{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T16:35:12Z","timestamp":1793810112188,"version":"4.6.1"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T00:00:00Z","timestamp":1716163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Nursing care residents have high hospitalization rates. To address this, we established a unique virtual geriatric unit that has developed a program aimed at providing support to nursing homes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aimed to evaluate effectiveness of in-house intravenous antibiotic treatment in nursing hospitals after the implementation of the specially designed training program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort study of nursing home residents to evaluate a training program for providers, designed to increase awareness and give practical tools for in-house treatment of acute infections. Data obtained included types of infections, antibiotics used, hospital transfer, and length of treatment. Primary outcomes were in-house recovery, hospitalization and mortality. Univariate analysis and multivariable logistic regression analysis to assess association between different factors and recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 890 cases of acute infections were treated with intravenous antibiotics across 10 nursing homes over a total of 4,436\u2009days. Of these cases, 34.8% were aged 90\u2009years or older. Acute pneumonia was the most prevalent infection accounted for 354 cases (40.6%), followed by urinary tract infections (35.7%), and fever of presumed bacterial infection (17.1%). The mean duration of intravenous antibiotic treatment was 5.09\u2009\u00b1\u20093.86\u2009days. Of the total cases, 800 (91.8%) recovered, 62 (7.1%) required hospitalization and nine (1.0%) resulted in mortality. There was no significant difference observed in recovery rates across different types of infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Appling a simple yet unique intervention program has led to more \u201cin-house\u201d residents receiving treatment, with positive clinical results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Treating in-house nursing home residents with acute infections resulted in high recovery rates. Special education programs and collaboration between healthcare organizations can improve treatment outcomes and decrease the burden on the healthcare system.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1333523","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T04:31:42Z","timestamp":1716179502000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Implementation of a program for treatment of acute infections in nursing homes without hospital transfer"],"prefix":"10.3389","volume":"11","author":[{"given":"Nadya","family":"Kagansky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reena","family":"Rosenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estela","family":"Derazne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelina","family":"Mazurez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yochai","family":"Levy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha","family":"Barchana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2712","DOI":"10.1001\/jama.294.21.2712","article-title":"Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States, 1988-2002","volume":"7","author":"Fry","year":"2005","journal-title":"JAMA"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2011\/247623","article-title":"Hospital admissions from nursing homes: rates and reasons","volume":"2011","author":"Kruger","year":"2011","journal-title":"Nurs Res Pract"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1186\/1471-2334-13-205","article-title":"Transmission of methicillin-resistant staphylococcus aureus in the long term care facilities in Hong Kong","volume":"13","author":"Cheng","year":"2013","journal-title":"BMC Infect Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1086\/368197","article-title":"Infectious disease outbreaks in nursing homes: an unappreciated Hazard for frail elderly persons","volume":"36","author":"Strausbaugh","year":"2003","journal-title":"CID"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1186\/s12877-016-0279-1","article-title":"Emergency department transfers and hospital admissions from residential aged care facilities: a controlled pre-post design study","volume":"16","author":"Hullick","year":"2016","journal-title":"BMC Geriatr"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1111\/j.1532-5415.2008.02109.x","article-title":"Patterns of chronic multimorbidity in the elderly population","volume":"57","author":"Marengoni","year":"2009","journal-title":"JAGS"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.1111\/j.1532-5415.2012.04188.x","article-title":"Guiding principles for the Care of Older Adults with multimorbidity: an approach for clinicians","volume":"60","year":"2012","journal-title":"J Am Geriatr Soc"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1852","DOI":"10.3201\/eid1312.070303","article-title":"Invasive group a streptococcal infection in older adults in long term care facilities and the community, United States, 1998-2003","volume":"13","author":"Thigpen","year":"2007","journal-title":"Emerg Infect Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1093\/cid\/ciq205","article-title":"Conceptual model for reducing infections and antimicrobial resistance in skilled nursing facilities: focusing on residents with indwelling devices","volume":"52","author":"Mody","year":"2011","journal-title":"Clin Infect Dis"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1111\/j.1532-5415.2000.tb03906.x","article-title":"Appropriateness of the decision to transfer nursing facility residents to the hospital","volume":"48","author":"Saliba","year":"2000","journal-title":"JAGS"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1651","DOI":"10.1111\/j.1475-6773.2006.00670.x","article-title":"Hospitalization of nursing home residents: the effects of states\u2019 Medicaid payment and bed-hold policies","volume":"42","author":"Intrator","year":"2007","journal-title":"HSR"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1111\/j.1532-5415.1997.tb00944.x","article-title":"Short \u2013term functional outcomes of long-term care residents with pneumonia treated with and without hospital transfer","volume":"45","author":"Fried","year":"1997","journal-title":"J Amer Geriat Soc"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1111\/j.1532-5415.2005.53205.x","article-title":"Outcomes of infection in nursing home residents with and without early hospital transfer","volume":"53","author":"Boockvar","year":"2005","journal-title":"J Amer Geriat Soc"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1111\/jgs.15662","article-title":"Hospital-associated complications of older people: a proposed multicomponent outcome for acute care","volume":"67","author":"Mudge","year":"2019","journal-title":"J Amer Geriat Soc"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1136\/pgmj.2008.076430","article-title":"Improving and of life care for nursing home residents an analysis of hospital mortality and readmission rates","volume":"86","author":"Ahearn","year":"2010","journal-title":"Postgrad Med J"},{"key":"ref16","volume-title":"The 65+ Population in Israel 2021.","author":"Shnoor","year":"2021"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1590\/S0104-42302007000200016","article-title":"Infection in elderly interned in long-term care facilities","volume":"53","author":"Villas B\u00f4as","year":"2007","journal-title":"Rev Assoc Med Bras"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/1472-6963-9-44","article-title":"A qualitative examination of inappropriate hospital admissions and lengths of stay","volume":"9","author":"Hammond","year":"2009","journal-title":"BMC Health Serv Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1016\/j.jamda.2017.02.007","article-title":"What are nursing facilities doing to reduce potentially avoidable hospitalizations?","volume":"18","author":"Daras","year":"2017","journal-title":"JAMDA"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1046\/j.1532-5415.2001.49999.x","article-title":"Practice guideline for evaluation of fever and infection in long \u2013term care facilities","volume":"49","author":"Bentley","year":"2001","journal-title":"JAGS"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1111\/j.1532-5415.2000.tb03034.x","article-title":"Treatment guideline for nursing home\u2010acquired pneumonia based on community practice","volume":"48","author":"Naughton","year":"2000","journal-title":"J Amer Geriat Soc"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"219","DOI":"10.7326\/0003-4819-118-3-199302010-00011","article-title":"Hazards of hospitalization of the elderly","volume":"118","author":"Creditor","year":"1993","journal-title":"Ann Intern Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1136\/thx.2009.124776","article-title":"Nursing home acquired pneumonia: a10 year single-Centre experience","volume":"65","author":"Polverino","year":"2010","journal-title":"Thorax"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1046\/j.1365-2524.2001.00314.x","article-title":"The use of acute hospital services by elderly residents of nursing and residential care homes","volume":"9","author":"Godden","year":"2001","journal-title":"Health Soc Care in the Community"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1136\/pmj.77.903.40","article-title":"Acute hospital admissions from nursing homes: some may be avoidable","volume":"77","author":"Bowmana","year":"2001","journal-title":"Postgrad Med"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"e538","DOI":"10.3399\/bjgp12X653589","article-title":"Hospital admissions from nursing homes: a qualitative study of GP decision making","volume":"62","author":"McDermott","year":"2012","journal-title":"Br J Gen Pract"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1186\/s13756-018-0364-7","article-title":"Comparing appropriateness of antibiotics for nursing home residents by setting of prescription initiation: a cross-sectional analysis","volume":"7","author":"Pulia","year":"2018","journal-title":"Antimicrob Resist Infect Control"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1007\/BF03339873","article-title":"Characteristics associated with inappropriate hospital use in elderly patients admitted to a general internal medicine service","volume":"12","author":"Ingold","year":"2000","journal-title":"Aging Clin Exp Res"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"324","DOI":"10.18043\/ncm.77.5.324","article-title":"Optimizing antibiotic use in nursing homes through antibiotic stewardship","volume":"77","author":"Sloane","year":"2016","journal-title":"N C Med J"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"s74","DOI":"10.1016\/j.jamda.2005.12.019","article-title":"Should I hospitalize my resident with nursing home-acquired pneumonia?","volume":"7","author":"Dosa","year":"2006","journal-title":"JAMDA"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1001\/jamainternmed.2017.2657","article-title":"Effects of an intervention to reduce hospitalizations from nursing homes a randomized implementation trial of the INTERACT program","volume":"177","author":"Kane","year":"2017","journal-title":"JAMA"},{"key":"ref32","volume-title":"HCUP facts and figures: Statistics on hospital \u2013based care in the United States","year":"2008"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1186\/s13584-018-0265-5","article-title":"Reduced hospitalization rates are not associated with increased mortality or readmission rates in an emergency department in Israel","volume":"7","author":"Greenberg","year":"2018","journal-title":"Isr J Health Policy Res"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/j.cmi.2020.04.013","article-title":"Comparison of influenza hospitalization outcomes among adults, older adults, and octogenarians: a US national population-based study","volume":"27","author":"Lee","year":"2021","journal-title":"Clin Microbiol Infect"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/0002-9343(86)90514-0","article-title":"Infections in the elderly","volume":"81","author":"Garibaldi","year":"1986","journal-title":"Am J Med"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"390","DOI":"10.3390\/microorganisms9020390","article-title":"Asymptomatic bacteriuria (ABU) in elderly: prevalence, virulence, phylogeny, antibiotic resistance and complement C3 in urine","volume":"9","author":"Leihof","year":"2021","journal-title":"Microorganisms"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s41999-023-00887-7","article-title":"Preadmission morbidity and healthcare utilization among older adults with potentially avoidable hospitalizations: a Danish case-control study","volume":"15","author":"Schr\u00f8der","year":"2024","journal-title":"Eur Geriatr Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1377\/hlthaff.26.6.1753","article-title":"The costs and potential savings associated with nursing home hospitalizations","volume":"26","author":"Grabowski","year":"2007","journal-title":"Health Aff (Millwood)"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1333523\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T04:31:46Z","timestamp":1716179506000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1333523\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,20]]},"references-count":38,"alternative-id":["10.3389\/fmed.2024.1333523"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1333523","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,20]]},"article-number":"1333523"}}