The tool uses existing evidence to form recommendations for staffing ratios in long-term care, acute and ambulatory care settings. All of the recommendations are based on key risk factors.

“We are excited to provide this tool to the infection prevention field,” Patricia Jackson, RN, president of APIC, said in a statement. “APIC members have been asking for a resource to help quantify staffing needs for years, and now we can begin to deliver on that promise. With member input, we will be able to provide a robust, accurate staffing tool that will help IP leaders make the case for adequate staff and resources to protect patients.”

The introductory version of the staffing calculator is an “exploratory approach,” APIC says. That is, it’s intended to provide a basic calculation of staffing needs and will collect data that can be used for creating a more rigorous algorithm in the future. 

Data gathered from healthcare facilities that use the tool will be utilized to update it so the tool improves over time. In the next year, an updated version will be released to reflect the accumulated data. In addition to updating the tool as it rolls out, APIC said that it will produce annual reports summarizing data to drive deeper insights into its effectiveness.

The news comes as more organizations are hiring chief infection prevention officers (CIPOs). An article published Dec. 7 in Infection Control Today shared details on this executive role that supports operational positions through the lens of preventing infection.

Home-delivered meals promote food security, socialization and independence in older adults who are homebound. The researchers wanted to know if it was feasible to enroll people with self-reported dementia for Meals on Wheels, and if doing so would delay nursing home placement. The findings appeared in JAMA Network Open Wednesday.

The program evaluated older adults with self-reported dementia who were on waiting lists for different Meals on Wheels programs in Florida and Texas between April and October 2021. Researchers compared daily delivery and frozen meals that were mailed every two weeks. 

The scientists randomized 325 participants into two groups. The first group included 128 people who received meals from a driver on a daily basis, and the second group was made up of 115 people who got frozen meals mailed to their homes every other week. Participants received the meals for up to six months. Of the people, the mean age was 81, 62.6% were women, and 49% of them lived alone.

At six months into the trial, 10.1% of participants were admitted to nursing homes. Participants who received daily-delivered meals had a lower, although nonsignificant, likelihood of being placed in a nursing home compared to those who received frozen meals. 

Six months after the program started, 65.8% were still getting meals; 68.8% of people who received meals daily finished the program, and 62.6% of people getting frozen meals finished the program. One factor that could be an obstacle for people who got frozen meals was that they needed to be heated up and didn’t come ready-to-eat like the ones delivered daily.

“This pilot study demonstrated the feasibility of implementing a pragmatic randomized clinical trial among participants with self- or proxy-reported dementia on waiting lists at Meals on Wheels programs,” the authors wrote. “We also showed the ability to link participants with their CMS data, monitor fidelity, and measure the time to nursing home placement.”

The goal of the 16-week program was to train staff to deliver personalized care to residents. 

Teams from the University of Exeter and King’s College London implemented the  Improving the Wellbeing and Health for People Living with Dementia (iWHELD) program, which included a one-month orientation phase followed by a four-month off-site training phase. The program allocated one day per month for person-centered care (PCC) classroom-based sessions led by an iWHELD trainer that incorporated didactic learning, experiential activities and implementation planning. The other four months required regular on-site consultation sessions with each care home to support the program as it launched. Live coaching was delivered during the COVID-19 pandemic. 

Researchers delivered the program to staff supporting 739 residents in 149 residential homes in the UK. The team compared those who used iWHELD to usual care. In addition to reducing use of sedatives, markers of quality of life were better in the intervention group.

“Urgent action is needed to ensure care homes have access to dementia care training and support that is both high quality and shown to be effective. Every person deserves thoughtful and compassionate care and not everyone is receiving it,” Joanne McDermid, creator of the iWHELD platform and lead author of the paper, said in a statement.

McDermid went on to say that iWHELD is the first program to provide an effective, evidence based, affordable and scalable solution that can address the care needs and improve the lives of the people with dementia.

“As part of the training around personalized care, we’ve realized we need to change our approaches and even our demeanors to communicate effectively with residents … so if someone is quite reserved, being very bubbly is less effective and relatable to that person,” Katie Ives, manager of  a care home that participated in the iWHELD training, said in a statement. “We’ve always tailored our approach to residents, but now we offer a wider variety of activities and clubs to suit people’s interests in their lives, and we’re seeing some residents spend more time in communal areas and less time in their rooms as a result.”

The National Vital Statistics Report was published on Dec. 15. Data in the report came from the National Center for Health Statistics between 2000 and 2019. Death patterns in older adults haven’t been investigated as much as they have in younger people, the authors noted.

Deaths from cardiovascular disease slipped during the study period, but deaths from alcohol- and drug-related causes rose. Suicide death rates increased from 2006 until 2019.

In people with dementia, there was a rising trend in death rates between 2000 and 2011, though increases after 2011 weren’t statistically significant. Dementia-related death rates were higher for women than men throughout the duration of the study (1.2 times higher in 2000 and 1.3 times higher in 2019). In 2019, dementia-related death rates for white adults were higher than rates for other groups.

Where people lived played a role in death rate fluctuations as well, as death rates were higher in rural areas compared to urban ones.

In 2019, the top six causes of death in people over the age of 65 were chronic diseases. In the future, death rates will take into account those from COVID-19, as it was the third leading cause of death in older adults in 2020 and 2021.

A few other notable statistics from the report:

• Age-adjusted death rates for people 65 and older decreased from 2000 through 2019. The numbers went from 5,169 in 2000 to 4,073.8 deaths in 2019 (per 100,000 U.S. standard population). 
• Death rates were lower in 2019 compared to 2000 in men and women over 65 among all race and Hispanic-origin groups. Death rates for Black men were higher compared to other groups during the period, but still declined overall. 
• Death rates went down in men and women ages 65 to 74. Death rates for Black men and women were higher than rates for other race and Hispanic-origin groups throughout the study period. 
• In those ages 75 to 84, death rates went down in men during the time studied; in women, the death rates were lower than in men.
• In those 85 years old and up, death rates in men went down. Rates in women were lower than in men. During the study period, death rates were highest for white men and women compared with other groups.

The team looked at 148 advanced treatments used in 116 patients. Modifying treatment courses was linked with improvements and lower rates of adverse effects. Clinicians initially sought to switch treatment plans due to symptom control issues and adverse effects, the authors reported.

Authors of the report said they would like to see larger studies to create clinical decision guidelines and recommendations for considering treatment changes. They’d make such changes in the event that advanced therapies don’t live up to their expectations as is the case with other chronic ailments.

“With patients living longer, we will be faced more and more often with the question of what we can do for patients when an advanced treatment fails,” Paul Lingor, MD, lead author and a professor of neurology at the Technical University of Munich in Germany, said in a statement. “We were able to show improvement for patients from a change in treatments is almost the same as when the original treatment is introduced. This is an enormous benefit.”

Since 2005, the team has looked at changes that were made to initial  therapy among people who have Parkinson’s disease. Data came from people who were treated at 22 Parkinson’s disease care centers in Germany.

A subgroup analysis showed that deep brain stimulation (DBS) was the most long-lasting therapy that required a change. Findings suggest adding DBS or pump therapies in patients with leading dyskinesia, adding levodopa/carbidopa intestinal gel (LCIG) for other cardinal motor symptoms, and adding of LCIG or continuous subcutaneous apomorphine infusion for dominant off-time, which is when symptoms return between doses.

The study was led by a team from Michigan Medicine and published Tuesday in Neurology.

In it, researchers say that nearly 30% of the caregivers went on to have major psychological distress in the year after a loved one survived a stroke.

The results come as no surprise, because stroke can have devastating impacts on a person. It can cause permanent disability or death. 

“As physicians, we usually concentrate on our patients, and it is important to recognize that caregivers may have long-term consequences from a loved one’s severe illness,” Lewis Morgenstern, MD, a professor of neurology, neurosurgery and emergency medicine at University of Michigan Medical School and professor of epidemiology at the U-M School of Public Health, said in a statement.

The team assessed people who survived strokes as well as their caregivers. The study population was limited to Nueces County, Texas. Study subjects had strokes between April 2016 and October 2020.

Anywhere from 17% to 28% of the caregivers had high scores when they were evaluated for psychological distress. The scientists looked at depression, anxiety and post-traumatic stress disorder, specifically. Of the people, 16% experienced all three conditions, they reported.

“This research suggests that depression, anxiety and post-traumatic stress are common among family members who make life and death decisions for their loved ones who are very sick,” he said. 

Because of where the study was confined to, it could have some specific findings that may not be replicated in a larger study. Post-traumatic stress may be more common in Mexican American caregivers, who made up about two-thirds of the study population, Morgenstern added. Post-traumatic stress, specifically, was worse among Mexican American caregivers compared to white people who were caregivers. 

Notably, caregivers’ depression scores improved more rapidly over time for white caregivers.

“There are important support systems for families in hospitals which include nurses, social workers and the patient’s medical team,” Morgenstern said. “The role of family-centered care has received a lot of traction in recent years, and this research emphasizes how important that is.”

Antihypertensive medicines include renin-angiotensin-aldosterone converting enzyme inhibitors (RAASi), amlodipine and thiazide diuretics. The researchers looked at Medicare fee-for-service beneficiaries who were living in nursing homes. They examined the use of the medication from claims between 2015 and 2018. Then the scientists linked that data with clinical assessments and data on falls, fractures and cardiac events from hospitalization data. All of the participants were followed from the day they started the medication until they disenrolled, passed away or until six months passed. The mean follow-up span was 5.3 months.

Researchers studied a total of 16,504 individuals; 9,574 were on RAASi drugs, 5,409 were on amlodipine and 1,881 were on thiazide. The mean age of participants was 83.5 years old and 70.6% were females.

Over the course of the follow-up period, 2% of people had a fall that caused injuries, 9.6% people experienced a major adverse cardiac event and 12.9% of the people died. The rates of cardiac events were similar in those on the blood pressure medicines. People stopped taking thiazides more often than other classes of the medicines, the authors found. 

“Older adults with limited life expectancy experience similar rates of injurious falls and short-term cardiovascular events after initiating any of the first-line antihypertensive medications,” the authors wrote.

Previous research has found a risk between the medicines and an older individual’s risk for falling, while other evidence found taking the drugs lowered the risk for cardiovascular events in older adults.

A team from Kaiser Permanente Northern California gave flu shots to more than 1.6 million patients ages 18 to 64 years. A total of 632,962 people received either the high-dose quadrivalent (four-strain) flu vaccine, while 997,366 people got one of two standard-dose vaccines. They were inoculated in the 2018-19 and 2019-20 respiratory virus seasons. The team compared how effective the shots were against infection and hospitalization.

Of the 675,252 older adults who were between the ages of  50 to 64 years, 41.4% received the recombinant vaccine, and 58.6% were given a standard-dose vaccine.

Then the team looked at flu tests. Of 16,340 tests performed, 23.4% were positive for the flu; 38.8% of cases were in people aged 50 to 64 years and 16.7% of them were hospitalized.

Among the older adults, 559 of 1,386 people in the recombinant group developed the flu compared to 925 out of 2,435 people in the standard-dose group. That means there’s a relative vaccine effectiveness of 15.3%.

The four-strain flu shot made by Sanofi is made without chicken eggs. This means it has a recombinant hemagglutinin protein that is genetically identical to the one in the strain of the flu virus — a perfect match.

“In traditional quadrivalent standard-dose inactivated influenza vaccines (SD-IIV4), chicken eggs are used to manufacture the influenza virus,” the authors wrote. “Mutations in the hemagglutinin protein during egg-based manufacturing can result in mismatch between the selected strain and the vaccine strain.”

If standard-dose vaccines were already preventing most cases of influenza and breakthrough cases were uncommon, preventing 15% of breakthrough cases wouldn’t be much of a public health perk, according to the researchers. 

“However, since standard-dose vaccines prevent at most 40 to 60% of influenza cases annually, reducing the incidence of breakthrough influenza by 15% would provide a substantial public health benefit, especially during more severe influenza seasons,” they said.