scholarly journals Factors associated with mortality and sequelae in patients living in long-term facilities hospitalized for COVID-19: a longitudinal 6-month follow-up study

2021 ◽  
Vol 106 (106(812)) ◽  
pp. 121-133
Author(s):  
M. Rivera-Izquierdo ◽  
A. Romero-Duarte ◽  
A. Cárdenas-Cruz
Keyword(s):  
Nursing Homes ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
Factors Associated ◽  
Causes Of Mortality ◽  
Main Factors

Objectives: To evaluate the main factors associated with prognosis (mortality, sequelae at 6 months and readmissions) of patients admitted for COVID-19 at the Hospital Clínico San Cecilio who live in a long-term care facility. Methods: Longitudinal observational study carried out on the cohort of 441 patients admitted for COVID-19 confirmed by PCR at the Hospital Clínico San Cecilio between 01/03/20 and 15/04/20. These patients were followed up, through their medical records, for 6 months after discharge. Sociodemographic, admission, clinical, therapeutic and sequelae variables were collected. Descriptive and bivariate analyses and multivariate logistic regression models were performed with R statistical software, through its R Commander tool. Results: The mean age of the cohort was 66.4 years (s=15.3), with 55.1% male. In-hospital mortality was 18.1%. Patients living in nursing homes had higher mean age and higher frequencies of comorbidities, mortality and hospital readmissions. During the 6 months after discharge, they had a high frequency of sequelae (59%), and a higher frequency of confusion, hematologic and nephrological problems, and superinfections. The main factors associated with mortality were advanced age, male sex, admission to the ICU and vulnerability at admission measured with clinical prognostic scales. Conclusions: Living in a long-term care facility was not an independent factor of mortality, but it did bring together a group of special vulnerability to COVID-19. The causes of mortality analysed in this study could be similar to the causes of mortality of elderly people in nursing homes during the first months of the pandemic. These data should serve to optimize strategies for in-hospital management and follow-up of the elderly during the months following hospital discharge, and to try to reduce the unrecorded mortality due to COVID-19 in this population.

Antibiotic-resistant pathogens associated with urinary tract infections in nursing homes: Summary of data reported to the National Healthcare Safety Network Long-Term Care Facility Component, 2013–2017

2020 ◽  
Vol 42 (1) ◽  
pp. 31-36
Author(s):  
Taniece R. Eure ◽  
Nimalie D. Stone ◽  
Elisabeth A. Mungai ◽  
Jeneita M. Bell ◽  
Nicola D. Thompson
Keyword(s):  
Urinary Tract ◽  
Nursing Homes ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Long Term Care Facility ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Tract Infections

AbstractObjective:Antibiotic resistance (AR) is a growing and highly prevalent problem in nursing homes. We describe selected AR phenotypes from pathogens causing urinary tract infections (UTIs) reported by nursing homes to the National Healthcare Safety Network (NHSN).Design:Pathogens and antibiotic susceptibility testing results for UTI events in nursing homes between January 2013 and December 2017 were analyzed. The pathogen distribution and pooled mean proportion of isolates that tested resistant to select antibiotic agents are reported.Setting and Participants:US nursing homes voluntarily participating in the Long-Term Care Facility component of the NHSN.Results:Overall, 243 nursing homes reported 1 or more UTIs: 121 (50%) were nonprofit facilities, median bed size was 91 (range: 9–801), and average occupancy was 87%. In total, 6,157 pathogens were reported for 5,485 UTI events. Moreover, 9 pathogens accounted for 90% of all reported UTIs; the 3 most frequently identified were Escherichia coli (41%), Proteus species (14%), and Klebsiella pneumoniae/oxytoca (13%). Among E. coli, fluoroquinolone, and extended-spectrum cephalosporin resistance were most prevalent (50% and 20%, respectively). Although Staphylococcus aureus and Enterococcus faecium represented <5% of pathogens reported, they had the highest rates of resistance (67% methicillin resistant and 60% vancomycin resistant, respectively). Multidrug resistance was most common in Pseudomonas aeruginosa (11%). For the resistant phenotypes we assessed, 36% of all UTIs reported were associated with a resistant pathogen.Conclusions:This is the first summary of AR among common pathogens causing UTIs reported to NHSN by nursing homes. Improved understanding of the resistance burden among common infections helps inform facility infection prevention and antibiotic stewardship efforts.

No more nursing homes? Changes in consumer preferences for long-term care facilities following COVID-19

2020 ◽  
Vol 26 (11) ◽  
pp. 276-280
Author(s):  
Amber F Schultz ◽  
Jia Yu
Keyword(s):  
Nursing Homes ◽  
Long Term Care ◽  
Consumer Preferences ◽  
Care Facility ◽  
The Elderly ◽  
Term Care ◽  
Long Term Care Facility ◽  
Medical Disorders ◽  
Care Facilities

Since the first COVID-19 case was discovered in December 2019, over 12.1 million cases have been reported in more than 188 countries and territories. In the USA, the Centers for Disease Control and Prevention has confirmed almost 3.05 million COVID-19 cases, with more than 132 000 deaths. The COVID-19 pandemic has had a particularly dramatic impact on the elderly and those with chronic underlying medical disorders. Before the second outbreak in July, long-term care facilities were the most severely affected in terms of case numbers, especially nursing homes. This article provides information and insight into the potential changes in consumer preferences toward long-term care facility selection and the possible structural change of the long-term care industry in three aspects; structure, conduct and performance.

A follow‐up study of change in quality of life among persons with dementia residing in a long‐term care facility

2003 ◽  
Vol 18 (4) ◽  
pp. 275-281 ◽  
Author(s):  
Constantine G. Lyketsos ◽  
Teresa Gonzales‐Salvador ◽  
Jing Jih Chin ◽  
Alva Baker ◽  
Betty Black ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Follow Up Study

Follow-Up of ESBL Positive Residents in a Long Term Care Facility

2011 ◽  
Vol 39 (5) ◽  
pp. E160-E161
Author(s):  
Zoran Pikula ◽  
Sumit Raybardhan ◽  
Wil Ng ◽  
Gladys George ◽  
Diane White ◽  
...  
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

scholarly journals Cultivating a Patient-Centered Environment (CAPE): Renovations in Long-Term Chronic Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 882-882
Author(s):  
Elizabeth Howard ◽  
Tammy Retalic
Keyword(s):  
Long Term Care ◽  
Care Facility ◽  
Functional Independence ◽  
Term Care ◽  
Data Set ◽  
Long Term Care Facility ◽  
Person Centered Care ◽  
Centered Care

Abstract Achieving institutional goal of full, person-centered care was encumbered by an outdated structural “hospital model” at one long-term care facility that undertook building renovations, transforming long hallways into “neighborhood” of compact households. Quality of Life Survey and Long-term Care Minimum Data Set generated data at baseline and 1-year follow-up, comparing renovated(RU) and non-renovated unit(NRU) residents (n=36) to evaluate achievement of person-centered care. RU residents indicating they could “eat when I want” increased 75% to 81% at follow-up and decreased 17% for NRU residents. Sixty-seven percent of RU residents reported bathing “when they want” in contrast to 40% of NRU residents. Most RU residents agreed, “staff act on my suggestions.”More RU residents (68% vs 53%) agreed: “I spend time with other like-minded residents” and more RU residents (86% vs 43%) reported opportunity to explore new skills, interests. RU residents more often reported (50% vs 37%) “people ask for my help or advice.” Similar differences were observed with “it is easy to make friends here,” 67% RU residents responding affirmatively. RU residents reporting “feeling down” improved, moving from 46% to 50% disagreeing with this item with while increased number of NRU residents (18% to 22%) reported “feeling down” at follow-up.Improvement with independent performance of bed mobility, transfer, walking, and dressing among RU residents was observed while NRU residents had decreased percentages of independence. Evaluation of resident outcomes demonstrated improvement with personal choice, activities, personal relationships, functional independence and mood. Physical unit renovations appear to enhance implementation of person-centered care model.

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