Isolation Precautions Use for Multidrug-Resistant Organism Infection in Nursing Homes
| Autor: | Catherine Crawford Cohen, Patricia W. Stone, Andrew W. Dick |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Gerontology
Male medicine.medical_specialty Isolation (health care) Quality Assurance Health Care Datasets as Topic 030501 epidemiology Article Patient Isolation 03 medical and health sciences 0302 clinical medicine Catheters Indwelling Anti-Infective Agents Isolation precautions medicine Infection control Humans 030212 general & internal medicine Mobility Limitation Retrospective Studies Aged 80 and over Minimum Data Set Cross Infection Transmission (medicine) business.industry Universal Precautions Drug Resistance Multiple United States Nursing Homes Cross-Sectional Studies Outcome and Process Assessment Health Care Emergency medicine Female Nursing Staff Geriatrics and Gerontology 0305 other medical science business Nursing homes Medicaid Health care quality |
| Zdroj: | Journal of the American Geriatrics Society. 65(3) |
| ISSN: | 1532-5415 |
| Popis: | Objectives To examine factors associated with isolation precaution use in nursing home (NH) residents with multidrug-resistant organism (MDRO) infection. Design Retrospective, cross-sectional analysis. Setting Nursing homes with Centers for Medicare and Medicaid Services’ certification from October 2010 to December 2013. Participants Elderly, long-stay NH residents with positive MDRO infection assessments. Measurements Data were obtained from the Minimum Data Set (MDS) 3.0, Certification and Survey Provider Enhanced Reporting, and Area Health Resource File. Multivariable regression with facility fixed effects was conducted. Results The sample included 191,816 assessments of residents with MDRO infection, of which isolation use was recorded in 12.8%. Of the NHs reporting MDRO infection in the past year, 31% used isolation at least once among residents with MDRO infection. Resident characteristics positively associated with isolation use included locomotion (23.6%, P < .001) and eating (17.9%, P < .001) support. Isolation use was 14.3% lower in those with MDRO history (P < .001). Residents in NHs that had received an infection control–related citation in the past year had a greater probability of isolation use (3.4%, P = .02); those in NHs that had received a quality-of-care citation had lower probability of isolation use (−3.3%, P = .03). Conclusion This is the first study to examine the new MDS 3.0 isolation and MDRO items. Isolation was infrequently used, and the proportion of isolated MDRO infections varied between facilities. Inspection citations were related to isolation use in the following year. Further research is needed to determine whether and when isolation should be used to best decrease risk of MDRO transmission and improve quality of care. |
| Databáze: | OpenAIRE |
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