Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 20:11:1333523.
doi: 10.3389/fmed.2024.1333523. eCollection 2024.

Implementation of a program for treatment of acute infections in nursing homes without hospital transfer

Nadya Kagansky  1   2 , Reena Rosenberg  1   3 , Estela Derazne  3 , Evelina Mazurez  1 , Yochai Levy #  3   4 , Micha Barchana #  5
Affiliations

Implementation of a program for treatment of acute infections in nursing homes without hospital transfer

Nadya Kagansky et al. Front Med (Lausanne). .

Abstract

Background: Nursing care residents have high hospitalization rates. To address this, we established a unique virtual geriatric unit that has developed a program aimed at providing support to nursing homes.

Aims: We aimed to evaluate effectiveness of in-house intravenous antibiotic treatment in nursing hospitals after the implementation of the specially designed training program.

Methods: A cohort study of nursing home residents to evaluate a training program for providers, designed to increase awareness and give practical tools for in-house treatment of acute infections. Data obtained included types of infections, antibiotics used, hospital transfer, and length of treatment. Primary outcomes were in-house recovery, hospitalization and mortality. Univariate analysis and multivariable logistic regression analysis to assess association between different factors and recovery.

Results: A total of 890 cases of acute infections were treated with intravenous antibiotics across 10 nursing homes over a total of 4,436 days. Of these cases, 34.8% were aged 90 years or older. Acute pneumonia was the most prevalent infection accounted for 354 cases (40.6%), followed by urinary tract infections (35.7%), and fever of presumed bacterial infection (17.1%). The mean duration of intravenous antibiotic treatment was 5.09 ± 3.86 days. Of the total cases, 800 (91.8%) recovered, 62 (7.1%) required hospitalization and nine (1.0%) resulted in mortality. There was no significant difference observed in recovery rates across different types of infections.

Discussion: Appling a simple yet unique intervention program has led to more "in-house" residents receiving treatment, with positive clinical results.

Conclusion: Treating in-house nursing home residents with acute infections resulted in high recovery rates. Special education programs and collaboration between healthcare organizations can improve treatment outcomes and decrease the burden on the healthcare system.

Keywords: acute infections; hospitalization; intravenous; nursing homes; training program.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Factors associated with recovery–results from multivariable logistic regression*. *Variables included in the model: diagnosis, patient sex and age, antibiotic type, days of antibiotic treatment, nursing homes type and year of treatment. Variables not statistically significant were not included in figure. UTI, urinary tract infection, COPD, chronic obstructive pulmonary disease, OR, Odds Ratio.
Figure 2
Figure 2
Decision tree for classification patients according to recovery.
Figure 3
Figure 3
Description of included cases.
See this image and copyright information in PMC

References

    1. Fry AM, Shay DK, Holman RC, Curns AT, Anderson LJ. Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States, 1988-2002. JAMA. (2005) 7:2712–9. doi: 10.1001/jama.294.21.2712 - DOI - PubMed
    1. Kruger K, Jansen K, Grimsmo A, Eide GE, Geitung GT. Hospital admissions from nursing homes: rates and reasons. Nurs Res Pract. (2011) 2011:1–6. doi: 10.1155/2011/247623, PMID: - DOI - PMC - PubMed
    1. Cheng VC, Tai JW, Wong ZS, Chen JHK, Pan KBQ, Hai Y, et al. . Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong. BMC Infect Dis. (2013) 13:205–15. doi: 10.1186/1471-2334-13-205, PMID: - DOI - PMC - PubMed
    1. Strausbaugh LJ, Sukumar SR, Joseph CL. Infectious disease outbreaks in nursing homes: an unappreciated Hazard for frail elderly persons. CID. (2003) 36:870–6. doi: 10.1086/368197, PMID: - DOI - PubMed
    1. Hullick C, Conway J, Higgins I, Hewitt J, Dilworth S, Holliday E, et al. . Emergency department transfers and hospital admissions from residential aged care facilities: a controlled pre-post design study. BMC Geriatr. (2016) 16:102–12. doi: 10.1186/s12877-016-0279-1, PMID: - DOI - PMC - PubMed

LinkOut - more resources