Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-24T00:05:14.437Z Has data issue: false hasContentIssue false
  • English
  • Français

Documentation of acute change in mental status in nursing homes highlights opportunity to augment infection surveillance criteria

Published online by Cambridge University Press:  28 April 2020

Austin R. Penna Open the ORCID record for Austin R. Penna [Opens in a new window] ,
Christina L. Sancken ,
Nimalie D. Stone ,
Taniece R. Eure ,
Wendy Bamberg ,
Grant Barney ,
Devra Barter ,
Stacy Carswell ,
Paula Clogher  and
Ghinwa Dumyati
...Show all authors
Austin R. Penna*
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Christina L. Sancken
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Nimalie D. Stone
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Taniece R. Eure
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Wendy Bamberg
Affiliation:
Colorado Department of Public Health and Environment, Denver, Colorado
Grant Barney
Affiliation:
New York Emerging Infections Program, Rochester, New York
Devra Barter
Affiliation:
Colorado Department of Public Health and Environment, Denver, Colorado
Stacy Carswell
Affiliation:
Georgia Emerging Infections Program, Atlanta, Georgia
Paula Clogher
Affiliation:
Connecticut Emerging Infections Program and the Yale School of Public Health, New Haven, Connecticut
Ghinwa Dumyati
Affiliation:
New York Emerging Infections Program, Rochester, New York University of Rochester Medical Center, Rochester, New York
Christina B. Felsen
Affiliation:
New York Emerging Infections Program, Rochester, New York University of Rochester Medical Center, Rochester, New York
Linda Frank
Affiliation:
California Emerging Infections Program, Oakland, California
Deborah Godine
Affiliation:
California Emerging Infections Program, Oakland, California
Helen Johnston
Affiliation:
Colorado Department of Public Health and Environment, Denver, Colorado
Marion A. Kainer
Affiliation:
Tennessee Department of Health, Nashville, Tennessee
Linda Li
Affiliation:
Maryland Department of Health, Baltimore, Maryland
Ruth Lynfield
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
J. P. Mahoehney
Affiliation:
Minnesota Department of Health, St Paul, Minnesota
Joelle Nadle
Affiliation:
California Emerging Infections Program, Oakland, California
Rebecca Pierce
Affiliation:
Oregon Health Authority, Portland, Oregon
Susan M. Ray
Affiliation:
Georgia Emerging Infections Program, Atlanta, Georgia Emory University, Atlanta, Georgia
Sarah Shrum Davis
Affiliation:
New Mexico Department of Health, Santa Fe, New Mexico
Marla Sievers
Affiliation:
New Mexico Department of Health, Santa Fe, New Mexico
Lucy E. Wilson
Affiliation:
Maryland Department of Health, Baltimore, Maryland
Alexia Y. Zhang
Affiliation:
Oregon Health Authority, Portland, Oregon
Shelley S. Magill
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
Nicola D. Thompson
Affiliation:
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
*
Author for correspondence: Austin R. Penna, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Acute change in mental status (ACMS), defined by the Confusion Assessment Method, is used to identify infections in nursing home residents. A medical record review revealed that none of 15,276 residents had an ACMS documented. Using the revised McGeer criteria with a possible ACMS definition, we identified 296 residents and 21 additional infections. The use of a possible ACMS definition should be considered for retrospective nursing home infection surveillance.

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , Volume 41 , Issue 7 , July 2020 , pp. 848 - 850
Check for updates
Creative Commons
Creative Common License - CCCreative Common License - BY
This work is classified, for copyright purposes, as a work of the U.S. Government and is not subject to copyright protection within the United States.
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

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.)

Footnotes

PREVIOUS PRESENTATION: Selected data included in this manuscript were presented in an abstract at the Society for Healthcare Epidemiology of America Spring Conference, April 26, 2019, in Boston, Massachusetts.

References

Inouye, SK. Delirium in older persons. N Engl J Med 2006;354:1157–1165.CrossRefGoogle ScholarPubMed
Kiely, DK, Bergmann, MA, Murphy, KM, Jones, RN, Orav, EJ, Marcantonio, ER. Delirium among newly admitted postacute facility patients: prevalence, symptoms, and severity. J Gerontol A Biol Sci Med Sci 2003;58:441–445.CrossRefGoogle ScholarPubMed
Inouye, SK, van Dyck, CH, Alessi, CA, Balkin, S, Siegal, AP, Horwitz, RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Ann Intern Med 1990;113:941–948.CrossRefGoogle Scholar
Wei, LA, Fearing, MA, Sternberg, EJ, Inouye, SK. The Confusion Assessment Method: a systematic review of current usage. J Am Geriatr Soc 2008;56:823–830.CrossRefGoogle ScholarPubMed
Stone, ND, Ashraf, MS, Calder, J, et al. Surveillance definitions of infections in long-term care facilities: revisiting the McGeer criteria. Infect Control Hosp Epidemiol 2012;33:965–977.CrossRefGoogle ScholarPubMed
Voyer, P, Richard, S, McCusker, J, et al. Detection of delirium and its symptoms by nurses working in a long term care facility. J Am Med Dir Assoc 2012;13:264–271.CrossRefGoogle Scholar
Inouye, SK, Foreman, MD, Mion, LC, Katz, KH, Cooney, LM Jr. Nurses’ recognition of delirium and its symptoms: comparison of nurse and researcher ratings. Arch Intern Med 2001;161:2467–2473.CrossRefGoogle ScholarPubMed
Voyer, P, McCusker, J, Cole, MG, et al. Nursing documentation in long-term care settings: new empirical evidence demands changes be made. Clin Nurs Res 2014;23:442–461.CrossRefGoogle Scholar
Thompson, ND, Penna, A, Eure, TR, et al. Epidemiology of antibiotic use for urinary tract infection in nursing home residents. J Am Med Dir Assoc 2020;21:91–96.CrossRefGoogle ScholarPubMed
Inouye, SK, Leo-Summers, L, Zhang, Y, Bogardus, ST Jr, Leslie, DL, Agostini, JV. A chart-based method for identification of delirium: validation compared with interviewer ratings using the confusion assessment method. J Am Geriatr Soc 2005;53:312–318.CrossRefGoogle ScholarPubMed
Saczynski, JS, Kosar, CM, Xu, G, et al. A tale of two methods: chart and interview methods for identifying delirium. J Am Geriatr Soc 2014;62:518–524.CrossRefGoogle ScholarPubMed