Het vierde generatie dilemma

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Restriction of long-term indwelling urethral catherisation in the elderly

Contains fulltext : 4459.pdf (publisher's version ) (Open Access

Natural course of care dependency in residents of long-term care facilities: prospective follow-up study

Geriatrics in primary car

How much time should long-term care and geriatric rehabilitation facilities (nursing homes) spend on infection control?

Background: For hospitals, standards for the required number of infection control personnel are outdated and disputed. Such standards are not even available for long-term care and geriatric rehabilitation facilities (ie, nursing homes). This study addressed the question of how much time nursing homes should spend on infection control. Methods: Through group discussions and individual sessions, experienced infection control practitioners, medical microbiologists, and nursing home doctors evaluated the time needed to perform infection control activities in a model nursing home. Results: The number of hours needed was estimated as 513 per 100 beds, or 154 per 10,000 care-days per year. Conclusion: Given that significant differences can be expected among the various facilities identified as nursing homes, long-term care facilities, or geriatric rehabilitation centers, as well as among countries, the standard that we propose for The Netherlands will not be generally applicable. However, the method we have used to determine this standard can be easily applied in other countries and settings.Public Health and primary careGeriatrics in primary careAntimicrobial treatment and prevention of infection

Cost-Effectiveness of Cranberry Capsules to Prevent Urinary Tract Infection in Long-Term Care Facilities: Economic Evaluation with a Randomized Controlled Trial

Analysis and support of clinical decision makin

Effectiveness of Cranberry Capsules to Prevent Urinary Tract Infections in Vulnerable Older Persons: A Double-Blind Randomized Placebo-Controlled Trial in Long-Term Care Facilities

Development and application of statistical models for medical scientific researc

Clinically diagnosed infections predict disability in activities of daily living among the oldest-old in the general population: the Leiden 85-plus Study

BACKGROUND: ageing is frequently accompanied by a higher incidence of infections and an increase in disability in activities of daily living (ADL). OBJECTIVE: this study examines whether clinical infections [urinary tract infections (UTI) and lower respiratory tract infections (LRTI)] predict an increase in ADL disability, stratified for the presence of ADL disability at baseline (age 86 years). DESIGN: the Leiden 85-plus Study. A population-based prospective follow-up study. SETTING: general population.Participants: a total of 154 men and 319 women aged 86 years. METHODS: information on clinical infections was obtained from the medical records. ADL disability was determined at baseline and annually thereafter during 4 years of follow-up, using the 9 ADL items of the Groningen Activity Restriction Scale. RESULTS: in 86-year-old participants with ADL disability, there were no differences in ADL increase between participants with and without an infection (-0.32 points extra per year; P = 0.230). However, participants without ADL disability at age 86 years (n = 194; 41%) had an accelerated increase in ADL disability of 1.07 point extra per year (P < 0.001). For UTIs, this was 1.25 points per year (P < 0.001) and for LRTIs 0.70 points per year (P = 0.041). In this group, an infection between age 85 and 86 years was associated with a higher risk to develop ADL disability from age 86 onwards [HR: 1.63 (95% CI: 1.04-2.55)]. CONCLUSIONS: among the oldest-old in the general population, clinically diagnosed infections are predictive for the development of ADL disability in persons without ADL disability. No such association was found for persons with ADL disability.Geriatrics in primary car

RESPONSE TO DAVID NACE AND PAUL DRINKA

Analysis and support of clinical decision makin

Infection control in a skilled nursing facility : a 6-year survey

Contains fulltext : 4492.pdf (publisher's version ) (Open Access