Long-term care facility

Environmental surfaces in a long-term care facility... 

Greig, J. D. and Lee, M. B. (2009). Enteric outbreaks in long-term care facilities and recommendations for prevention A review. Epidemiol. Infect. 137,145-155. 

Ohwaki, K., Nagashima, H., Aoki, M., Aoki, H., and Yano, E. (2009). A foodborne norovirus outbreak at a hospital and an attached long-term care facility. Jpn. J. Infect. Dis. 62, 450-454. 

Wu, H. M., Fornek, M., Schwab, K. J., Chapin, A. R., Gibson, K., Schwab, E., Spencer, C., and Henning, K. (2005). A norovirus outbreak at a long-term-care facility The role of environmental surface contamination. Infect. Control Hosp. Epidemiol. 26, 802-810. 

The consultant pharmacist is reviewing the care of AN, who is a 79-year-old male resident of a long-term care facility. According to his records, he has received phenytoin and phenobarbital ever since suffering a stroke 12 years ago. There is no record of a seizure in his chart, and the nursing staff has not observed a seizure since he arrived at the facility 2 years ago. His family recalls that he had 1 seizure around the time of his stroke, but has not had any more seizures. 

Despite the growing emphasis on pain management, pain often remains undertreated and continues to be a problem in hospitals, long-term care facilities, and the community. In one series of reports, 50% of seriously ill hospitalized patients reported pain however, 15% were dissatisfied with pain control, and some remained in pain after hospitalization.14,15... 

People who live in nursing homes and other long-term care facilities that house those with long-term illnesses... 

Pressures sores, also known as decubitous ulcers or bedsores, affect 1.5 to 3 million Americans annually.35 The cost of healing pressure sores can be substantial, with current estimates ranging from 2000 to 70,000 per wound.35 Although the prevalence of pressure sores is highest in long-term care facilities, 57% to 60% of new pressure sores actually develop in the hospital, most commonly in intensive-care and orthopedic patients. Elderly patients and those with spinal cord injuries are most at risk36... 

Many potential indications for EN exist (Table 98-2). PN was used extensively previously for many of these conditions. Advances in EN technology now allow many patients with these conditions to receive EN. EN is administered in both institutional (e.g., hospital and long-term care facility) and home settings. 

A number of EN formulas are marketed commercially Hospitals and long-term care facilities usually limit their formularies of EN formulas, stocking only a limited number of... 

Intravenous (i.v.) solutions are commonly administered to patients in hospitals, long-term care facilities, and ambulances. They are used primarily to replace body fluids and to serve as a vehicle for injecting drugs into the body. The advantages of this pharmaceutical dosage form include the rapid onset of action, the ability to treat patients unable to take medication orally and the ability to administer a medication unavailable in any other dosage form. 

Long-term care facility residents, regardless of vaccination status, when an outbreak has occurred in the institution. 

In long-term care facilities, where vaccination is most effective against complications, the aims of the vaccination campaign are fulfilled, at least in part. However, according to reliable evidence the usefulness of vaccines in the community is modest. The apparent high effectiveness of the vaccines in preventing death from all causes may reflect a baseline imbalance in health status and other systematic differences in the two groups of participants. 

Influenza is responsible for several thousand deaths each year. Individuals over the age of 65, residents of long-term care facilities, and patients with long-term health problems (i.e., diabetes, HIV or AIDS, heart disease, kidney disease, lung disease, cancer) are at highest risk for severe influenza and complications. Yearly vac-... 

Gurwitz JH, Field TS, Judge J, et al The incidence of adverse drug events in two large academic long-term care facilities. Am J Med 2005 1 18 251-258. 

Goto, K., Kanaya, S., Nishikawa, T., Hara, H., Terada, A., Ishigami, T., and Hara, Y., The influence of tea catechins on fecal flora of elderly residents in long-term care facilities, Ann. Long-Term Care, 6, 43, 1998. 

Pharmacists and technicians play a major role in medication safety in modern pharmacy practice. After summarizing several studies performed in hospitals and long-term care facilities, Allan and Barker (1990) estimated that medication errors occur at a rate of about 1 per patient per day. In a more recent study performed in ambulatory pharmacies, they found an overall dispensing accuracy rate for prescription medications of 98.3 percent (Allan, Barker, and Carnahan, 2003). While most of these errors probably have minimal clinical relevance and do not affect patients adversely, many experts believe that medication error rates may be higher in the ambulatory care setting because errors may not always be evident to the health professionals who work there. For example, medication errors can occur when a patient purchases nonprescription medications without speaking with the pharmacist about any potential interactions with his or her prescription medications or if patients fail to verify the appropriate dose of the over-the-counter (OTC) medication. 

Lombardi TP, Kennicutt JD. 2001. Promotion of a Safe Medication Environment Focus on the Elderly and Residents of Long-Term Care Facilities. Available at www.medscape.com/ accessed on May 14, 2001. 

Conn DK, Fansabedian N. Pattern of use of neuroleptics and sedative-hypnotic medication in a Canadian long-term care facility. Int J Geriatr Psychopharmacol 1999 2 18-22. 

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