Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-22T06:28:16.876Z Has data issue: false hasContentIssue false
  • English
  • Français

The Hospital Epidemiologist in Long-Term Care: Practical Considerations

Published online by Cambridge University Press:  21 June 2016

Joseph M. Mylotte
Joseph M. Mylotte*
Affiliation:
Department of Medicine, Division of Infectious Diseases, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, and the Buffalo General Hospital, Buffalo, New York
*
Department of Medicine, Buffalo General Hospital, 100 High St, Buffalo, NY 14203
Get access Rights & Permissions [Opens in a new window]

Extract

Infection control practices in long-term care facilities have been the subject of an increasing number of reports in the past few years. A recent review by Smith in this series outlined important problems regarding infection surveillance in long-term care facilities including: the lack of standard definitions of infection and the difficulty of applying Centers for Disease Control (CDC) definitions in long-term care facilities: the lack of a consensus on the best approach to infection surveillance in long-term care facilities; the lack of full-time commitment to infection control among long-term care facilities; and the lack of risk stratification of patients. For reasons mentioned previously, the effective solution to these problems will require the input of hospital-based infection control professionals. It would be ideal if, prior to this effort, these professionals could gain some experience regarding the important differences between the long-term care facility and the acute hospital setting.

In this article, the observations of a hospital epidemiologist who has consulted for several years with long-term care facilities will be discussed. Specifically, I will deal with experiences and problems I have dealt with in long-term care facilities that were either new to me or variations of hospital-based experience.

Type
Topics in Long-Term Care
Information
Infection Control & Hospital Epidemiology , Volume 12 , Issue 7 , July 1991 , pp. 439 - 442
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

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. Price, LE, Sarubbi, FA, Rutala, WA Infection control programs in twelve North Carolina extended care facilities. Infect Control. 1985;6:437–441.10.1017/S0195941700064778CrossRefGoogle ScholarPubMed
2. Crossley, KB, Irvine, P, Kazzor, DJ, Loewenson, RB. Infection control practices in Minnesota nursing homes. JAMA. 1985;254:2918–2921.10.1001/jama.1985.03360200070029Google Scholar
3. Khabbaz, RF, Penney, JH. Infection control in Maryland nursing homes. Infect Control Hosb Ebidemiol. 1988;9:159–162.10.2307/30145424Google Scholar
4. Pearson, DA, Checko, PJ, Hierholzer, WJ, Jekel, JE Infection control practices in Connecticut's skilled nursing facilities. Am J Infect Control. 1990;18:269–276.CrossRefGoogle ScholarPubMed
5. Bentley, DW, Cheney, L. Infection control in the nursing home: the physician's role. Geriatrics. 1990;45:59–66.Google ScholarPubMed
6. Smith, PW. Infection surveillance in long-term care facilities. Infect Control Hosp Epidemiol. 1991;12:55–58.Google Scholar
7. Bentley, DW. Current challenges and future opportunities. Infect Control Hosp Epidemiol. 1989;10:481–483.Google Scholar
8. McGeer, A, Campbell, B, Emori, TG, et al. Definitions of infection for surveillance in long-term care facilities. Am J Infect Control. 1991;19:1–7.Google Scholar
9. Pearson, DA, Checko, PF, Hierholzer, WJ, Jekel, JE Infection control practitioners and committees in skilled nursing facilities in Connecticut. AmJ Infect Control. 1990;18:167–175.Google Scholar
10. Franson, TR, Schicker, JM, LeClair, SM, Hoffmann, RG, Duthie, EH. Documentation and evaluation of fevers in hospital-based and community-based nursing homes. Infect Control Hosp Epidemiol. 1988;9:447–450.Google Scholar
11. Smith, PW. Infections in long-term care facilities. Infect Control. 1985;6:435–436.Google ScholarPubMed
12. Hing, E, Seksenski, E, Strahan, G. The national nursing home survey: 1985 summary for the United States. Vital and Health Statistics. 1989;97:1–249.Google Scholar
13. Jackson, MM, Fierer, J. Infections and infection risk in residents of long-term care facilities: a review of the literature, 1970-1984. Am J Infect Control. 1985;13:63–77.10.1016/0196-6553(85)90084-7Google Scholar
14. Jacobson, C, Strausbaugh, LJ. Incidence and impact of infection in a nursing home care unit. Am J Infect Control. 1990;18:151–159.10.1016/0196-6553(90)90180-ZCrossRefGoogle Scholar
15. Childress, JA, Childress, JD. Statistical test for possible infection outbreaks. Infect Control. 1981;2:247–249.CrossRefGoogle ScholarPubMed
16. Bentley, DW. Tuberculosis in long-term care facilities. Infect Control Hosp Epidemiol. 1990;11:42–46.10.1086/646077CrossRefGoogle ScholarPubMed
17. Garabaldi, RA, Brodine, S, Matsumiya, S. Infections among patients in nursing homes. Policies, prevalence, and problems. N Engl J Med. 1981;305:731–735.10.1056/NEJM198109243051304CrossRefGoogle Scholar
18. Farber, BR, Brennen, C, Puntereri, AJ, Brody, JP. A prospective study of nosocomial infections in a chronic care facility. J Am Geriatr Soc. 1984;32:499–502.10.1111/j.1532-5415.1984.tb02234.xCrossRefGoogle Scholar
19. Scheckler, WE, Peterson, PJ. Infections and infection control among residents of eight rural Wisconsin nursing homes. Arch Intern Med. 1986;146:1981–1984.CrossRefGoogle ScholarPubMed
20. Brennen, C, Muder, RR. Conjunctivitis associated with methicillin-resistant S aureus in a long-term care facility. Am J Med. 1990;88:14N–17N.Google Scholar
21. Juranek, D, Currier, RW, Millikan, LE. Scabies control in institutions. In: Orkin, M, Maiback, HI, eds. Cutaneous Infections and Insect Bites. New York, NY: Dekker; 1985:139–156.Google Scholar
22. Currier, RW, Christie, C, Wintermeyer, LA Scabies in health care facilities-Iowa. MMWR. 1988;37:178–179.Google Scholar
23. Meyers, LN. Clinical presentation of scabies in a nursing home population. J Am Acad Dermatol. 1988;18:396–397.CrossRefGoogle Scholar
24. Currier, RW. Scabies and nediculosis: hosoitalized mites and lice. Asepsis—The Infection Cdntrol Forum. 1984;6:13–21.Google Scholar
25. Strausbaugh, LJ, Jacobson, C, Sewell, DL, Potter, S, Ward, ‘IT Methicillin-resistant Staphylococcus aureus in extended care facilities: experiences in a Veterans' Affairs nursing home and a review of the literature. Infect Control Hosp Epidemiol. 1991;12:36–45.10.1086/646236CrossRefGoogle Scholar
26. Kauffman, CA, Bradley, SE Terpenning, MS. Methicillin- resistant Staphylococcus aureus in long-term care facilities. Infect Control Hosp Epidemiol. 1990;11:600–603.10.2307/30148435Google Scholar
27. Fanale, JE. The nursing home medical director. J Am Geriatr Soc. 1989;37:369–375.Google Scholar
28. Ouslander, JG. Medical care in the nursing home. JAMA. 1989;262:2582–2590.10.1001/jama.1989.03430180124042CrossRefGoogle ScholarPubMed