stay residents (14 495 LTCFs). LTCFs with lower RSIRs had more licensed independent practitioners (nurse practitioners or physician assistants) among short-stay (44.9% vs 41.6%, P < .001) and long-stay residents (47.4% vs 37.9%, P < .001), higher registered nurse hours/resident/day among short-stay and long-stay residents (mean [SD], 0.5 [0.7] vs 0.4 [0.4], P < .001), and fewer residents for whom antipsychotics were prescribed among short-stay (21.4% [11.6%] vs 23.6% [13.2%], P < .001) and long-stay residents (22.2% [14.3%] vs 25.5% [15.0%], P < .001). Conclusions LTCF characteristics may play an important role in preventing P&I hospitalizations. Hiring more registered nurses and licensed independent practitioners, increasing staffing hours, and higher-quality care practices may be modifiable means of reducing P&I in LTCFs.

scholarly journals LONG-TERM CARE FACILITY VARIATION IN THE INCIDENCE OF PNEUMONIA AND INFLUENZA HOSPITALIZATIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S821-S822
Author(s):  
Elliott Bosco ◽  
Andrew Zullo ◽  
Kevin McConeghy ◽  
Patience Moyo ◽  
Robertus van Aalst ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Long Term Care ◽  
Care Facility ◽  
Incidence Rates ◽  
Short Stay ◽  
Term Care ◽  
Data Set ◽  
Facility Level ◽  
Physician Extenders

Abstract Pneumonia and influenza (P&I) increase morbidity and mortality among older adults, especially those residing in long-term care facilities (LTCFs). Facility-level characteristics may affect P&I risk beyond resident-level determinants. However, the relationship between facility characteristics and P&I is poorly understood. We therefore identified potentially modifiable facility-level characteristics that might influence the incidence of P&I across LTCFs. We conducted a retrospective cohort study using 100% of 2013-2015 Medicare claims linked to Minimum Data Set 3.0 and LTCF-level data. Short-stay (<100 days) and long-stay (≥100 days) LTCF residents aged ≥65 were followed for the first occurrence of hospitalization, LTCF discharge, Medicare disenrollment, or death. We calculated LTCF risk-standardized incidence rates (RSIRs) per 100 person-years for P&I hospitalizations by adjusting for over 30 resident-level demographic and clinical covariates using hierarchical logistic regression. The final study cohorts included 1,767,241 short-stay (13,683 LTCFs) and 922,863 long-stay residents (14,495 LTCFs). LTCFs with lower RSIRs had more Physician Extenders (Nurse Practitioners or Physician’s Assistants) among short-stay (44.9% vs. 41.6%, p<0.001) and long-stay residents (47.4% vs. 37.9%, p<0.001), higher Registered Nurse hours/resident/day among short-stay and long-stay residents (Mean (SD): 0.5 (0.7) vs. 0.4 (0.4), p<0.001), and fewer residents prescribed antipsychotics among short-stay (21.4% (11.6) vs. 23.6% (13.2), p<0.001) and long-stay residents (22.2% (14.3) vs. 25.5% (15.0), p<0.001). LTCF characteristics may play an important role in preventing P&I hospitalizations. Hiring more Registered Nurses and Physician Extenders, increasing staffing hours, and reducing antipsychotic use may be modifiable means of reducing P&I in LTCFs. Funding provided by Sanofi Pasteur.

Reliability of the Minimum Masking Level as Outcome Variable in Tinnitus Clinical Research

2020 ◽  
Vol 29 (3) ◽  
pp. 429-435
Author(s):  
Patricia C. Mancini ◽  
Richard S. Tyler ◽  
Hyung Jin Jun ◽  
Tang-Chuan Wang ◽  
Helena Ji ◽  
...  
Keyword(s):  
Standard Deviation ◽  
High Frequency ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Outcome Variable ◽  
Reliable Estimate ◽  
Moderate Correlation ◽  
Trained Subjects ◽  
The Relationship ◽  
Minimum Intensity

Purpose The minimum masking level (MML) is the minimum intensity of a stimulus required to just totally mask the tinnitus. Treatments aimed at reducing the tinnitus itself should attempt to measure the magnitude of the tinnitus. The objective of this study was to evaluate the reliability of the MML. Method Sample consisted of 59 tinnitus patients who reported stable tinnitus. We obtained MML measures on two visits, separated by about 2–3 weeks. We used two noise types: speech-shaped noise and high-frequency emphasis noise. We also investigated the relationship between the MML and tinnitus loudness estimates and the Tinnitus Handicap Questionnaire (THQ). Results There were differences across the different noise types. The within-session standard deviation averaged across subjects varied between 1.3 and 1.8 dB. Across the two sessions, the Pearson correlation coefficients, range was r = .84. There was a weak relationship between the dB SL MML and loudness, and between the MML and the THQ. A moderate correlation ( r = .44) was found between the THQ and loudness estimates. Conclusions We conclude that the dB SL MML can be a reliable estimate of tinnitus magnitude, with expected standard deviations in trained subjects of about 1.5 dB. It appears that the dB SL MML and loudness estimates are not closely related.

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.

Relation of Maximal Ankle Dorsiflexion Angle and Passive Resistive Torque to Passive-Elastic Stiffness of Ankle Dorsiflexion Stretch

2002 ◽  
Vol 95 (1) ◽  
pp. 323-325 ◽  
Author(s):  
Richard L. Gajdosik ◽  
Ann K. Williams
Keyword(s):  
Multiple Regression ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Elastic Stiffness ◽  
Ankle Dorsiflexion ◽  
Regression Analyses ◽  
Moderate Correlation ◽  
Ankle Stiffness ◽  
Resistive Torque ◽  
Clinical Measurements

The maximal passive ankle dorsiflexion angle and the maximal passive resistive torque at this angle were measured for 81 women 20 to 84 years of age and correlated with the passive-elastic stiffness (stiffness) of an ankle dorsiflexion stretch. Pearson correlation coefficients and multiple regression analyses were used to examine whether the two clinical measurements could predict ankle stiffness. The maximal passive resistive torque showed a moderate correlation with stiffness in the full stretch range ( r = .69) and high correlation with stiffness in the last half of the full stretch range ( r = .84). The maximal dorsiflexion angle showed a low correlation with stiffness in the full stretch range ( r = .27) and in the last half of the full stretch range ( r = .36). The maximal passive resistive torque and the dorsiflexion angle together accounted for 54% of the stiffness variance in the full stretch range and 76% of the stiffness variance in the last half of the full stretch range. Thus, the clinical measurements of the maximal passive dorsiflexion angle and the maximal passive resistive torque were directly and significantly related to the ankle dorsiflexion passive-elastic stiffness and good predictors of stiffness in the last half of the passive ankle dorsiflexion stretch.

scholarly journals BETTER LIVING THROUGH TECH: TECHNOLOGY-MEDIATED RECREATION AND LONG-TERM CARE FACILITY RESIDENTS’ QUALITY OF LIFE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S442-S442
Author(s):  
Ethan A McMahan ◽  
Marion Godoy ◽  
Abiola Awosanya ◽  
Robert Winningham ◽  
Charles De Vilmorin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Data Set ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Care Facilities

Abstract Empirical research on long-term care facility resident engagement has consistently indicated that increased engagement is associated with more positive clinical outcomes and increased quality of life. The current study adds to this existing literature by documenting the positive effects of technologically-mediated recreational programing on quality of life and medication usage in aged residents living in long-term care facilities. Technologically-mediated recreational programming was defined as recreational programming that was developed, implemented, and /or monitored using software platforms dedicated specifically for these types of activities. This study utilized a longitudinal design and was part of a larger project examining quality of life in older adults. A sample of 272 residents from three long-term care facilities in Toronto, Ontario participated in this project. Resident quality of life was assessed at multiple time points across a span of approximately 12 months, and resident engagement in recreational programming was monitored continuously during this twelve-month period. Quality of life was measured using the Resident Assessment Instrument Minimum Data Set Version 2.0. Number of pharmacological medication prescriptions received during the twelve-month study period was also assessed. Descriptive analyses indicated that, in general, resident functioning tended to decrease over time. However, when controlling for age, gender, and baseline measures of resident functioning, engagement in technologically-mediated recreational programming was positively associated with several indicators of quality of life. The current findings thus indicate that engagement in technology-mediated recreational programming is associated with increased quality of life of residents in long-term care facilities.

The STOP (Staff Taking Ownership for Prevention) FLU Initiative: Improving Influenza Vaccination Rates Among Staff in a Long-Term Care Facility

2012 ◽  
Vol 40 (5) ◽  
pp. e95-e96
Author(s):  
Marguerite O'Donnell ◽  
Kelli Bachman ◽  
Chasity Daugherty ◽  
Holly Hovan ◽  
Michelle Stewart ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Vaccination Rates

scholarly journals The Impact of Rhode Island's Mandatory Health Care Worker Influenza Vaccination Regulation on Influenza Incidence in Long-Term Care Facility Residents

2018 ◽  
Author(s):  
Wendy Chicoine
Keyword(s):  
Health Care ◽  
Influenza Vaccination ◽  
Rhode Island ◽  
Health Care Workers ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Care Workers ◽  
The Impact

Seasonal influenza is a serious public health problem that contributes to significant morbidity and mortality locally, nationally, and globally. The Centers for Disease Control and Prevention (CDC) estimates that influenza has caused between 9.2 million and 60.8 million illnesses, between 140,000 and 710,000 hospitalizations, and between 12,000 and 56,000 deaths annually since 2010, and approximately 80- 90 percent of influenza related deaths occurred in people 65 years and older. In 2012, prompted by the mounting\ evidence of the risk of nosocomial influenza infection for patients and low influenza vaccination rates of health care workers, the Rhode Island Department of Health (RIDOH) amended its Rules and Regulations for Immunization and Testing for Healthcare Workers. This amendment included mandatory influenza vaccinations for all health care workers, students, volunteers, and trainees who have direct patient contact within a health care facility. The purpose of this study was to evaluate the impact of the regulation of mandating influenza vaccination for health care workers in Rhode Island on influenza incidence, hospitalizations, and deaths of residents of long-term care facilities (LTCF). Surveillance data for influenza incidence, hospitalizations, and deaths among residents of LTCF pre and post the policy implementation are analyzed and results presented. Policy and practice implications for public health nursing are discussed.

scholarly journals Surveillance of COVID-19 vaccination in US nursing homes, December 2020-April 2021

2021 ◽  
Author(s):  
Andrew I Geller ◽  
Daniel S Budnitz ◽  
Heather Dubendris ◽  
Radhika Gharpure ◽  
Minn Minn Soe ◽  
...  
Keyword(s):  
Vaccination Coverage ◽  
Long Term Care ◽  
Pearson Correlation ◽  
Vaccine Dose ◽  
Correlation Coefficients ◽  
Care Program ◽  
High Coverage ◽  
Term Care ◽  
National Healthcare Safety Network

Monitoring COVID-19 vaccination coverage among nursing home (NH) residents and staff is important to ensure high coverage and guide patient-safety policies. With the termination of the federal Pharmacy Partnership for Long-Term Care Program, another source of facility-based vaccination data is needed. We compared numbers of COVID-19 vaccinations administered to NH residents and staff reported by pharmacies participating in the temporary federal Pharmacy Partnership for Long-Term Care Program with those reported by NHs participating in new COVID-19 vaccination modules of CDC's National Healthcare Safety Network (NHSN). Pearson correlation coefficients comparing the number vaccinated between the two approaches were 0.89, 0.96, and 0.97 for residents and 0.74, 0.90, and 0.90 for staff, in the weeks ending January 3, 10, and 17, respectively. Based on subsequent NHSN reporting, vaccination coverage with ≥1 vaccine dose reached 77% for residents and 50% for staff the week ending January 31 and plateaued through April 2021.

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