INAPPROPRIATE FENTANYL PRESCRIBING AMONG NURSING HOME RESIDENTS IN THE UNITED STATES

Persons age 65 and over constitute the largest reservoir of Mycobacterium tuberculosis infection in the United States today. During 1987, 6,150 tuberculosis cases were reported among this high-risk group. These cases represent 27% of the total US tuberculosis morbidity, although this age group constitutes only 12% of the US population. Tuberculosis case rates in the United States are higher among the elderly (20.6 per 100,000) than among all other age groups (average 9.3 per 100,000).More Americans live in nursing homes than in any other type of residential institution; on any given day approximately 5% of all elderly persons are living in a nursing home. Elderly nursing home residents are at greater risk for tuberculosis than elderly persons living in the community. In a Centers for Disease Control (CDC)-sponsored survey of 15,379 routinely-reported tuberculosis cases from 29 states, 8% of the 4,919 cases that occurred among elderly persons occurred among residents of nursing homes. The incidence of tuberculosis among nursing home residents was 39.2 per 100,000 person years, whereas the incidence of tuberculosis among elderly persons living in the community was 21.5 per 100,000. The observed rate of tuberculosis among nursing home employees was three times the rate expected in employed adults of similar age, race and sex (CDC, unpublished data).

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Prevalence of First-Step Mutants among Levofloxacin-Susceptible Invasive Isolates of Streptococcus pneumoniae in the United States

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.50.4.1561-1563.2006 ◽

2006 ◽

Vol 50 (4) ◽

pp. 1561-1563 ◽

Cited By ~ 22

Author(s):

Mathias W. R. Pletz ◽

Ardaman P. Shergill ◽

Lesley McGee ◽

Bernard Beall ◽

Cynthia G. Whitney ◽

...

Keyword(s):

United States ◽

Nursing Home ◽

Streptococcus Pneumoniae ◽

Restriction Fragment Length Polymorphism ◽

Length Polymorphism ◽

Fragment Length Polymorphism ◽

Nursing Home Residents ◽

The United States ◽

Fluoroquinolone Resistance ◽

Restriction Fragment Length

ABSTRACT By use of a PCR-restriction fragment length polymorphism assay, we screened 496 levofloxacin-susceptible invasive pneumococcal strains (MIC ≤ 2 mg/liter) for quinolone resistance-determining region mutations known to confer fluoroquinolone resistance. Among those with a levofloxacin MIC of 2 mg/liter, 16.2% of isolates recovered from nursing home residents and 6.4% from non-nursing home residents had first-step mutations.

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Mortality in Nursing Home Evacuations in the United States from 1995-2017

Prehospital and Disaster Medicine ◽

10.1017/s1049023x19000244 ◽

2019 ◽

Vol 34 (s1) ◽

pp. s2-s2

Author(s):

Sharon Mace ◽

Daniel Caicedo ◽

Aishwarya Sharma

Keyword(s):

United States ◽

Nursing Home ◽

Nursing Homes ◽

Natural Disasters ◽

Nursing Home Residents ◽

The United States ◽

Loss Of Life ◽

External Events ◽

Analyze Data

Introduction:There are an estimated 15,600 nursing homes with a total of 1.4 million residents in the United States. The number of residents will continue to increase due to the aging population, and the associated morbidities will make it difficult to evacuate them safely.Aim:This study is the first of its kind to provide an analysis of the number of nursing home deaths caused by external and internal events following evacuations.Methods:Information from the databases Lexis Nexis and PubMed were compiled and limited to news articles from 1995-2017. The gathered information included the reason for evacuation, injuries, deaths, and locations within the United States.Results:From 1995 to 2017, there was a total of 51 evacuations and 141 deaths in nursing homes. 27 (53%) evacuations were due to external events which resulted in a combined 121 (86%) deaths, and 24 (47%) evacuations were due to internal events which resulted in a combined 20 (14%) deaths. Hurricanes were responsible for the majority of deaths during evacuations, followed by fires and floods. The number of evacuations and deaths increased the greatest between 2005 to 2008.Discussion:External events have the greatest impact on loss of life. Internal disasters are about equal in the number of incidents, however, external events have a much greater mortality rate. Exact numbers on injuries, morbidity, and mortality are difficult to ascertain, but it appears to be related to natural disasters. In view of the increasing likelihood of natural disasters related to global warming, a drastic improvement of standard evacuation procedures of long-term nursing homes is critical to decreasing mortality of nursing home residents. There also needs to be a nationally standardized method of reporting evacuations in order to better analyze data on nursing homes.

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Comment on: Decrease of anticholinergic drug use in nursing home residents in the United States

Journal of the American Geriatrics Society ◽

10.1111/jgs.17182 ◽

2021 ◽

Author(s):

Ulla L. Aalto ◽

Hannu Kautiainen ◽

Kaisu H. Pitkälä

Keyword(s):

United States ◽

Nursing Home ◽

Drug Use ◽

Anticholinergic Drug ◽

Nursing Home Residents ◽

The United States

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Navigating Long-Term Care

Gerontology and Geriatric Medicine ◽

10.1177/2333721417700368 ◽

2017 ◽

Vol 3 ◽

pp. 233372141770036

Author(s):

James D. Holt

Keyword(s):

United States ◽

Nursing Home ◽

Long Term Care ◽

Care Home ◽

Nursing Home Residents ◽

The United States ◽

Transitions Of Care ◽

Term Care ◽

Levels Of Care

Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly) to possibly 20% in 2030 (70 million elderly). In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC), 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States. Transitions of care, among these various levels of care, are common: Nursing home to hospital transfer, one of the best-studied transitions, occurs in more than 25% of nursing home residents per year. This article follows one patient through several levels of care.

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