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- COVID-19 (6)
- (-) Elderly (9)
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- Healthcare-Associated Infections (HAIs) (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 9 of 9 Research Studies DisplayedCrnich CJ
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
This paper provides an overview of nursing home (NH) infection and control, reviews the 2016 CMS changes to federal regulations, and proposes recommendations to sustain improvements. COVID-19 put further pressure on nursing homes who were already strained by rising numbers of infections from C. difficile and multidrug-resistant organisms. The author puts out a call for reimagining infection prevention and control using the Systems Engineering Initiative for Patient Safety framework. Additional recommendations are made to enhance NH infection prevention and control programs in the areas of people, tasks, tools, organization, built environment, and external environment.
AHRQ-funded; HS022465.
Citation: Crnich CJ .
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
J Am Med Dir Assoc 2022 Dec;23(12):1909-15. doi: 10.1016/j.jamda.2022.10.022..
Keywords: Elderly, COVID-19, Public Health, Infectious Diseases, Nursing Homes, Healthcare-Associated Infections (HAIs), Prevention
Guo W, Li Y, Temkin-Greener H
Coronavirus disease 2019 (COVID-19) in assisted living communities: neighborhood deprivation and state social distancing policies matter.
Investigators examined the association between COVID-19 cases in assisted living communities (ALCs) and the proportion of Medicare-Medicaid (dual) eligible minority residents, neighborhood area deprivation, and state COVID-19 policy stringency. They found that ALCs with higher proportions of dual-eligible minority residents were more likely to have COVID-19 outbreaks within their communities. Further, ALCs located in more socioeconomically deprived neighborhoods, and in states with less stringent state social distancing policies, tended to have more COVID-19 cases.
AHRQ-funded; HS026893.
Citation: Guo W, Li Y, Temkin-Greener H .
Coronavirus disease 2019 (COVID-19) in assisted living communities: neighborhood deprivation and state social distancing policies matter.
Infect Control Hosp Epidemiol 2022 Aug;43(8):1004-09. doi: 10.1017/ice.2022.46..
Keywords: COVID-19, Elderly, Long-Term Care, Policy, Public Health
Lee JL, Gustavson AM, Kian L
Reimagining cross-sector collaborations post-pandemic to optimize care for vulnerable homebound older adult populations.
This research letter discusses the development process for cross-sector collaborations post-pandemic to optimize care for vulnerable homebound older adult populations. These collaborations are proposed between health, social, and academic research systems. The authors collaborated with their local Houston Meals on Wheels (MOW) program, the University of Texas Health Science Center at Houston, and the Harris County Health System. These organizations formed a Healthy Aging Committee with several healthcare professionals from different healthcare systems participating as volunteers. The goal of the Committee was to identify ways to highlight the potential benefits of nutritious meal delivery. The three institutions worked together through all stages of research, from grant writing to recruiting participants, establishing trust in their relationships, and leveraging their connections and expertise in different areas. In their first research project, they investigated the addition of a home-based exercise program with enhanced meal deliveries to improve frailty status in older adults who were frail and homebound. This pilot study had been stopped during the pandemic. The restarted study was revised so that the MOW drivers delivering frozen and shelf-stable meals in person once a week would now also provide exercise handouts for those in the treatment group to minimize face-to-face contact. Their current second research project is evaluating whether the combination of a virtual assistant device such as Amazon Alexa with meal delivery can improve mental health for homebound older adults with cognitive impairment.
AHRQ-funded; HS026379.
Citation: Lee JL, Gustavson AM, Kian L .
Reimagining cross-sector collaborations post-pandemic to optimize care for vulnerable homebound older adult populations.
J Am Geriatr Soc 2022 Jul; 70(7):1939-41. doi: 10.1111/jgs.17813..
Keywords: Elderly, Home Healthcare, Vulnerable Populations, Public Health
Montoya A, Jenq G, Mills JP
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
In this study, the authors described, among short-term and long-term residents at three nursing homes (NHs) in Michigan, the outbreak identification process, universal testing, point prevalence of COVID-19, and subsequent containment efforts, outcomes, and challenges. They found that proactive and coordinated steps between NH medical directors and administrators, referral hospitals including their laboratories, and local public health officials were necessary to respond rapidly to an outbreak and to limit the transmission of COVID-19. They suggested that this coordinated public health approach may save lives, minimize the burden to the healthcare system, and reduce healthcare costs.
AHRQ-funded; HS025451.
Citation: Montoya A, Jenq G, Mills JP .
Partnering with local hospitals and public health to manage COVID-19 outbreaks in nursing homes.
J Am Geriatr Soc 2021 Jan;69(1):30-36. doi: 10.1111/jgs.16869..
Keywords: Hospitals, Nursing Homes, Long-Term Care, Public Health, COVID-19, Elderly, Infectious Diseases
Temkin-Greener H, Guo W, Mao Y
COVID-19 pandemic in assisted living communities: results from seven states.
The purpose of this observational study was to describe variations in COVID-19 confirmed cases and deaths among assisted living (AL) residents and examine their associations with key AL characteristics. The investigators concluded that ALs with a higher proportion of minorities had more COVID-19 cases. Many of the previously identified individual risk factors were also present in this vulnerable population.
AHRQ-funded; HS024923; HS026893; HS026893.
Citation: Temkin-Greener H, Guo W, Mao Y .
COVID-19 pandemic in assisted living communities: results from seven states.
J Am Geriatr Soc 2020 Dec;68(12):2727-34. doi: 10.1111/jgs.16850..
Keywords: Elderly, Public Health, COVID-19, Nursing Homes, Vulnerable Populations, Risk
White EM, Kosar CM, Feifer RA
Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities.
The objective of this study was to identify county and facility factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks in skilled nursing facilities (SNFs). The investigators concluded that larger SNFs and SNFs in areas of high SARS-CoV-2 prevalence were at high risk for outbreaks and must have access to universal testing to detect cases, implement mitigation strategies, and prevent further potentially avoidable cases and related complications.
AHRQ-funded; HS000011.
Citation: White EM, Kosar CM, Feifer RA .
Variation in SARS-CoV-2 prevalence in U.S. skilled nursing facilities.
J Am Geriatr Soc 2020 Oct;68(10):2167-73. doi: 10.1111/jgs.16752..
Keywords: COVID-19, Elderly, Nursing Homes, Long-Term Care, Public Health, Infectious Diseases
Jones KM, Mantey J, Mills JP
COVID-19 preparedness in Michigan nursing homes.
The objectives of this study were to understand preparedness among Michigan nursing homes (NHs) in the midst of an ongoing pandemic and to compare with a 2007 survey on pandemic influenza preparedness in Michigan NHs. Findings showed that, in 2020, NHs were able to make policy and procedure changes within 1 week in response to urgent guidance from CMS and the CDC, which likely helped the facilities prepare for the COVID-19 pandemic. Most NHs had a dedicated staff member responsible for preparedness and were willing to accept patients from hospitals to assist in their surge capacity planning, particularly for non-COVID patients. NHs did express concerns about staffing shortages and PPE supply constraints as cases rose.
AHRQ-funded; HS025451.
Citation: Jones KM, Mantey J, Mills JP .
COVID-19 preparedness in Michigan nursing homes.
J Am Geriatr Soc 2020 May;68(5):937-39. doi: 10.1111/jgs.16490..
Keywords: COVID-19, Elderly, Nursing Homes, Long-Term Care, Emergency Preparedness, Public Health
Adams C, Young D, Gastanaduy PA
Quantifying the roles of vomiting, diarrhea, and residents vs. staff in norovirus transmission in U.S. nursing home outbreaks.
Norovirus transmissibility is poorly understood and the goal of this study was to examine transmission via vomiting, diarrhea, and patient exposures. Six nursing home outbreaks in South Carolina were examined from 2014 to 2016. Vomiting infected 2.12 times the number of individuals as non-vomiters, diarrhea 1.39 times, and resident cases infected 1.53 times the number of individuals as staff cases. This finding is important for not just nursing homes, but other sites of norovirus outbreaks such as cruise ships.
AHRQ-funded; HS025987.
Citation: Adams C, Young D, Gastanaduy PA .
Quantifying the roles of vomiting, diarrhea, and residents vs. staff in norovirus transmission in U.S. nursing home outbreaks.
PLoS Comput Biol 2020 Mar;16(3):e1007271. doi: 10.1371/journal.pcbi.1007271..
Keywords: Elderly, Nursing Homes, Long-Term Care, Infectious Diseases, Healthcare-Associated Infections (HAIs), Prevention, Public Health
Malik S, Lee DC, Doran KM
Vulnerability of older adults in disasters: emergency department utilization by geriatric patients after Hurricane Sandy.
Older adults are a potentially medically vulnerable population with increased mortality rates during and after disasters. To evaluate the impact of a natural disaster on this population, the authors of this study performed a temporal and geospatial analysis of emergency department (ED) use by adults aged 65 years and older in New York City (NYC) following Hurricane Sandy's landfall.
AHRQ-funded; HS024172.
Citation: Malik S, Lee DC, Doran KM .
Vulnerability of older adults in disasters: emergency department utilization by geriatric patients after Hurricane Sandy.
Disaster Med Public Health Prep 2018 Apr;12(2):184-93. doi: 10.1017/dmp.2017.44..
Keywords: Elderly, Emergency Department, Vulnerable Populations, Public Health, Healthcare Utilization