养老机构的大流行性流感计划。
Pandemic influenza plans in residential care facilities.
机构信息
Division of Geriatric Medicine, School of Medicine, University of Colorado, Aurora, Colorado; Denver Veterans Affairs Medical Center, Denver, Colorado.
出版信息
J Am Geriatr Soc. 2014 Jul;62(7):1310-6. doi: 10.1111/jgs.12879. Epub 2014 May 22.
OBJECTIVES
To identify characteristics of residential care facilities (RCFs) associated with having a pandemic influenza plan.
DESIGN
Nationally representative, cross-sectional survey.
SETTING
RCFs in the United States.
PARTICIPANTS
Participating facilities in the 2010 National Survey of RCFs (N = 2,294), representing 31,030 assisted living facilities and personal care homes.
MEASUREMENTS
Facility-level characteristics associated with a pandemic influenza plan, including general organization descriptors, staffing, resident services, and immunization practices.
RESULTS
Forty-five percent (95% confidence interval (CI) = 43-47%) had a pandemic plan, 14% (95% CI = 13-16%) had a plan in preparation, and 41% (95% CI = 38-43%) had no plan. In the multivariable model, organization characteristics, staffing, and immunization practices were independently associated with the presence of a pandemic preparedness plan. Organization characteristics were larger size (extra large, OR = 3.27, 95% CI = 1.96-5.46; large, OR = 2.60, 95% CI = 1.81-3.75; medium, OR = 1.66, 95% CI = 1.21-2.27 vs small), not-for-profit status (OR = 1.65, 95% CI = 1.31-2.09 vs for profit), and chain affiliation (OR = 1.65, 95% CI = 1.31-2.09 vs nonaffiliated). Staffing characteristics included number of registered nurse hours (<15 minutes, OR = 1.36, 95% CI = 1.07-1.74 vs no hours), any licensed practical nurse hours (OR = 1.47, 95% CI = 1.08-1.99 vs no hours), and at least 75 hours of required training for aides (OR = 1.34, 95% CI = 1.05-1.71 vs <75 hours). RCFs with high staff influenza vaccination rates (81-100%, OR = 2.12, 95% CI = 1.27-3.53 vs 0% vaccinated) were also more likely to have a pandemic plan.
CONCLUSION
A majority of RCFs lacked a pandemic influenza plan. These facilities were smaller, for-profit, non-chain-affiliated RCFs and had lower staff vaccination rates. These characteristics may help target facilities that need to develop plans to handle a pandemic, or other disasters.
目的
确定与制定大流行性流感计划相关的住宅护理设施（RCF）的特征。
设计
全国代表性的横断面调查。
地点
美国的 RCF。
参与者
参加 2010 年 RCF 全国调查的设施（N = 2294），代表 31030 个辅助生活设施和个人护理院。
措施
与大流行性流感计划相关的设施特征，包括一般组织描述符，人员配备，居民服务和免疫接种实践。
结果
45%（95%置信区间（CI）= 43-47%）有大流行性流感计划，14%（95%CI = 13-16%）有计划在准备中，而 41%（95%CI = 38-43%）没有计划。在多变量模型中，组织特征，人员配备和免疫接种实践与大流行性流感防备计划的存在独立相关。组织特征是规模较大（特大，OR = 3.27，95%CI = 1.96-5.46；大，OR = 2.60，95%CI = 1.81-3.75；中，OR = 1.66，95%CI = 1.21-2.27 与小），非营利性地位（OR = 1.65，95%CI = 1.31-2.09 与营利性）和连锁隶属关系（OR = 1.65，95%CI = 1.31-2.09 与非附属）。人员配备特征包括注册护士小时数（<15 分钟，OR = 1.36，95%CI = 1.07-1.74 与无小时数），任何持照的实习护士小时数（OR = 1.47，95%CI = 1.08-1.99 与无小时数），以及助手至少需要 75 小时的规定培训（OR = 1.34，95%CI = 1.05-1.71 与<75 小时）。员工流感疫苗接种率高（81-100%，OR = 2.12，95%CI = 1.27-3.53 与 0%接种）的 RCF 也更有可能制定大流行性流感计划。
结论
大多数 RCF 都缺乏大流行性流感计划。这些设施规模较小，为营利性，非连锁附属设施，员工疫苗接种率较低。这些特征可能有助于确定需要制定计划以应对大流行或其他灾害的设施。
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