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J Am Geriatr Soc. 2013 May;61(5):782-7. doi: 10.1111/jgs.12206. Epub 2013 Apr 16.

Specialty care delivery: bringing infectious disease expertise to the residents of a Veterans Affairs long-term care facility.

Author information

1
Geriatric Research, Education and Clinical Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio 44106, USA. robinjump@gmail.com

Abstract

OBJECTIVE:

To initiate a long-term care facility (LTCF) infectious disease (LID) service that provides on-site consultations to LTCF residents to improve the care of residents with possible infections.

DESIGN:

Clinical demonstration project.

SETTING:

A 160-bed LTCF affiliated with a tertiary care Veterans Affairs (VA) hospital.

PARTICIPANTS:

Residents referred to the LID team.

MEASUREMENTS:

The reason for and source of LTCF residents' referral to the LID team and their demographic characteristics, infectious disease diagnoses, interventions, and hospitalizations were determined.

RESULTS:

Between July 2009 and December 2010, the LID consultation service provided 291 consultations for 250 LTCF residents. Referrals came from LTCF staff (75%) or the VA hospital's ID consult service (25%). The most common diagnoses were Clostridium difficile infection (14%), asymptomatic bacteriuria (10%), and urinary tract infection (10%). More than half of referred residents were receiving antibiotic therapy when they first saw the LID team; 46% of residents required an intervention. The most common interventions, stopping (32%) or starting (26%) antibiotics, were made in accordance with principles of antibiotic stewardship.

CONCLUSION:

The LID team represents a novel and effective means to bring subspecialty care to LTCF residents.

PMID:
23590125
PMCID:
PMC3656129
DOI:
10.1111/jgs.12206
[Indexed for MEDLINE]
Free PMC Article
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