Nosocomial infection in long-term care facilities. A survey in a Brazilian psychiatric hospital

Nosocomial infection among male patients in a public psychiatric hospital was studied and the definitions for use in long-term care facilities were employed for diagnosis. The overall nosocomial infection rate was 6.7 per 1,000 day inpatients; 55.6% of these infections were identified in the respiratory tract, 50% of them being respiratory viral diseases; 38.9% of the nosocomial infections involved the eyes, ears, nose, throat and mouth, and 5.6% involved the skin and soft tissues. The epidemiological characteristics and the main clinical alterations of these inpatients were also identified.

Measuring the diffusion of palliative care in long-term care facilities - a death census

ABSTRACT: BACKGROUND: The dissemination of palliative care for patients presenting complex chronic diseases at various stages has become an important matter of public health. A death census in Swiss long-term care facilities (LTC) was set up with the aim of monitoring the frequency of selected indicators of palliative care. METHODS: The survey covered 150 LTC facilities (105 nursing homes and 45 home health services), each of which was asked to complete a questionnaire for every non-accidental death over a period of six months. The frequency of 4 selected indicators of palliative care (resort to a specialized palliative care service, the administration of opiates, use of any pain measurement scale or other symptom measurement scale) was monitored in respect of the stages of care and analysed based on gender, age, medical condition and place of residence. RESULTS: Overall, 1200 deaths were reported, 29.1% of which were related to cancer. The frequencies of each indicator varied according to the type of LTC, mostly regarding the administration of opiate. It appeared that the access to palliative care remained associated with cancer, terminal care and partly with age, whereas gender and the presence of mental disorders had no effect on the indicators. In addition, the use of drugs was much more frequent than the other indicators. CONCLUSION: The profile of patients with access to palliative care must become more diversified. Among other recommendations, equal access to opiates in nursing homes and in home health services, palliative care at an earlier stage and the systematic use of symptom management scales when resorting to opiates have to become of prime concern.

Radio frequency identification (RFID) of dentures in long-term care facilities.

STATEMENT OF PROBLEM: The difficulty of identifying the ownership of lost dentures when found is a common and expensive problem in long term care facilities (LTCFs) and hospitals. PURPOSE: The purpose of this study was to evaluate the reliability of using radiofrequency identification (RFID) in the identification of dentures for LTCF residents after 3 and 6 months. MATERIAL AND METHODS: Thirty-eight residents of 2 LTCFs in Switzerland agreed to participate after providing informed consent. The tag was programmed with the family and first names of the participants and then inserted in the dentures. After placement of the tag, the information was read. A second and third assessment to review the functioning of the tag occurred at 3 and 6 months, and defective tags (if present) were reported and replaced. The data were analyzed with descriptive statistics. RESULTS: At the 3-month assessment of 34 residents (63 tags) 1 tag was unreadable and 62 tags (98.2%) were operational. At 6 months, the tags of 27 of the enrolled residents (50 tags) were available for review. No examined tag was defective at this time period. CONCLUSIONS: Within the limits of this study (number of patients, 6-month time span) RFID appears to be a reliable method of tracking and identifying dentures, with only 1 of 65 devices being unreadable at 3 months and 100% of 50 initially placed tags being readable at the end of the trial.

Report of the Interdepartmental Working Group on Long Term Care, 2006

Report of the Interdepartmental Working Group on Long Term Care, 2006 This report was finalised by the working group at the end of 2005 and submitted to Government in January 2006. While the reportâ?Ts proposals were not formally endorsed by Government, its analysis and recommendations have informed subsequent decisions, including the Fair Deal policy on Long-Term Nursing Home Care.The principles underpinning the report formed the basis for discussions about long term care with the Social Partners prior to the new national programme negotiations leading to a clear vision articulated in Towards 2016 on a number of priority actions to support older people to participate in society in a full and meaningful way. Click here to download PDF 693kb

An evaluation of the inappropriate prescribing in older residents in long term care facilities in the greater Cork and Northern Ireland regions using the STOPP and Beers' criteria.

This work has highlighted a number of areas of prescribing concern, for example, the long term use of both benzodiazepines and hypnotics, in older residents residing in long term care facilities. Each of these individual areas should be further investigated to determine the underlying reason(s) for the prescribing concerns in these areas and strategic methods of addressing and preventing further issues should be developed on a national level.This resource was contributed by The National Documentation Centre on Drug Use.

CARDI Research Brief: Future demand for long-term care in Ireland

With the population across the island of Ireland growing older, the issue of how to provide and pay for care in the home and in residential settings is becoming more urgent. It is important that a strategy for providing long-term care for an ageing population is put in place, and understanding what the demand for care will be is a major part of this. As a result, CARDI funded a research project led by Professor Charles Normand at Trinity College Dublin which aimed to develop a predictive model of future long-term care demand in NI and ROI.This research brief contains information collated by CARDI and a summary of the findings in the full report, Towards the Development of a Predictive Model of Long-Term Care Demand for Northern Ireland and the Republic of Ireland (Wren et al., 2012).

Northern Ireland Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in Long Term Care Facilities

The Northern Ireland Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in Long Term Care Facilities, also known as the 'HALT' survey was conducted as part of the 2013 European Centre for Disease Prevention and Control (ECDC) European HALT survey.In May 2013, 42 Northern Ireland long-term care facilities (nursing and residential homes) participated in a European point prevalence survey of healthcare-associated infections and antimicrobial use. Thirty-one privately owned nursing homes and 11 HSC Trust-controlled residential homes took part.The report and results have highlighted priority areas for future interventions to prevent and control HCAI, antimicrobial stewardship and future local and national prevalence surveys in long-term care facilities. The 2013 European report was published on 5th May 2014.

Office of the State Long-Term Care Ombudsman Annual Report 2004, January 2005.

The State Long-Term Care Ombudsman program operates as a unit within the Office of Elder Rights at Iowa Department of Elder Affairs. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, residential care facilities, elder group homes and assisted living programs. Iowa’s State Long-Term Care Ombudsman’s Office has gone through many changes this past year ranging from staff changes to increase in jurisdiction area. Jeanne Yordi is now the State Long-Term Care Ombudsman, joining this promotion, will be three additional Long-Term Care Ombudsmen to the unit. With additional staff this office hopes to create more public awareness; however, cases and complaints are top priority as this office may begin to fulfill the mandates of the Older Americans Act.

Office of the State Long-Term Care Ombudsman Annual Report 2007, January 2008.

The State Long-Term Care Ombudsman program operates as a unit within the Office of Elder Rights at Iowa Department of Elder Affairs. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, residential care facilities, elder group homes and assisted living programs. With the addition of 2 ombudsmen, regional offices were closed and 7 local programs were established in 2007. Local long-term care ombudsmen are becoming more aware of issues that need to be addressed, yet as evidenced by the tables included in this report, the increase in work load has been phenomenal, and is reaching the point of being unmanageable with the current staff.

Office of the State Long-Term Care Ombudsman Annual Report 2006, January 2007

The State Long-Term Care Ombudsman program operates as a unit within the Office of Elder Rights at Iowa Department of Elder Affairs. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, residential care facilities, elder group homes and assisted living programs. With an increasing number of complaints for federal fiscal year 2006 this office continues to struggle with fulfilling all of the mandates of the Older Americans Act. Complaint investigations and working with residents and families remain the priority.

Office of the State Long-Term Care Ombudsman Annual Report 2005, January 2006.

The State Long-Term Care Ombudsman program operates as a unit within the Office of Elder Rights at Iowa Department of Elder Affairs. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, residential care facilities, elder group homes and assisted living programs. Cases and complaints remain to be this office’s top priority. Facility closures take a tremendous amount of time, and with 1 Long-Term Care Ombudsman per 10,500 beds this office struggles to meet all of the mandates of the Older Americans Act.

Office of the State Long-Term Care Ombudsman Annual Report 2008, January 2009

The State Long-Term Care Ombudsman program operates as a unit within the Iowa Department of Elder Affairs. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, skilled nursing facilities, residential care facilities, nursing facilities in hospitals, elder group homes and assisted living programs. The long-term care system in Iowa has changed significantly over the past 10 years. Local long-term care ombudsman programs in Iowa are now well established. Iowa still ranks near the bottom of 53 ombudsman programs in the nation for ratio of paid staff to residents with one ombudsman for each 7,400 residents compared to the national average of one ombudsman for each 2,174 residents. The Resident Advocate Committee Program remains stable at 2400 volunteers and Iowa continues to be the only state in the nation with this type of program. Because volunteers do not receive training as required by the Administration on Aging, volunteers are not certified volunteer ombudsmen and the work done by these volunteers cannot be included in Iowa’s annual federal reports. With the changing population living in long-term care facilities, this volunteer job is much more challenging than in the past. Helping to build a long-term care system in Iowa that provides individualized, person-directed quality care is the long-term goal for this office.

Iowa Department on Aging Office of the State Long-Term Care Ombudsman Annual Report 2009, (Federal Fiscal Year October 1, 2008 through September 30, 2009), January 2010.

The State Long-Term Care Ombudsman program operates as a unit within the Iowa Department on Aging. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, skilled nursing facilities, residential care facilities, nursing facilities in hospitals, elder group homes and assisted living programs. In order to carry out all of the mandates of the Older Americans Act this office recommends to increase the number of staff and create a volunteer ombudsman program. NOTE: The second file includes a correction to the report on page 8.

Iowa Department on Aging Office of the State Long-Term Care Ombudsman Annual Report 2010 (Federal Fiscal Year October 1, 2009 through September 30, 2010), January 2011.

The State Long-Term Care Ombudsman program operates as a unit within the Iowa Department on Aging. Duties of all long-term care ombudsmen are mandated by the Older Americans Act. This office serves people living in nursing facilities, skilled nursing facilities, residential care facilities, nursing facilities in hospitals, elder group homes and assisted living programs. In order to carry out all of the mandates of the Older Americans Act this office recommends to increase the number of local long-term care ombudsman, develop a volunteer long-term care ombudsman program, clarify the definition of assisted living in Iowa, expand the long-term care ombudsman program into home and community based services, and reinstate the Iowa Office of Substitute Decision Maker.