scholarly journals Health care strategies in long-term care facilities in Bahia State, Brazil

2021 ◽  
Vol 15 ◽  
Author(s):  
Meirelayne Borges Duarte ◽  
João Victor Nunes Freitas ◽  
Rafaela Andrade Correia ◽  
Mônica Hupsel Frank ◽  
Helena Patáro de Oliveira Novaes ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Long Term Care ◽  
The State ◽  
Lower Percentage ◽  
Care Providers ◽  
Term Care ◽  
Care Facilities ◽  
Health Care Strategies

OBJECTIVE: To describe health care strategies for older people living in long-term care facilities (LTCFs) in Bahia state, Brazil. METHODS: This is an ecological study involving LTCFs identified in Bahia state, which were invited to participate in a survey conducted between April and June 2021. The variables of interest were LTCF characteristics, health care strategies, visits received from national public health system (SUS, in Portuguese) teams, and health care actions taken by SUS. A comparative analysis was performed between LTCFs located in the East macro-region and other parts of the state, in general and also stratified by funding type (private and non-private). RESULTS: The sample consisted of 177 LTCFs, more than half of them were located in the East macro-region, seat of the state capital. Most facilities declared themselves as non-private (68%). Less than one-third of the LTCFs had their own health teams. Although 67% of LTCFs reported some health care provided by SUS, only 49% reported clinical consultations, with even lower percentages for other SUS actions, except for vaccination (91%). The East macro-region had a lower percentage of LTCFs accompanied by a SUS team, and the highest percentage of LTCFs with supplementary health insurance. CONCLUSIONS: This study shows the limited access of LTCF residents to essential health services, due to a general neglect of this population by public health care providers. The inadequacy of public policies to support LTCFs has important consequences for the quality of care offered to residents.

scholarly journals Perspectives and experiences of compassion in long-term care facilities within Canada: a qualitative study of patients, family members and health care providers

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lorraine Smith-MacDonald ◽  
Lorraine Venturato ◽  
Paulette Hunter ◽  
Sharon Kaasalainen ◽  
Tamara Sussman ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Long Term Care ◽  
Family Members ◽  
Care Providers ◽  
Term Care ◽  
Care Facilities

Patient-Centered Communication Survey of Nursing Homes and Rehabilitation Centers

2007 ◽  
Vol 8 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Amy Skinder-Meredith ◽  
Lynn Bye ◽  
Kari Bulthuis ◽  
Angie Schueller
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Long Term Care ◽  
Communication Disorders ◽  
Care Providers ◽  
Patient Centered ◽  
Term Care ◽  
Rehabilitation Centers ◽  
Care Facilities

A surge of research has recently been published on the importance of patient-centered communication (P-CC). However, patients with communication disorders are rarely considered in these discussions. Health care workers in long-term care facilities (L-TCFs) and rehabilitation centers were surveyed in order to: (1) assess the level of P-CC used with people with communication disorders versus those without communication disorders; (2) identify the tools and strategies currently used by health care providers in long-term care facilities and rehabilitation centers to enhance P-CC with people with communication disorders; (3) assess the perceived level of effectiveness of these tools and strategies; and (4) identify the tools desired by health care providers in these settings. The results regarding P-CC levels were fairly consistent across settings. Health care providers reported that they achieve slightly higher P-CC with patients without communication disorders than with those with communication disorders. Respondents in both settings used similar tools and strategies, but the reported level of effectiveness varied greatly between the two settings, with rehabilitation centers indicating better success than L-TCFs. Interestingly, rehabilitation center respondents were more interested in obtaining additional tools than were L-TCF respondents, but the types of tools desired were similar.

scholarly journals The Impact of Enhanced Antimicrobial Stewardship Support on Antibiotic Starts in Long-Term Care Facilities

2020 ◽  
Vol 41 (S1) ◽  
pp. s527-s527
Author(s):  
Gabriela Andujar-Vazquez ◽  
Kirthana Beaulac ◽  
Shira Doron ◽  
David R Snydman
Keyword(s):  
Public Health ◽  
Pilot Study ◽  
Infection Control ◽  
Antimicrobial Stewardship ◽  
Long Term Care ◽  
Medical Center ◽  
Term Care ◽  
Care Facilities ◽  
The Impact

Background: The Tufts Medical Center Antimicrobial Stewardship (ASP) Team has partnered with the Massachusetts Department of Public Health (MDPH) to provide broad-based educational programs (BBEP) to long-term care facilities (LTCFs) in an effort to improve ASP and infection control practices. LTCFs have consistently expressed interest in individualized and hands-on involvement by ASP experts, yet they lack resources. The goal of this study was to determine whether “enhanced” individualized guidance provided by an ASP expert would lead to antibiotic start decreases in LTCFs participating in our pilot study. Methods: A pilot study was conducted to test the feasibility and efficacy of providing enhanced ASP and infection control practices to LTCFs. In total, 10 facilities already participating in MDPH BBEP and submitting monthly antibiotic start data were enrolled, were stratified by bed size and presence of dementia unit, and were randomized 1:1 to the “enhanced” group (defined as reviewing protocols and antibiotic start cases, providing lectures and feedback to staff and answering questions) versus the “nonenhanced” group. Antibiotic start data were validated and collected prospectively from January 2018 to July 2019, and the interventions began in April 2019. Due to staff turnover and lack of engagement, intervention was not possible in 2 of the 5 LTCFs randomized to the enhanced group, which were therefore analyzed as a nonenhanced group. An incidence rate ratios (IRRs) with 95% CIs were calculated comparing the antibiotic start rate per 1,000 resident days between periods in the pilot groups. Results: The average bed sizes for enhanced groups versus nonenhanced groups were 121 (±71.0) versus 108 (±32.8); the average resident days per facility per month were 3,415.7 (±2,131.2) versus 2,911.4 (±964.3). Comparatively, 3 facilities in the enhanced group had dementia unit versus 4 in the nonenhanced group. In the per protocol analysis, the antibiotic start rate in the enhanced group before versus after the intervention was 11.35 versus 9.41 starts per 1,000 resident days (IRR, 0.829; 95% CI, 0.794–0.865). The antibiotic start rate in the nonenhanced group before versus after the intervention was 7.90 versus 8.23 antibiotic starts per 1,000 resident days (IRR, 1.048; 95% CI, 1.007–1.089). Physician hours required for ASP for the enhanced group totaled 8.9 (±2.2) per facility per month. Conclusions: Although the number of hours required for intervention by an expert was not onerous, maintaining engagement proved difficult and in 2 facilities could not be achieved. A statistically significant 20% decrease in the antibiotic start rate was achieved in the enhanced group after interventions, potentially reflecting the benefit of enhanced ASP support by an expert.Funding: This study was funded by the Leadership in Epidemiology, Antimicrobial Stewardship, and Public Health (LEAP) fellowship training grant award from the CDC.Disclosures: None

scholarly journals Early warning and rapid public health response to prevent COVID-19 outbreaks in long-term care facilities (LTCF) by monitoring SARS-CoV-2 RNA in LTCF site-specific sewage samples and assessment of antibodies response in this population: prospective study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e052282
Author(s):  
Bonita E Lee ◽  
Christopher Sikora ◽  
Douglas Faulder ◽  
Eleanor Risling ◽  
Lorie A Little ◽  
...  
Keyword(s):  
Public Health ◽  
Early Warning ◽  
Early Warning System ◽  
Long Term Care ◽  
Warning System ◽  
Control Measures ◽  
Term Care ◽  
Site Specific ◽  
Care Facilities

IntroductionThe COVID-19 pandemic has an excessive impact on residents in long-term care facilities (LTCF), causing high morbidity and mortality. Early detection of presymptomatic and asymptomatic COVID-19 cases supports the timely implementation of effective outbreak control measures but repetitive screening of residents and staff incurs costs and discomfort. Administration of vaccines is key to controlling the pandemic but the robustness and longevity of the antibody response, correlation of neutralising antibodies with commercial antibody assays, and the efficacy of current vaccines for emerging COVID-19 variants require further study. We propose to monitor SARS-CoV-2 in site-specific sewage as an early warning system for COVID-19 in LTCF and to study the immune response of the staff and residents in LTCF to COVID-19 vaccines.Methods and analysisThe study includes two parts: (1) detection and quantification of SARS-CoV-2 in LTCF site-specific sewage samples using a molecular assay followed by notification of Public Health within 24 hours as an early warning system for appropriate outbreak investigation and control measures and cost–benefit analyses of the system and (2) testing for SARS-CoV-2 antibodies among staff and residents in LTCF at various time points before and after COVID-19 vaccination using commercial assays and neutralising antibody testing performed at a reference laboratory.Ethics and disseminationEthics approval was obtained from the University of Alberta Health Research Ethics Board with considerations to minimise risk and discomforts for the participants. Early recognition of a COVID-19 case in an LTCF might prevent further transmission in residents and staff. There was no direct benefit identified to the participants of the immunity study. Anticipated dissemination of information includes a summary report to the immunity study participants, sharing of study data with the scientific community through the Canadian COVID-19 Immunity Task Force, and prompt dissemination of study results in meeting abstracts and manuscripts in peer-reviewed journals.

Improving the Fate of Nursing Homes During the COVID-19 Pandemic: The Need for Policy

2021 ◽  
pp. e1-e3
Author(s):  
R. Tamara Konetzka
Keyword(s):  
Public Health ◽  
United States ◽  
New York ◽  
Nursing Homes ◽  
Long Term Care ◽  
New York Times ◽  
The United States ◽  
Term Care ◽  
Care Facilities

Approximately 40% of all COVID-19 deaths in the United States have been linked to long-term care facilities.1 Early in the pandemic, as the scope of the problem became apparent, the nursing home sector generated significant media attention and public alarm. A New York Times article in mid-April referred to nursing homes as “death pits”2 because of the seemingly uncontrollable spread of the virus through these facilities. This devastation continued during subsequent surges,3 but there is a role for policy to change this trajectory. (Am J Public Health. Published online ahead of print January 28, 2021: e1–e3. https://doi.org/10.2105/AJPH.2020.306107 )

Survey of health care personnel's attitudes toward oral hygiene in long‐term care facilities in Finland

2019 ◽  
Vol 39 (6) ◽  
pp. 557-563
Author(s):  
Kaija Hiltunen ◽  
Nele Fogelholm ◽  
Riitta K. T. Saarela ◽  
Päivi Mäntylä
Keyword(s):  
Health Care ◽  
Oral Hygiene ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities

Mealtimes as Active Processes in Long-term Care Facilities

2005 ◽  
Vol 66 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Amie J. Gibbs-Ward ◽  
Heather H. Keller
Keyword(s):  
Long Term Care ◽  
Comparison Method ◽  
Theory Approach ◽  
Care Providers ◽  
Term Care ◽  
Individualized Care ◽  
People With Dementia ◽  
Care Facilities ◽  
Active Processes

Mealtimes are central to the nutritional care of residents in long-term care facilities. There has been little Canadian research to guide interdisciplinary practice around mealtimes. This study included a grounded theory approach to explore mealtime experiences of 20 people with dementia living in two long-term care facilities, and the meal-related care they received from registered nurses, health care aides, and dietitians. Theoretical sampling directed the collection and analysis of data from mealtime observations in special care units and key informant interviews with care providers. The constant comparison method was used to analyze and conceptualize the data. A substantive theory emerged with three key themes: Each mealtime is a unique process embedded within a long-term care facility's environment. Residents are central to the process through their actions (i.e., arriving, eating, waiting, socializing, leaving, and miscellaneous distracted activities). Internal (i.e., residents’ characteristics) and external (i.e., co-resident, direct caregiving, indirect caregiving, administrative, and government activities) influences affect residents’ actions at mealtimes. The theory suggests that optimal mealtime experiences for residents require individualized care that reflects interdisciplinary, multi-level interventions.

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