Descriptive Analysis of Long-Term Care Facility Healthcare Worker Surveys in GA, NY, and TN Open Access
Kellogg, Joseph (Spring 2020)
It has been established that long term care facilities (LTCF) are a key component of both the incidence and prevalence of multi-drug resistant organisms (MDROs) within healthcare systems. Despite this fact, there is an inadequate body of work involving the role that LTCF nurse staffings and their unique considerations play in the transmission of MDROs. Novel methods and strategies are needed to better collect and interpret data involving transmission of MDROs in LTCFs.
This study seeks to contribute to this gap in knowledge by analyzing the information collected as part of an ongoing CDC funded research study of nursing contact networks within LTCFs. The study included collection of hourly survey data from staff in 9 facilities in GA, TN, and NY. In total, 18 different wards were sampled at these sites. Variations in frequency of care activities were evaluated; activities were categorized into enhanced barrier precaution (EBP) activities and non-EBP activities and stratified by time of day, HCW type and ward type.
Patient transfer (28%) was the most common EBP activity, while medication administration (37%) was the most common non-EBP activity. CNAs contributed the most to EBP activities (93%). Within any grouping of geographic location, there is considerable variation with large interquartile ranges of frequency of activities per hour. Differences in the median activities per hour exist when stratifying by ward type, but not by time in the shift. For specifically EBP activities, hourly frequency does not vary by ward type, while it does for non-EBP activity. Nursing activities can be recorded through scheduled mini-survey techniques, allowing quantification of activity types for epidemiologic analysis and research. Differences in care activities can be quantified using this technique.
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