America Loves and Cares for Veterans

2021 ◽  
Vol 36 (1) ◽  
pp. 63-63
Author(s):  
Paul Baldwin
Keyword(s):  
Long Term Care ◽  
Veterans Affairs ◽  
State Funding ◽  
Department Of Veterans Affairs ◽  
Term Care ◽  
Us Veterans

The author discusses benefits available to US Veterans starting with the Department of Veterans Affairs and going into state funding and long-term care benefits.

America Loves and Cares for Veterans

2021 ◽  
Vol 36 (1) ◽  
pp. 63-63
Author(s):  
Paul Baldwin
Keyword(s):  
Long Term Care ◽  
Veterans Affairs ◽  
State Funding ◽  
Department Of Veterans Affairs ◽  
Term Care ◽  
Us Veterans

The author discusses benefits available to US Veterans starting with the Department of Veterans Affairs and going into state funding and long-term care benefits.

scholarly journals A Qualitative Work System Analysis Using a Human Factors Engineering Approach to Evaluate Environmental Cleaning in Veterans’ Affairs Hospitals

2021 ◽  
Vol 1 (S1) ◽  
pp. s62-s63
Author(s):  
Linda McKinley ◽  
Cassie Goedken ◽  
Erin Balkenende ◽  
Stacey Hockett Sherlock ◽  
Heather Reisinger ◽  
...  
Keyword(s):  
Human Factors ◽  
System Analysis ◽  
Long Term Care ◽  
Veterans Affairs ◽  
Human Factors Engineering ◽  
Term Care ◽  
Environmental Cleaning ◽  
Veterans Affairs Hospitals ◽  
Environmental Surfaces

Background: Environmental cleaning is important in the interruption of pathogen transmission and subsequent infection. Although recent initiatives have targeted cleaning of high-touch surfaces and incorporated audit-and-feedback monitoring of cleaning practices, practice variations exist and compliance is still reportedly low. Evaluation of human factors influencing variations in cleaning practices can be valuable in developing interventions, leading to standardized practices and improved compliance. We conducted a work system analysis using a human-factors engineering framework [the Systems Engineering Initiative for Patient Safety (SEIPS) model] to identify barriers and facilitators to current environmental cleaning practices within Veterans’ Affairs hospitals. Methods: We conducted semistructured interviews with key stakeholders (ie, environmental staff, nursing, and infection preventionists) at 3 VA facilities across acute-care and long-term care settings. Interviews were conducted among 18 healthcare workers, audio recorded, and transcribed verbatim. Transcripts were analyzed for thematic content within the SEIPS constructs (ie, person, environment, organization, tasks, and tools). Results: Within the SEIPS domain ‘person,’ we found that many environment service (EVS) staff were veterans and were highly motivated to serve fellow veterans, especially to prevent them from acquiring infections. However, the hiring of service members as EVS staff comes with significant hurdles that affect staffing. Within the domain of ‘environment’, EVS staff reported rooms that were either occupied by the patient or were multibed, were more difficult to clean. Conversely, they reported that it was easier to clean in settings where the patient was more likely to be out of bed (eg, long-term care residents). Patient flow and/or movement greatly influenced workload within the ‘organizational’ domain. Workload also changed by patient population and setting (eg, the longer the stay or more critical the patient), increased their workload. EVS staff felt that staffing consistency and experience improved cleaning practices. Within the ‘task’ domain, EVS staff were motivated for cleaning high-touch surfaces; however, knowledge of these surfaces varied. Finally, within the ‘tool’ domain, most EVS staff described having effective cleaning products; however, sometimes in limited supply. Most sites reported some form of monitoring of their cleaning process; however, there was variation in type and frequency. Conclusions: Human-factors analysis identified barriers to and facilitators of cleaning compliance. Incorporating environmental cleaning practices that address barriers and facilitators identified may facilitate standardized cleaning of environmental surfaces. Standardized procedures for cleaning multibed rooms and environmental surfaces surrounding occupied beds may improve cleaning compliance. Future research should evaluate standardized cleaning procedures or bundles that incorporate these best practices and steps to overcoming barriers and pilot feasibility.Funding: NoDisclosures: None

Changes in antibiotic use following implementation of a telehealth stewardship pilot program

2019 ◽  
Vol 40 (7) ◽  
pp. 810-814 ◽  
Author(s):  
Brigid M. Wilson ◽  
Richard E. Banks ◽  
Christopher J. Crnich ◽  
Emma Ide ◽  
Roberto A. Viau ◽  
...  
Keyword(s):  
Antibiotic Stewardship ◽  
Long Term Care ◽  
Antibiotic Use ◽  
Veterans Affairs ◽  
Term Care ◽  
Medical Centers ◽  
Stewardship Program ◽  
Days Of Therapy ◽  
Veterans Affairs Medical Centers

AbstractStarting in 2016, we initiated a pilot tele-antibiotic stewardship program at 2 rural Veterans Affairs medical centers (VAMCs). Antibiotic days of therapy decreased significantly (P < .05) in the acute and long-term care units at both intervention sites, suggesting that tele-stewardship can effectively support antibiotic stewardship practices in rural VAMCs.

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 &lt;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.

Clostridium difficile Infection in a Department of Veterans Affairs Long-Term Care Facility

2011 ◽  
Vol 32 (5) ◽  
pp. 513-515 ◽  
Author(s):  
Dubert M. Guerrero ◽  
Michelle M. Nerandzic ◽  
Lucy A. Jury ◽  
Shelley Chang ◽  
Robin L. Jump ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Long Term Care ◽  
Medical Center ◽  
Care Facility ◽  
Healthcare Facility ◽  
Veterans Affairs ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility

In a Veterans Affairs medical center, 39% of healthcare facility–onset, healthcare facility-associated Clostridium difficile infections had their onset in the affiliated long-term care facility (LTCF). Eighty-five percent of LTCF-onset patients had been transferred from the hospital within the past month. Delays in diagnosis and treatment were common for LTCF-onset patients.

Respiratory Syncytial Virus Outbreak in a Veterans Affairs Long-term Care Facility

2020 ◽  
Vol 28 (4) ◽  
pp. 200-203
Author(s):  
Nancy Barrett ◽  
Lisa Bailey ◽  
Florence Ford ◽  
Monique Thorne ◽  
Nancy Azab ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Long Term Care ◽  
Care Facility ◽  
Veterans Affairs ◽  
Term Care ◽  
Term Care Facility ◽  
Long Term Care Facility ◽  
Syncytial Virus

scholarly journals 857. A Tele-Antibiotic Stewardship Program Influences Antibiotic Use at 2 Rural Veterans Affairs Medical Centers

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S19-S19
Author(s):  
Brigid Wilson ◽  
Richard Banks ◽  
Christopher Crnich ◽  
Emma Ide ◽  
Roberto Viau ◽  
...  
Keyword(s):  
Antibiotic Stewardship ◽  
Long Term Care ◽  
Antibiotic Use ◽  
Veterans Affairs ◽  
Term Care ◽  
Limited Access ◽  
Days Of Therapy ◽  
The Mean ◽  
Length Of Therapy

Abstract Background Telehealth offers the possibility of supporting antibiotic stewardship in settings with limited access to people with infectious diseases (ID) expertise. Previously, we described preliminary results from a pilot project that used the Veterans Affairs (VA) telehealth system to facilitate a Videoconference Antimicrobial Stewardship Team (VAST) which connected a multidisciplinary team from a rural VA medical center (VAMC) with ID physicians at a remote site to support antibiotic stewardship. Here, we present 3 distinct metrics to assess the influence of the VAST on antibiotic use at 2 intervention sites. Methods Outcomes assessed antibiotic use in the hospital and long-term care units of 2 rural VAMCs in the year before and after VAST implementation, allowing for a 1-month wash-in period in the first month of the VAST. Using VA databases, we determined 3 metrics: the rate of antibiotic use (days of therapy per 1,000 bed days of care); the mean length of therapy (days); and the mean patient antibiotic spectrum index (ASI), a measure of antibiotic spectrum increasing from narrow to broad. Using segmented regression on monthly measures of each metric with a knot at the wash-in month (gray square), we calculated predicted values (solid lines), and confidence intervals (dashed lines) to examine trends before (black squares) and after (white squares) implementing the VAST. Results The rate of antibiotic use, mean length of therapy, and ASI decreased at Site A. As indicated in the figure, the effect was more pronounced in long-term care compared with the hospital, where the VAST sustained but did not accelerate downward trends. At Site B, the most notable influence of the VAST was on the ASI for the hospital and long-term care units. Conclusion The VAST is a feasible, sustainable program that is effective at inducing change in antibiotic use at 2 VAMCs. The influence of the VAST differed between the 2 sites and, at Site A had a more pronounced effect on the long-term care compared with hospital units. These distinct metrics capture changes in overall antibiotic use, length of therapy, and agent selection. Tele-antibiotic stewardship programs hold potential to improve antibiotic use at facilities with limited access to people with antibiotic stewardship expertise. Disclosures All authors: No reported disclosures.

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