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. 2013 May;61(5):782-7.
doi: 10.1111/jgs.12206. Epub 2013 Apr 16.

Specialty care delivery: bringing infectious disease expertise to the residents of a Veterans Affairs long-term care facility

Robin L P Jump  1 , Danielle M Olds, Lucy A Jury, Brett Sitzlar, Elie Saade, Brook Watts, Robert A Bonomo, Curtis J Donskey
Affiliations

Specialty care delivery: bringing infectious disease expertise to the residents of a Veterans Affairs long-term care facility

Robin L P Jump et al. J Am Geriatr Soc. 2013 May.

Abstract

Objective: To initiate a long-term care facility (LTCF) infectious disease (LID) service that provides on-site consultations to LTCF residents to improve the care of residents with possible infections.

Design: Clinical demonstration project.

Setting: A 160-bed LTCF affiliated with a tertiary care Veterans Affairs (VA) hospital.

Participants: Residents referred to the LID team.

Measurements: The reason for and source of LTCF residents' referral to the LID team and their demographic characteristics, infectious disease diagnoses, interventions, and hospitalizations were determined.

Results: Between July 2009 and December 2010, the LID consultation service provided 291 consultations for 250 LTCF residents. Referrals came from LTCF staff (75%) or the VA hospital's ID consult service (25%). The most common diagnoses were Clostridium difficile infection (14%), asymptomatic bacteriuria (10%), and urinary tract infection (10%). More than half of referred residents were receiving antibiotic therapy when they first saw the LID team; 46% of residents required an intervention. The most common interventions, stopping (32%) or starting (26%) antibiotics, were made in accordance with principles of antibiotic stewardship.

Conclusion: The LID team represents a novel and effective means to bring subspecialty care to LTCF residents.

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Figures

Figure 1
Figure 1
The number of new consultations (A) and the percentage of interventions (B) made by the LID service during the study period.
See this image and copyright information in PMC

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