Specialty Care Delivery:: Bringing Infectious Disease Expertise to the Residents of a Veterans Affairs Long-Term Care Facility

• Autores: Robin L. P. Jump, Danielle M. Olds, Lucy A. Jury, Brett Sitzlar, Elie Saade, Brook Watts, Robert A. Bonomo, Curtis J. Donskey
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 61, Nº. 5, 2013, págs. 782-787
• Idioma: inglés
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• Resumen

  • 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.