Pennsylvania long-term care facilities report gastrointestinal infections, including norovirus, to the Pennsylvania Patient Safety Authority through its Pennsylvania Patient Safety Reporting System.
|
Unit Name (N) |
Number of Infections |
Resident Days |
Pooled Infection
Rate (95% CI)* |
Clostridium difficile—The resident has diarrhea and a stool sample is positive for
C. difficile toxin A or B, or a
toxin-producing
C. difficile organism is identified from stool culture or by molecular testing, or Pseudomembranous colitis identified through endoscopic examination, surgery, or biopsy |
| Dementia unit (32) | 53 | 2,293,538 | 0.02 (0.02 - 0.03) |
| Mixed unit (160) | 548 | 7,739,418 | 0.07 (0.06 - 0.08) |
| Nursing unit (150) | 447 | 8,426,415 | 0.05 (0.05 - 0.06) |
| SN/STR unit (250) | 1,074 | 9,109,775 | 0.12 (0.11 - 0.12) |
| Vent unit (11) | 43 | 173,405 | 0.25 (0.17 - 0.32) |
|
Total (480) |
2,165 |
27,742,551 |
0.08 (0.07 - 0.08) |
|
Norovirus—The resident has diarrhea and/or vomiting and laboratory results are positive for Norovirus |
| Dementia unit (1) | 1 | 2,293,538 | 0 (0 - 0) |
| Mixed unit (7) | 15 | 7,739,418 | 0 (0 - 0) |
| Nursing unit (4) | 4 | 8,426,415 | 0 (0 - 0) |
| SN/STR unit (13) | 21 | 9,109,775 | 0 (0 - 0) |
| Vent unit (0) | 0 | 173,405 | 0 (0 - 0) |
|
Total (22) |
41 |
27,742,551 |
0 (0 - 0) |
|
Bacterial gastroenteritis—The resident has diarrhea and/or vomiting and laboratory results are positive for a bacteriologic pathogen |
| Dementia unit (1) | 1 | 2,293,538 | 0 (0 - 0) |
| Mixed unit (6) | 7 | 7,739,418 | 0 (0 - 0) |
| Nursing unit (5) | 5 | 8,426,415 | 0 (0 - 0) |
| SN/STR unit (7) | 8 | 9,109,775 | 0 (0 - 0) |
| Vent unit (0) | 0 | 173,405 | 0 (0 - 0) |
|
Total (19) |
21 |
27,742,551 |
0 (0 - 0) |
|
Kaplan—Norovirus is suspected based on Kaplan criteria; the resident has diarrhea and/or vomiting and
C. difficile
results are negative |
| Dementia unit (17) | 137 | 2,293,538 | 0.06 (0.05 - 0.07) |
| Mixed unit (20) | 294 | 7,739,418 | 0.04 (0.03 - 0.04) |
| Nursing unit (25) | 325 | 8,426,415 | 0.04 (0.03 - 0.04) |
| SN/STR unit (30) | 417 | 9,109,775 | 0.05 (0.04 - 0.05) |
| Vent unit (0) | 0 | 173,405 | 0 (0 - 0) |
|
Total (67) |
1,173 |
27,742,551 |
0.04 (0.04 - 0.04) |
|
Total Gastrointestinal Infections Reported |
| Dementia unit (32) | 192 | 2,293,538 | 0.08 (0.07 - 0.1) |
| Mixed unit (160) | 864 | 7,739,418 | 0.11 (0.1 - 0.12) |
| Nursing unit (150) | 781 | 8,426,415 | 0.09 (0.09 - 0.1) |
| SN/STR unit (250) | 1,520 | 9,109,775 | 0.17 (0.16 - 0.18) |
| Vent unit (11) | 43 | 173,405 | 0.25 (0.17 - 0.32) |
|
Total (504) |
3,400 |
27,742,551 |
0.12 (0.12 - 0.13) |
Notes: As reported through the Pennsylvania Patient Safety Reporting System (PA-PSRS) in 2016. Table rows indicating totals show the number of nursing homes reporting for the given type of infection with each unit name. This is not to be confused with the sum of the unit types for that infection. There may be overlap of unit types reporting at any given facility.
CI, Confidence interval; SN/STR, skilled nursing/short-term rehabilitation; vent, ventilator dependent. |
To aid Pennsylvania nursing homes, the Figure provides seasonal trends to help nursing homes prepare for norovirus in the coming year associated with timing and expected duration of external pressure. A norovirus outbreak is defined as three or more cases of norovirus defined within a three-day period. Further, the Figure shows the number of reports from nursing homes that did or did not meet the norovirus outbreak definition.
Figure. Norovirus Outbreaks by Month, 2016
Excerpted from: Pennsylvania Patient Safety Authority. 2016 Annual Report. 2016 Apr 28 [cited 2017 Jun 7]. http://patientsafety.pa.gov/PatientSafetyAuthority/Pages/annual_report_2016.aspx
