Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, 31-121 Cracow, Poland.
Statistical Laboratory, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Cracow, Poland.
Medicina (Kaunas). 2024 Jan 11;60(1):137. doi: 10.3390/medicina60010137.
: The number of residents of long-term care facilities (LTCFs) is expected to increase. Determining the epidemiological situation in the context of organizational conditions is therefore extremely important for planning the necessary future activities in the field of infection prevention. The aim of this study was to analyze the prevalence rates in Polish nursing vs. residential homes, in the context of the medical and functional burdens of residents and the organizational conditions of both types of units. : the data that were analyzed came from a point prevalence survey of infections and antibiotic consumption in LTCFs, conducted in accordance with the HALT-3 protocol in Poland in 2017, between April and June. : This study included a total of 2313 residents in 24 LTCFs. The most common risk factors for infections in the study population were urinary and fecal incontinence (77.0%), impaired mobility (the patient was in a wheelchair or lying down) (68.7%), and impaired spatial and temporal orientation (52.5%). The median prevalence in nursing homes (NHs) was 3.2% and that in residential homes (RHs) was 0.7%, but without statistical significance. The median for the entire group was 2.6%. A total of 93 healthcare-related infections were detected in 91 residents. The most frequently reported forms of infections were urinary tract infections, lower respiratory tract infections, and skin infections. A statistically significant positive correlation was found only between the percentage of residents with pressure ulcers and other wounds and the incidence of gastrointestinal infections (correlation coefficient = 0.413, < 0.05). Infection prevention and control measures were implemented mainly in nursing homes, and in residential homes, only hand hygiene procedures were commonly available. : For the two types of LTCFs, the epidemiological situation in terms of nosocomial infections is diverse. Consequently, both types of facilities require different approaches to infection control and prevention and outcomes analysis.
长期护理机构(LTCF)的居民数量预计将会增加。因此,在组织条件的背景下确定流行病学情况对于规划未来感染预防领域的必要活动极其重要。本研究的目的是分析波兰护理院和养老院居民的患病率,考虑到居民的医疗和功能负担以及这两种机构的组织条件。
本研究分析的数据来自于 2017 年波兰按照 HALT-3 协议进行的长期护理机构感染和抗生素使用的时点患病率调查,调查时间在 4 月至 6 月间。该研究共纳入了 24 家 LTCF 的 2313 名居民。研究人群中感染的最常见危险因素是尿失禁和大便失禁(77.0%)、行动能力受损(患者在轮椅上或卧床)(68.7%)以及空间和时间定向障碍(52.5%)。护理院(NHs)的患病率中位数为 3.2%,养老院(RHs)为 0.7%,但无统计学意义。整组的中位数为 2.6%。共在 91 名居民中检测到 93 例与医疗保健相关的感染。报告的感染形式最常见的是尿路感染、下呼吸道感染和皮肤感染。仅在居民中压疮和其他伤口的比例与胃肠道感染的发生率之间发现具有统计学意义的正相关(相关系数=0.413,<0.05)。感染预防和控制措施主要在护理院实施,而在养老院,仅普遍执行手部卫生程序。
对于这两种类型的 LTCF,医院感染的流行病学情况各不相同。因此,这两种类型的设施需要采取不同的感染控制和预防措施以及结果分析方法。