Background and Objectives The COVID-19 pandemic may fundamentally change neighborhood environments and ways of aging in place. This research aimed to investigate perceptions of and engagement in neighborhoods since the pandemic onset among aging Americans. Research Design and Methods Data were from the COVID-19 Coping Study, a longitudinal cohort study of health and wellbeing of US adults aged ≥55 years during the COVID-19 pandemic. In the present analysis, we conducted a qualitative thematic analysis of responses to an open-ended survey question about how respondents felt that COVID-19 has impacted their neighborhood and relationships with neighbors. The survey data were collected June-September 2020 and analyzed for a random stratified sub-sample of 1,000 study participants. Sampling quotas for age, gender, race/ethnicity, and education aimed to match the US population aged ≥55 (average age: 67.7 years). Results We identified four overarching themes: altered neighborly social interactions, support levels, and community environments; and no observed changes. Geographic factors that impacted neighborhood engagement included age structure, sociopolitical diversity, urbanicity/rurality, and walkability; while individual factors included age, race/ethnicity, socioeconomic status, political orientation, health status, duration of residence, lifestyle, and personality. Discussion and Implications The results highlight resilience among aging adults and their neighbors, sources of individual and community vulnerability, and opportunities to strengthen social infrastructure to support aging in place since the pandemic onset.

Nicaragua is a very low-income country entering a period of rapid aging with limited geriatric training for health care professionals. To help build capacity and to enhance student learning, a short-term international service-learning program was implemented in 2004 in partnership with the Jessie F. Richardson Foundation and Nicaraguan community stakeholders. Graduate and undergraduate students at Portland State University complete coursework for one term in the United States then travel to Nicaragua for about two weeks to participate in educational, research, and service activities, primarily in group homes for older Nicaraguans. Students learn about global aging, gerontology, community development, service learning, and Nicaraguan history and culture, then apply their gerontology-related knowledge by training direct care staff, older adults and their family members, and students. The authors describe the impetus for and evolution of the program, students' evaluation of the program, faculty observations on program benefits and challenges, lessons learned, and future plans.

Background Postoperative cardiovascular surgical site infections are preventable events that may lead to increased morbidity, mortality, and health care costs. Objective To improve surgical wound surveillance and reduce the incidence of surgical site infections. Methods An institutional review of surgical site infections led to implementation of 8 surveillance and process measures: appropriate preparation the night before surgery and the day of surgery, use of appropriate preparation solution in the operating room, appropriate timing of preoperative antibiotic administration, placement of a photograph of the surgical site in the patient’s chart at discharge, sending a photograph of the surgical site to the patient’s primary care physician, 30-day follow-up of the surgical site by an advanced nurse practitioner, and placing a photograph of the surgical site obtained on postoperative day 30 in the patient’s chart. Results Mean overall compliance with the 8 measures from March 2013 through February 2014 was 88%. Infections occurred in 10 of 417 total operative cases (2%) in 2012, in 8 of 437 total operative cases (2%) in 2013, and in 7 of 452 total operative cases (1.5%) in 2014. Conclusions Institution of the surveillance process has resulted in improved identification of suspected surgical site infections via direct rather than indirect measures, accurate identification of all surgical site infections based on definitions of the National Healthcare Safety Network, collaboration with all persons involved, and enhanced communication with patients’ family members and referring physicians.

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Background: Healthcare-associated infections are a major focus for quality improvement in hospitals today. Surgical site infections (SSIs), a postoperative complication in cardiac surgery, are associated with increased morbidity, mortality, hospital length of stay, and financial burden. Methods: A recent increase in cardiothoracic surgery SSIs (CT-SSIs) at our institution instigated a multidisciplinary team to explore infection prevention, bundle element compliance, and to identify interventions to reduce the CT-SSI rate. Key interventions included preoperative screening and decolonization of methicillin-sensitive Staphylococcus aureus and methicillin-resistant S. aureus with repeated intranasal applications of mupirocin, universal skin prep with chlorhexidine for all patients, and additional antibiotic dosing upon initiating cardiopulmonary bypass. Results: In 2014, the CT-SSI rate at our institution was 1.9/100 cases, which increased during the “intervention period” to 3.6 infections/100 cases in 2015 (16 total infections). Postinterventions, the CT-SSI rate decreased to 0.3 infections/100 cases (2 total infections), which was significantly lower than our baseline before the spike in infection rate. Conclusions: A comprehensive interdisciplinary approach with multiple interventions was successful in significantly reducing the CT-SSI rate in cardiothoracic surgery at a tertiary care pediatric hospital.