Title
Reliability of Nonlocalizing Signs and Symptoms as Indicators of the Presence of Infection in Nursing-Home Residents
Authoring Organization
Publication Month/Year
December 8, 2020
Last Updated Month/Year
December 19, 2024
Document Type
Consensus
External Publication Status
Published
Country of Publication
US
Document Objectives
Antibiotics are among the most common medications prescribed in nursing homes. The annual prevalence of antibiotic use in residents of nursing homes ranges from 47% to 79%, and more than half of antibiotic courses initiated in nursing-home settings are unnecessary or prescribed inappropriately (wrong drug, dose, or duration). Inappropriate antibiotic use is associated with a variety of negative consequences including Clostridioides difficile infection (CDI), adverse drug effects, drug–drug interactions, and antimicrobial resistance. In response to this problem, public health authorities have called for efforts to improve the quality of antibiotic prescribing in nursing homes.
Target Patient Population
Nursing-home residents
PICO Questions
What criteria should clinicians use to identify the presence of fever in a nursing home resident?
Should identification of fever in a nursing home resident prompt further evaluation for infection?
What criteria should clinicians use to identify the presence of hypothermia in a resident of a nursing home?
Should identification of new-onset hypothermia in a nursing home resident prompt further evaluation for infection?
What criteria should clinicians use to identify the presence of hypotension in a resident of a nursing home?
Should identification of new-onset hypotension in a nursing home resident prompt further evaluation for infection?
What criteria should clinicians use to identify the presence of hyperglycemia in a resident of a nursing home?
Should identification of new-onset hyperglycemia in a nursing home resident prompt further evaluation for the presence of infection?
What criteria should clinicians use to identify the presence of delirium in a resident of a nursing home?
Should identification of delirium in a nursing home resident prompt further evaluation for the presence of infection?
Should identification of new-onset behavioral change(s), exclusive of delirium, in a nursing home resident prompt further evaluation for the presence of infection?
Should identification of new-onset functional decline in a nursing home resident prompt further evaluation for the presence of infection?
Should a fall in a nursing home resident prompt further evaluation for the presence of infection?
Should new-onset anorexia a nursing home resident prompt further evaluation for the presence of infection?
Inclusion Criteria
Male, Female, Older adult
Health Care Settings
Long term care
Intended Users
Epidemiology infection prevention, nurse, nurse practitioner, physician, physician assistant
Scope
Management, Prevention
Diseases/Conditions (MeSH)
D005851 - Geriatric Nursing, D006701 - Home Nursing, D009735 - Nursing Homes
Keywords
nursing home, infection prevention
Source Citation
Rowe TA, et al. (2020). Reliability of non-localizing signs and symptoms as indicators of the presence of infection in nursing-home residents. Infection Control & Hospital Epidemiology, 1–10. doi:10.1017/ice.2020.1282