Systematic decolonization of nursing home patients reduced hospitalizations and infections (SHIELD-OC)
About half of nursing home residents and 80% of patients in long term acute care hospital (LTACH) patients are colonized with multidrug resistant organisms (MDROs). The rate is 10-15% in most acute care hospitals. The spread of MDROs through health care environments seems like an unstoppable force, but a new study provides encouraging proof the tide can at least be slowed.
Thirty-five centers in southern California–including 16 hospitals, 16 nursing homes, and 3 LTACHs—launched a quality improvement program from 2017-2019 in which all nursing home and LTACH patients were bathed with chlorhexidine solutions (~3x/week), and their nares treated with povidone-iodine. ICUs were encouraged to follow high-intensity decolonization practices.
As compared with the pre-implementation period,
MDRO prevalence fell from 80% to 53% in LTACHs, from 64% to 50% in nursing homes, and from 64% to 55% in hospitalized patients in contact precautions.
Infection-related hospitalizations and deaths, as well as …
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