Diarrheal diseases are a growing problem in nursing homes. Among other causes, one of the most frequent sources of diarrheal diseases is Clostridium difficile. This infection is a type of spore-forming bacteria that is especially harmful for older individuals. Among the elderly, it causes an increase in mortality and morbidity.
The Agency for Healthcare Research noted that cases of diarrheal diseases caused by Clostridium difficule (CDI) rose from 85,700 to 148,900 cases from 1993 to 2001 among hospital discharges. In just a four year span from 2001 to 2005, cases more than doubled. Out of these cases, 69 percent were older than 60 years of age. Depending on the state, nursing homes may be required to report the number of CDI-related cases that they have every year.
In long-term care facilities, the nursing homes with the sickest residents had the highest reported cases of CDI infections. Long-term care facilities reported 0 to 2.62 cases for every 1,000 days of residence at a nursing home. An estimated 10 to 20 percent of individuals are believed to acquire CDI during their stay in a nursing home.
There are many different risk factors associated with having diarrheal diseases. Among them, antibiotic use is one of the most common. A study of 73 nursing homes from September of 2001 to February of 2002 showed that 40 percent of residents were given antibiotics. When antibiotics are prescribed, the incidence of CDI increases. Individuals who were infected with CDI had a one-year mortality of 83 percent versus the normal 50 percent.
One of the main reasons that diarrheal diseases are a concern for nursing homes is the type of patient who regularly stays in these facilities. Older individuals typically have lower immune system function. They may also have chronic illnesses that make them more likely to contract CDI. Longer stays and tube feedings seem to increase the health risks associated with CDI. Likewise, proton pump inhibitors are connected to a higher mortality among CDI cases. These pumps may increase mortality since they increase the colonization of the gastrointestinal tract and suppress gastric acid.
Diarrheal illnesses are typically transmitted by the hands of medical personnel or an unclean environment. The bacteria that causes diarrheal disease is shed in the stool and spread through contact with the stool. If medical personnel regularly wash their hands and clean tools, it can reduce the spread of this disease.
Once CDI is reported in the nursing home, there are several preventative measures that must be put in place. Infected patients are typically moved to a separate area so that the disease is less likely to spread. Cleaning the nursing home, medical devices and other equipment must be done to reduce the chances of a continued outbreak. Likewise, hand sanitizing stations and hand-washing regulations must be implemented. Through proper staff education, the incidence of diarrheal diseases can be reduced.
If staff members do not take appropriate precautions, a single case of diarrheal illness can quickly spread among other nursing home residents. Since the mortality rate is higher among the elderly, this causes an increase in deaths and life-threatening illnesses. If you or a loved one has dealt with CDI or a similar diarrheal illness in a nursing home, you have legal recourse available. Negligence or neglect on the part of the nursing home can be remedied in court. For more information, contact a lawyer to find out the options that are available to you. In the meantime, make sure to seek medical treatment for the illness. If it is caught early, CDI can be treated more effectively and transmission rates can be reduced.
Sources:
http://patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2010/mar18_7(suppl1)/Pages/10.aspx
https://www.nhqualitycampaign.org/files/AE_Factsheet_for_Leadership_Infections.pdf
http://www.hupy.com/library/nursing-home-abuse-statistics-the-true-story.cfm