Antibiotikabruk og infeksjoner i sykehjem

Alberg, Torunn; Holen, Øyunn; Blix, Hege Salvesen; Lindbæk, Morten; Bentele, Horst; Eriksen, Hanne-Merete

doi:10.4045/tidsskr.16.0621

Cited by 22 publications

(20 citation statements)

References 13 publications

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“…On the other hand, several infection surveillance registries report a trend of decreasing rates of surgical site infection (SSI) after THA, including both superficial and deep infections (Manniën et al 2008 , Choi et al 2016 , Sodhi et al 2019 ). This was also the finding of the Norwegian Institute of Public Health’s SSI surveillance registry (Berg et al 2019 ). The European Centre for Disease Prevention and Control (ECDC) reports a stable in-hospital incidence of SSI after total hip arthroplasty since 2011 (ECDC 2019 ), similar to what we found for that period.…”

Section: Discussionsupporting

confidence: 76%

Increasing but levelling out risk of revision due to infection after total hip arthroplasty: a study on 108,854 primary THAs in the Norwegian Arthroplasty Register from 2005 to 2019

et al. 2020

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Background and purpose — Focus on prevention, surveillance, and treatment of infection after total hip arthroplasty (THA) in the last decade has resulted in new knowledge and guidelines. Previous publications have suggested an increased incidence of surgical revisions due to infection after THA. We assessed whether there have been changes in the risk of revision due to deep infection after primary THAs reported to the Norwegian Arthroplasty Register (NAR) over the period 2005–2019. Patients and methods — Primary THAs reported to the NAR from January 1, 2005 to December 31, 2019 were included. Adjusted Cox regression analyses with the first revision due to deep infection after primary THA were performed. We investigated changes in the risk of revision as a function of time of primary THA. Time was stratified into 5-year periods. We studied the whole population of THAs, and the subgroups: all-cemented, all-uncemented, reverse hybrid (cemented cup), and hybrid THAs (cemented stem). In addition, we investigated factors that were associated with the risk of revision, and changes in the time span from primary THA to revision. Results — Of the 108,854 primary THAs that met the inclusion criteria, 1,365 (1.3%) were revised due to deep infection. The risk of revision due to infection, at any time after primary surgery, increased through the period studied. Compared with THAs implanted in 2005–2009, the relative risk of revision due to infection was 1.4 (95% CI 1.2–1.7) for 2010–2014, and 1.6 (1.1–1.9) for 2015–2019. We found an increased risk for all types of implant fixation. Compared to 2005–2009, for all THAs, the risk of revision due to infection 0–30 days postoperatively was 2.2 (1.8–2.8) for 2010–2014 and 2.3 (1.8–2.9) for 2015–2019, 31–90 days postoperatively 1.0 (0.7–1.6) for 2010–2014 and 1.6 (1.0–2.5) for 2015–2019, and finally 91 days–1 year postoperatively 1.1 (0.7–1.8) for 2010–2014 and 1.6 (1.0–2.6) for 2015–2019. From 1 to 5 years postoperatively, the risk of revision due to infection was similar to 2005–2009 for both the subsequent time periods Interpretation — The risk of revision due to deep infection after THA increased throughout the period 2005–2019, but appears to have levelled out after 2010. The increase was mainly due to an increased risk of early revisions, and may partly have been caused by a change of practice rather than a change in the incidence of infection.

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Section: Discussionsupporting

confidence: 76%

Increasing but levelling out risk of revision due to infection after total hip arthroplasty: a study on 108,854 primary THAs in the Norwegian Arthroplasty Register from 2005 to 2019

et al. 2020

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“…The Healthcare-Associated infections in Long-Term care facilities (HALT) project showed that, among the participating countries, Denmark had the highest antibiotic use for elderly residing in nursing homes (NHs) [2]. In Europe, urinary tract infection (UTI) is the most common reason for antibiotic prescribing in NH residents [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Quality of the Diagnostic Process, Treatment Decision, and Predictors for Antibiotic Use in General Practice for Nursing Home Residents with Suspected Urinary Tract Infection

Sommer-Larsen¹,

Arnold²,

Holm³

et al. 2021

Antibiotics

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Urinary tract infections (UTIs) are common in nursing home (NH) residents and Denmark is one of the countries with the highest antibiotic use in NHs. The aim of this study was to assess the quality of the diagnostic process and treatment decision on the day of the first contact from NHs to general practice and assess predictors for prescription of antibiotics in NH residents without an indwelling urinary catheter. The study was a prospective observational study in general practice in the Capital Region of Denmark; 490 patients were included; 158 out of 394 (40.1%, 95% CI 35; 45) patients with suspected UTI had urinary tract symptoms; 270 out of 296 (91.2%, 95% CI 87; 94) patients without urinary tract symptoms had a urine culture performed. Performing urine culture in the general practice was inversely associated to prescription of antibiotics on day one (OR 0.27, 95% CI 0.13; 0.56). It is imperative to support the implementation of interventions aimed at improving the quality of the diagnostic process on day one, as less than half of the patients given the diagnosis “suspected UTI” had urinary tract symptoms, and most patients without urinary tract symptoms had a urine culture performed.

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“…It More than 80 per cent of the residents have dementia and need full-time attention (NPH, 2018). Residents in nursing homes have a relatively low tolerance for acute infections (Kittang & Krüger, 2018) and have a higher risk of developing infections that require antibiotics treatment than do elderly people living at home (Alberg et al, 2017). Approximately 7.8% of the residents received antibiotics in 2016 (NPH, 2017).…”

Section: Introductionmentioning

confidence: 99%

Students' observations of hand hygiene in nursing homes using the five moments of hand hygiene

Løyland

Peveri

Hessevaagbakke

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To use nursing students to observe hand hygiene adherence in nursing homes and to explore whether the students' reflections after observing hand hygiene practices gives them a deeper understanding of the subject matter. Background Residents in nursing homes worldwide have low tolerance for healthcare‐associated infections that require antibiotics, and hand hygiene is the single most effective action to reduce infections. Design Observational study using (a) World Health Organization's (WHO) “Five moments for hand hygiene” validated tool to record indications and adherence and (b) an exploratory study of individual reflection notes from students conducted during and after observations. Methods From February 12–15, 2018, 26 nursing students in their second semester of a 3‐year bachelor programme participated as observers in five wards in four nursing homes in the Oslo metropolitan area. This study was performed according to the STROBE statement. Results Hand hygiene was performed for 57.2% of the 2,393 indications observed and recorded. Adherence differed significantly by type of personnel and by location. Four thematic categories emerged from the reflection notes: (a) practical awareness and introspection; (b) visualisation and enhancement of understanding of practice learning; (c) incorrect hand hygiene practices; and (d) stimulation to increase essential knowledge. Conclusion Hand hygiene adherence was too low to prevent healthcare‐associated infections and to reduce the use of antibiotics. The students' reflection notes indicated more “insight and understanding of the complexity of hand hygiene.” We suggest using nursing students in clinical placement as a means of incorporating different interventions as part of their learning skills and become “living reminders” of the importance of hygiene and infection prevention. Relevance for clinical practice Improving the student's activity about hygiene and infection prevention in clinical placement may help to raise awareness by healthcare workers in nursing homes.

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Antibiotikabruk og infeksjoner i sykehjem

Cited by 22 publications

References 13 publications

Increasing but levelling out risk of revision due to infection after total hip arthroplasty: a study on 108,854 primary THAs in the Norwegian Arthroplasty Register from 2005 to 2019

Increasing but levelling out risk of revision due to infection after total hip arthroplasty: a study on 108,854 primary THAs in the Norwegian Arthroplasty Register from 2005 to 2019

Quality of the Diagnostic Process, Treatment Decision, and Predictors for Antibiotic Use in General Practice for Nursing Home Residents with Suspected Urinary Tract Infection

Students' observations of hand hygiene in nursing homes using the five moments of hand hygiene

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