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Results for “Long-term care facilities”

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At least 19 recordsLinked to original sources
PubMed2026

Impact of a CARE-ORIENT Education Program on Oral Hygiene Among Institutionalized Older Adults: A Double Blinded Cluster Randomized Controlled Study.

BACKGROUND: Older adults residing in long-term care facilities often depend on caregivers for daily oral care. Inadequate caregiver training may contribute to poor plaque control and denture hygiene. METHODS: A six-month parallel-arm cluster randomized controlled study was conducted in selected long-term care facilities in Northern India. Two old age homes were randomly selected, with one allocated to the intervention group and the other to the control group. A total of 150 older adults and 46 caregivers participated. Caregivers in the intervention group received a structured caregiver oriented oral health education. Clinical assessments were performed at baseline, 3 and 6 months. Outcomes included Debris Index, Turesky-Gilmore-Glickman Plaque Index, Denture Plaque Index and Denture Stomatitis Index. Caregiver knowledge and practice were evaluated using a validated questionnaire. RESULTS: Caregiver knowledge and practice scores improved significantly in the intervention group at 3 and 6 months. Significant differences were observed in Debris Index (DI), Plaque Index (PI), and Denture Plaque Index (DPI) in the intervention group over the six-month follow-up (p < 0.001). The Debris Index decreased from 2.76 &#xb1; 0.07 at baseline to 1.54 &#xb1; 0.05 at 6 months. Plaque Index scores declined from 3.26 &#xb1; 0.06 to 1.85 &#xb1; 0.08, and Denture Plaque Index scores reduced from 3.22 &#xb1; 0.03 to 1.74 &#xb1; 0.05. Denture Stomatitis Index improved over time; however, intergroup differences were not statistically significant. CONCLUSION: Structured caregiver-focused oral health education significantly improved oral hygiene among institutionalized older adults over six months, supporting integration of caregiver training within routine long-term care.

Humans↗
PubMed1978

Teamwork eases long-term care admissions.

The teamwork approach to admitting new residents used at St. Joseph Home of Chicago, Inc., is based on the philosophy that proper admission of new residents can help lessen the apprehensions as elderly people open the "forbidding" door to a long-term care facility. The team approach begins before an applicant is accepted and continues through the new resident's initial period of adjusting to a new home.

Aged↗
PubMed1978

Multiple primary malignancy in the elderly.

The longer a patient lives, the more predisposed he is to become host to primary malignant neoplasms at various sites. Hence the importance of follow-up clinics in long-term care facilities. Data on multiple malignancies at Oak Forest Hospital are presented. Among 34 such patients (average age, 72 years), 28 had malignant lesions at two primary sites, and 6 at three primary sites.

Age Factors↗
PubMed2015

Advanced age is associated with worsened outcomes and a unique genomic response in severely injured patients with hemorrhagic shock.

INTRODUCTION: We wished to characterize the relationship of advanced age to clinical outcomes and to transcriptomic responses after severe blunt traumatic injury with hemorrhagic shock. METHODS: We performed epidemiological, cytokine, and transcriptomic analyses on a prospective, multi-center cohort of 1,928 severely injured patients. RESULTS: We found that there was no difference in injury severity between the aged (age &#x2265;55, n&#x2009;=&#x2009;533) and young (age <55, n&#x2009;=&#x2009;1395) cohorts. However, aged patients had more comorbidities. Advanced age was associated with more severe organ failure, infectious complications, ventilator days, and intensive care unit length of stay, as well as, an increased likelihood of being discharged to skilled nursing or long-term care facilities. Additionally, advanced age was an independent predictor of a complicated recovery and 28-day mortality. Acutely after trauma, blood neutrophil genome-wide expression analysis revealed an attenuated transcriptomic response as compared to the young; this attenuated response was supported by the patients' plasma cytokine and chemokine concentrations. Later, these patients demonstrated gene expression changes consistent with simultaneous, persistent pro-inflammatory and immunosuppressive states. CONCLUSIONS: We concluded that advanced age is one of the strongest non-injury related risk factors for poor outcomes after severe trauma with hemorrhagic shock and is associated with an altered and unique peripheral leukocyte genomic response. As the general population's age increases, it will be important to individualize prediction models and therapeutic targets to this high risk cohort.

Adult↗
PubMed2026

Use of Whole Genome Sequencing to Investigate the Risk for Transmission of Clostridioides difficile From Prior Room Occupants: A Single-Center Study.

BACKGROUND: Admission to a room previously occupied by a patient with Clostridioides difficile infection (CDI) has been identified as a risk factor for CDI. However, previous studies have not included molecular typing to definitively link healthcare-associated CDI (HA-CDI) cases to prior room occupants. METHODS: In a hospital and affiliated long-term care facility, we conducted a 1-year cohort study to determine if exposure to a room previously occupied by a CDI patient and/or with environmental contamination after cleaning and disinfection in the past 3 months was associated with an increased risk of HA-CDI. Multivariable logistic regression was used to assess risk factors for HA-CDI. Whole genome sequencing was used to determine the relatedness of HA-CDI isolates and isolates from prior CDI cases or environmental surfaces. RESULTS: Of 5,746 admitted patients, 55 were diagnosed with HA-CDI. Exposure to a room previously occupied by a CDI patient and/or with a positive post-discharge culture was not associated with an increased risk of HA-CDI (adjusted odds ratio 1.15, 95% confidence interval 0.65-1.98; P=0.62). None of the 21 HA-CDI patients with prior room-level exposures were infected with isolates genomically related to isolates from prior room occupants with CDI or from room surfaces. Five HA-CDI cases were linked to prior CDI patients or environmental isolates on the same ward or without ward-level exposure. CONCLUSION: Despite frequent exposure to rooms previously occupied by CDI patients or contaminated with C. difficile, no HA-CDI cases were linked to prior room exposures in a facility using sporicidal disinfectants in CDI rooms.

Clostridioides difficile↗
PubMed2026

Effects of comprehensive oral care on nasogastric tube removal in long-term care residents with dysphagia: A multi-center randomized controlled trial.

Oral care is essential for residents in long-term care (LTC) facilities to reduce complications such as aspiration pneumonia. While routine oral hygiene is standard practice, comprehensive oral care (COC)-which includes facial and intraoral muscle massage, salivary gland stimulation, and oral moisturization-may further enhance swallowing function. However, evidence linking COC directly to nasogastric (NG) tube removal remains limited. This study evaluated the effectiveness of COC in facilitating NG tube removal and improving swallowing function among LTC residents with dysphagia. A multicenter, open-label randomized controlled trial was conducted across eight LTC facilities. The intervention group (n = 40) received daily one-on-one COC sessions lasting 30-40 min, while the control group (n = 37) received routine oral hygiene. Participants were followed for six months, with outcomes including NG tube removal, swallowing function, body weight, and pneumonia incidence. At six months, the COC group demonstrated a significantly higher NG tube removal rate, with eight participants achieving full oral intake (p = 0.005). Functional Oral Intake Scale scores were also significantly higher in the intervention group (p = 0.005). Time to NG tube removal ranged from 17 to 182 days. Under intention-to-treat principles, the NG tube removal rate remained significantly higher in the COC group (16.7%vs. 0%, p = 0.005). Competing risks analysis using the Aalen-Johansen estimator confirmed a 6-month cumulative incidence of NG tube removal of 14.6% in the COC group versus 0% in the control group (Gray's test: p = 0.005), with no significant between-group difference in mortality (p = 0.500). No significant differences were observed in body weight change or pneumonia incidence between groups. Among participants who successfully discontinued NG tube use, dementia was the most common underlying condition. These findings suggest that daily one-on-one COC is a feasible intervention in LTC settings and may improve swallowing function while facilitating NG tube removal in residents with dysphagia.

Humans↗
PubMed2025

Evaluation of swabbing methods for culture and non-culture-based recovery of multidrug-resistant organisms from environmental surfaces.

OBJECTIVES: Sponge-Sticks (SS) and ESwabs are frequently utilized for detection of multidrug-resistant organisms (MDROs) in the environment. Head-to-head comparisons of SS and ESwabs across recovery endpoints are limited. DESIGN: We compared MDRO culture and non-culture-based recovery from (1) ESwabs, (2) cellulose-containing SS (CS), and (3)&#xa0;polyurethane-containing SS (PCS). METHODS: Known quantities of each MDRO were pipetted on a stainless-steel surface and swabbed by each method. Samples were processed, cultured, and underwent colony counting. DNA was extracted from sample eluates, quantified, and underwent metagenomic next-generation sequencing (mNGS). MDROs underwent whole genome sequencing (WGS). MDRO recovery from paired patient perirectal and PCS-collected environmental samples from clinical studies was determined. SETTING: Laboratory experiment, tertiary medical center, and long-term acute care facility. RESULTS: Culture-based recovery varied across MDRO taxa, it was highest for vancomycin-resistant Enterococcus and lowest for carbapenem-resistant Pseudomonas aeruginosa (CRPA). Culture-based recovery was significantly higher for SS compared to ESwabs except for CRPA, where all methods performed poorly. Nucleic acid recovery varied across methods and MDRO taxa. Integrated WGS and mNGS analysis resulted in successful detection of antimicrobial resistance genes, construction of high-quality metagenome-assembled genomes, and detection of MDRO genomes in environmental metagenomes across methods. In paired patient and environmental samples, multidrug-resistant Pseudomonas aeruginosa (MDRP) environmental recovery was notably poor (0/123), despite detection of MDRP in patient samples (20/123). CONCLUSIONS: Our findings support the use of SS for the recovery of MDROs. Pitfalls of each method should be noted. Method selection should be driven by MDRO target and desired endpoint.

Humans↗
PubMed2025

Candida auris outbreak in a cardiothoracic transplant intensive care unit: implications for infection prevention practices and keeping pace with an evolving landscape.

OBJECTIVE: To describe the mitigation strategies for a Candida auris outbreak in a cardiothoracic transplant intensive care unit (CTICU) and its implications for infection prevention practices. DESIGN: Retrospective cohort study from July 2023 to February 2024. SETTING: A large academic medical center. METHODS: A multidisciplinary team convened to conduct the outbreak investigation and develop mitigation strategies in the CTICU. RESULTS: From July 2023 to February 2024, 34 possible hospital-onset cases of C. auris were identified in our CTICU. Whole-genome sequencing and phylogenetic analysis based on pairwise single nucleotide polymorphism (WG-SNP) distance revealed two distinct outbreak clusters. Of the 34 patients, 11 (32.3%) were solid organ transplant recipients and 12 (35.3%) had a mechanical circulatory support device. Of the cohort, only 11/34 (32.3%) had prior exposure to high-risk healthcare facilities within six months prior to admission, as follows: acute inpatient rehabilitation facilities (AIRs) (n = 5, 14.7%), skilled nursing facilities (SNFs) (n = 3, 8.8%), and long-term acute care hospitals (LTACHs) (n = 3, 8.8%). The cohort had a median of 22.0 antibiotic-days prior to their positive results. Five (14.7%) patients had C. auris candidemia, three of whom expired likely due to infection. Infection Prevention (IP) interventions addressed several modes of transmission, including healthcare personnel hands, shared patient equipment, and the environment. CONCLUSION: Our experience suggests that the epidemiology of C. auris may be changing, pointing towards a rising prevalence in acute care settings. IP interventions targeting hand hygiene behavior and promoting centralizing cleaning and disinfection of shared patient equipment may have contributed to outbreak resolution.

Humans↗
PubMed1975

Psychogeriatrics and community care.

The meaning of community care, as at present organised for the elderly mentally ill, is examined critically. It is argued that often the phrase is used to conceal the deficiencies of traditional institutional facilities, for which community care is apt to be regarded as a cheap substitute. It is suggested that it would be beneficial to have available true community care, capable of providing a full-time service to patients in their own homes, in preference to institutional facilities. Though such a scheme would benefit patients, it would have implications for the community discordant with present official attitudes.

Aged↗
PubMed1978

[Molsidomin and intraocular pressure. No effect in healthy subjects and in glaucoma patients].

Molsidomine is a new agent in coronary therapy. It does not influence the intra-ocular pressure in healthy volunteers or in glaucoma patients. This was tested in double-blind studies in short trials and in a long term study of 3 months. The outflow facility or the visual fields were also unchanged. These results correspond closely to those obtained previously with other coronary therapeutics. Molsidomine is not dangerous for glaucoma patients.

Coronary Disease↗