McKnight’s had an article about the importance of hand washing to prevent infections from spreading in nursing homes.  A new study finds that — by harnessing hand hygiene methods already popular in hospitals — infections in nursing homes can be prevented.  Researchers concluded that implementing simple hand-hygiene protocols in nursing homes helped drop both mortality rates and the number of antibiotic prescriptions doled out, according new study results published in the February American Journal of Infection Control.

“Hand hygiene protocols have traditionally focused on acute-care settings. Our study is changing this narrative, underscoring that we can take a proven intervention practice and make it work outside of the hospital space, by specifically adapting it to long-term settings,” said Laura Temime, lead author of the study and a professor at the Conservatoire National des Arts et Métiers, in Paris, in a press release.

Newsweek reported that a new study published online in Acta Neuropathologica suggests that eight young adults who developed serious brain plaque buildup may have been “infected” with amyloid proteins via dirty medical instruments during brain surgeries in their youth.

Brain plaque buildup is one of the most recognized characteristics of Alzheimer’s disease, as well as other neurodegenerative diseases, such as Creutzfeldt-Jakob Disease (CJD), also known as “human” mad-cow disease, New Scientist reported. Eight patients in England experienced brain plaque buildup caused by excessive amyloid proteins so severe it caused blood vessels in their brain to burst.

Researchers from University College London reviewed the cases of eight young patients who had experienced cerebral amyloid angiopathy (CAA), a condition where amyloid proteins build up in blood vessels in the brain. Not only are both CAA and Alzheimer’s disease both characterized by brain plaque buildup, but both illnesses are also found in much older patients. All eight patients were under 60-years-old, therefore not yet at risk for brain plaque buildup. In addition, none of the patients were at predisposed genetic risk for this disease, New Scientist reported. Instead, the researchers found these patients shared one salient common factor: brain surgery during adolescence.

Lead researcher Sebastian Brandner, a professor of neuropathology at University City London and his UCL team, hypothesized that the amyloid proteins may have been transferred into the patients’ brains during surgery by hitching a ride on surgical instruments that had not been cleaned well enough, New Scientist reported.

The theory is that medical instruments previously used on Alzheimer’s patients were then used on these young adults. If the tools were not properly cleaned, amyloid proteins from the Alzheimer’s patients could then be transferred to other patients operated on with the same tools.

Brandner told Newsweek that there are no other risk factors that can explain such early onset CAA, and this suggests that transfer of proteins via medical tools is likely why these patients developed the disease so young.

“Brain surgery is so far the most likely cause,” said Brandner. “In theory other routes are thinkable, but we have no evidence.”

This is not the first time researchers have proposed that brain proteins can be transferred from patient to patient via surgery. A 2015 study also led by Brandner also suggested that fragments of sticky amyloid proteins spread among patients through contaminated surgical tools, The Guardian reported.

Brain protein buildup in young people is rare but not completely unheard of. Another study from 2015 suggested that plaque buildup in young people could simply be a sign that the “resource” and “machinery” needed to make these protein clumps already exist in young people.

“The implication appears to be that if we want to prevent these clumps from forming when a person becomes old, we may need to intervene much earlier than we have thought, to try and get rid of amyloid very early in life,” the 2015 study co-author Changiz Geula, a professor at the Northwestern University Feinberg School of Medicine in Chicago who focuses on Alzheimer’s disease, told CBS News.

WABE reported on the problem of infections in Georgia nursing homes.  The article was written by Andy Miller, editor and CEO of Georgia Health News. Kaiser Health News study and analysis of federal inspection records found that 43 percent of Georgia nursing homes have been cited for infection-related problems in recent years.  The KHN analysis of four years of federal inspection records shows 74 percent of nursing homes nationally have been cited for lapses in infection control — more than for any other type of health violation.

Nationwide, only one of 75 nursing homes found deficient in those four years has received a high-level citation that can result in a financial penalty, the analysis found.

The federal Centers for Medicare and Medicaid Services has required long-term care facilities to establish better systems to prevent infections, detect outbreaks early on and limit unnecessary use of antibiotics through a stewardship program.  Infections cause a quarter of the medical harm cases that Medicare beneficiaries experience in nursing homes, according to a federal report. They are among the most frequent reasons why residents are sent back to the hospital.

As average hospital stays have shortened from 7.3 days in 1980 to 4.5 days in 2012, patients who a generation ago would have recuperated in hospitals now go to nursing homes for short term rehabilitation.  This increases the acuity and needs of the residents without a corresponding increase in the necessary staffing.

You’ve got this influx of vulnerable patients, but the staffing models are still geared more to the traditional long-stay resident,” said Dr. Nimalie Stone, the Centers for Disease Control and Prevention’s medical epidemiologist for long-term care. “The kind of care is so much more complicated that facilities need to consider higher staffing.”



The L.A. Times reported the problem with infection control at nursing homes, and the lack of enforcement by investigators.  “Basic steps to prevent infections — such as washing hands, isolating contagious patients and keeping ill nurses and aides from coming to work — are routinely ignored in the nation’s nursing homes, endangering residents and spreading hazardous germs.”

Inspection records show nurses and aides are often not familiar with basic protocols, such as wearing protective clothing when coming into contact with contagious residents and isolating them from others in the home and visitors. Others are not trained properly on how to clean patients. Still others, in a rush and understaffed, take shortcuts that compromise sanitary precautions

Infections, most of which are avoidable, cause a quarter of the medical injuries Medicare beneficiaries experience in nursing homes, according to a federal report. They are among the most frequent reasons residents are sent back to the hospital. By one government estimate, healthcare-associated infections may result in as many as 380,000 deaths each year.

A Kaiser Health News analysis of four years of federal inspection records shows 74% of nursing homes have been cited for lapses in infection control — more than for any other type of health violation.  However, only 1 of 75 homes found deficient in those four years has received a high-level citation that can result in a financial penalty, the analysis found.  Only 161 homes among the 12,056 that violated infection-control rules were cited at those higher levels since 2014, according to Kaiser Health News’ analysis.

As average hospital stays have shortened to 4.5 days in 2012 from 7.3 days in 1980, patients who a generation ago would have fully recuperated in hospitals now frequently conclude their recoveries in nursing homes.  “You’ve got this influx of vulnerable patients but the staffing models are still geared more to the traditional long-stay resident,” said Dr. Nimalie Stone, the Centers for Disease Control and Prevention’s medical epidemiologist for long-term care. “[That] kind of care is so much more complicated that facilities need to consider higher staffing.”

The Age published an article on recent deaths caused by untreated flu.  The fatal flu outbreak at St John’s Village nursing home caused the death of 10 residents and two others from respiratory illness.  The government investigation blames serious management failures–it took days after infections began in August for management to report the outbreak.  By the time they did, 16 residents and eight staff were already sick.

In response, the St John’s Village nursing home accepted the resignation of its own former acting care services manager and referred him to his professional body for potential sanction.

The number of infections that occur each year in the nation’s long term care facilities is estimated to be between 1.6 and 3.8 million resulting in 388,000 fatalities. These infections cost between $673 million and $2 billion every year.  A new study proves that the failure to change gloves is a significant factor in the spread of dangerous pathogens in nursing homes. The study from the University of Iowa College of Nursing was published in the September issue of the American Journal of Infection Control, the journal of the Association for Professionals in Infection Control and Epidemiology (APIC).

Incorrect glove usage by these healthcare professionals causes the spread of pathogens from patient to patient and in the environment. These pathogens then develop into healthcare-associated infections (HAIs).

Nursing home residents are vulnerable to infection. According to lead study author, Deborah Patterson Burdsall, PhD, RN-BC, CIC, using gloves are vital when it comes to preventing germs from spreading into infectious diseases. When the gloves have touched blood or body fluids, after completing a patient task, in between patients, and after the gloves touch a potentially contaminated surface are all points where gloves should be changed.

In the study, gloves were readily available in public areas, shower rooms, patient rooms, and patient bathrooms to the certified nursing assistants on duty. Although gloves were being worn for 80 percent of touchpoints, researchers noted that at 66 percent of glove change points, the certified nursing assistants continued using the gloves they already had on. They observed contaminated glove touch points more than 44 percent of the time. The study shows how much potential exists for cross contamination between patients and the healthcare environment, all from incorrect glove use.

Burdsall concludes that the study shows a definite need for the monitoring of glove use behavior the same way hand hygiene is tracked in healthcare facilities. To prevent the spread of infection, training programs must be developed to educate healthcare workers about the importance of proper glove use in patient care. reported the tragic case of Anna Burkhart who developed a large, painful and deadly bedsore while in the care of staff at Oradell Health Care Center.  Burkhart was accepted by Oradell after she suffered a fractured right hip on Oct. 30, 2015.  Oradell either failed to notice or ignored the bedsore as it developed and grew.

Burkhart was kept in a hospital bed in Oradell for 100 days – until her insurance ran out.  Then Oradell discharged the woman, the family brought her home and discovered she was suffering from the sore on her sacrum or lower back.

They rushed her to the hospital, where doctors determined the bedsore, called a Stage 4 decubitus ulcer, had festered for so long that Burkhart had developed fatal sepsis.

The suit alleges “reckless indifference and deliberate disregard” and contends the center violated the New Jersey Nursing Home Responsibility and Rights of Residents Act.

“There was inadequate staff supervision, understaffing and the intentional underutilization of critical services,” the lawsuit states.

The Times News reported the lawsuit filed against White Oak Manor and White Oak Management for neglect of a wound after an amputation—larvae and maggots were growing in his body and he lost his remaining leg.

William Brooks was admitted to Burlington’s White Oak Manor on May 5, 2014, while recovering from an amputation below the right knee.  That July, after an infection sent him back to the hospital, Brooks had doctor’s orders for frequent cleaning and redressing a wound on his remaining foot. According to the suit, there was no record of that treatment being done in June or July of 2014.

A doctor was called in to evaluate Brooks when maggots were found in the wound on his left ankle. He was treated, but he ended having his left leg amputated below the knee.

The suit claims White Oak Manor and its staff were negligent in caring for Brooks, and he suffered physically, emotionally, financially and was disfigured because of it.


Rates of catheter-associated urinary tract infections (CAUTIs) dropped by 54 percent across more than 400 long-term care facilities that participated in a patient safety project funded by the Agency for Healthcare Research and Quality (AHRQ), according to a study published today in JAMA Internal Medicine.

The project adapted AHRQ’s Comprehensive Unit-based Safety Program (CUSP) for use in long-term care facilities. Previous AHRQ efforts to implement CUSP and other safety programs in hospitals have led to significant reductions in CAUTIs and bloodstream infections associated with central line catheters.

We continue to see the power of AHRQ tools to help front-line staff tackle safety problems, now in nursing homes as well as hospitals,” said Jeffrey Brady, M.D., M.P.H., director of AHRQ’s Center for Quality Improvement and Patient Safety. “This means that some of the most vulnerable members of society – those who reside in long-term care facilities and nursing homes – are less likely to be harmed as a result of infections.”

CAUTI is a type of healthcare-associated infection (HAI) that is common in long-term care facilities, where up to 10 percent of residents have urinary catheters. CAUTI can sometimes lead to severe illness and hospitalization and generates significant expenses for antibiotics and hospitalizations. The infections are generally treatable with antibiotics, but long-term or repeated use of antibiotics can increase the risk of other infections as well as lead to development of antibiotic resistance.

CUSP is designed to promote improvement in leadership, teamwork, communication and safety culture to facilitate consistent use of evidence-based practices for infection prevention.  During the project, CAUTI rates dropped from about 6.4 to 3.3 per 1,000 catheter days. Three-quarters of the facilities showed a CAUTI rate reduction of at least 40 percent, indicating that this approach could benefit a majority of long-term care facilities.

To help doctors, nurses and other leaders in all long-term care facilities prevent CAUTIs, AHRQ has released a Toolkit to Reduce CAUTIs and Other HAIs in Long-Term Care Facilities. This practical resource is based on the experiences of facilities that participated in the project. It includes checklists and other tools and educational materials to guide facilities that seek to apply infection-reduction programs.

AHRQ, part of the Department of Health and Human Services (HHS), works with other federal agencies, researchers, and providers to prevent and reduce HAIs and combat antibiotic-resistant bacteria. AHRQ’s mission is to produce evidence to make health care safer, higher quality, more accessible, equitable and affordable and to work within HHS and with other partners to make sure that the evidence is understood and used. For more information about AHRQ’s work to prevent HAIs, visit

The Waco Tribune reported that a jury found that Jeffrey Place Rehabilitation Center officials were negligent in their care of a blind, diabetic Waco man and compensated the man’s family $450,000 in actual damages. Homer Byrd, a 79-year-old retired tractor mechanic, died in November 2015, only a month after being admitted to Jeffrey Place.

Jurors deliberated about 7½ hours over two days before siding with Greg H. Byrd and his wife, Kim, in their wrongful death lawsuit against the Waco nursing center and its parent company, Senior Living Properties LLC.

Testimony from the five-day trial showed that Byrd, a diabetic on dialysis, developed an infected big toe that turned gangrenous, which led to Byrd’s right leg being amputated just above his knee and, ultimately, to his death.

Jeffrey Place staff breached the ordinary standard of care by failing to promptly discover and treat the infected toe. Nurses testified they noticed the toe, but not until the wound had turned black, had a foul odor and was 4 centimeters by 5 centimeters.


The awards include $100,000 for pain and mental anguish suffered by Homer Byrd before his death, $75,000 for Greg Byrd’s loss of his father’s companionship and love and $75,000 for Greg Byrd’s mental anguish over his father’s death. The jury awarded $200,000 in deterrent damages so this type of neglect doesn’t happen again.


“Due to the evidence we saw, it was just gross negligence,” juror Crocker said. “There was a lot more that could have been done for this man, and it was just absolute refusal to see a problem that is blatantly obvious.”