Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-06T10:16:38.273Z Has data issue: false hasContentIssue false
  • English
  • Français

Documentation and Evaluation of Fevers in Hospital-Based and Community-Based Nursing Homes

Published online by Cambridge University Press:  21 June 2016

Timothy R. Franson ,
Jeffrey M. Schicker ,
Susan M. LeClair ,
Raymond G. Hoffmann  and
Edmund H. Duthie Jr.
Timothy R. Franson
Affiliation:
Sections of Infectious Disease, Medical Service, Zablocki Veterans Administration Medical Center, Milwaukee, Wisconsin
Jeffrey M. Schicker
Affiliation:
Geriatrics/Gerontology, Medical Service, Zablocki Veterans Administration Medical Center, Milwaukee, Wisconsin
Susan M. LeClair
Affiliation:
Geriatrics/Gerontology, Medical Service, Zablocki Veterans Administration Medical Center, Milwaukee, Wisconsin
Raymond G. Hoffmann
Affiliation:
Division of Biostatistics and Clinical Epidemiology, Medical College of Wisconsin, Milwaukee, Wisconsin
Edmund H. Duthie Jr.*
Affiliation:
Geriatrics/Gerontology, Medical Service, Zablocki Veterans Administration Medical Center, Milwaukee, Wisconsin
*
Medical Service/11 I P, VA Medical Center, 5000 W.National Ave., Milwaukee, WI 53295
Get access Rights & Permissions [Opens in a new window]

Abstract

Abstract

We reviewed clinical evaluation practices and documentation of fever (>100.2°F) in all febrile patients over a two-month period in a hospital-based nursing home (HBNH) compared with a community-based nursing home (CBNH). Results showed 38 febrile (mean 101.9°F) HBNH patients and 26 febrile (mean 101.5°F) CBNH patients. Median time from fever onset to physician contact was 4 hours in HBNH and 12.5 hours in CBNH episodes (P<0.01). Laboratory studies were initially performed in 68% of HBNH and 31% of CBNH episodes (P<0.005), and diagnosis of fever source was documented in 76% of HBNH and 16% of CBNH episodes (P<0.005). Overall assessment stratification showed 81% febrile HBNH patients had both evaluation and therapy performed compared with 38% in CBNH (P<0.0001); 39% of febrile CBNH patients had no evaluation or therapy performed. Results indicate lack of documentation, and fever evaluation in CBNHs may preclude complete detection of nursing home-acquired infections and thereby hamper preventive responses to potential infection problems.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 9 , Issue 10 , October 1988 , pp. 447 - 450
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1988

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Smith, IM: Infection in the elderly. Hosp Pract 1982; 17(7):69-77, 81–85.CrossRefGoogle Scholar
2. Tresch, DD, Simpson, WM Jr, Burton, JR: Relationship of long-term and acute care facilities. The problem of patient transfer and continuity of care. J Am Genatr Soc 1985;33:819–826.10.1111/j.1532-5415.1985.tb05433.xCrossRefGoogle ScholarPubMed
3. Franson, TR. Duthie, EH, Cooper, JE. et al: Prevalence survey of infections and their predisposing factors at a hospital-based nursing home care unit. J Am Genatr Soc 1986; 34:95–100.10.1111/j.1532-5415.1986.tb05475.xCrossRefGoogle Scholar
4. Garibaldi, RA, Brodine, S, Matsumiya, S: Infection among patients in nursing homes: Policies, prevalence and pmhlems. N Engl J Med 1981; 305:7312–7315.CrossRefGoogle Scholar
5. Gehan, EA: A generalized Wilcoxon test for comparing arbitrarily singly-censored samples. Biometrika 1965; 52:203–223.10.1093/biomet/52.1-2.203CrossRefGoogle ScholarPubMed
6. Snedecor, GM': Statistical Methods. Ames Fower, Iowa State University Press, 1967.Google Scholar
7. Finnegan, TP, Austin, TW, Cape, RDT: A 12-month fever surveillance study in a veterans' long-stay institution. J Am Genatr Soc 1985; 33:590–594.CrossRefGoogle Scholar
8. Brown, NK, Thompson, DJ: Nontreatment of fever in extended-care facilities. N Engl J Med 1979; 300:1246–1250.CrossRefGoogle ScholarPubMed
9. LeClair, SM, Schicker, JM, Duthie, EH, et al: A survey of nursing personnel attitudes toward infections and their control in the elderly. Am J Infect Control (in press, 1988).Google Scholar
10. Centers for Disease Control: Outline for surveillance and control of nosocomial infections. Appendix 11. Guidelines for determining presence and classification of infection, 1976, pp 19–21.Google Scholar