One in four seniors is bringing along stowaways from the hospital to their next stop: so-called “superbugs” on their hands. Moreover, seniors who go to a nursing home or another post-acute care facility will continue to acquire new superbugs during their stay, according to findings made by researchers at the University of Michigan and published in JAMA Internal Medicine.
The study focused on patients who were recently admitted to the hospital for a medical or surgical issue and temporarily needed extra medical care in a post-acute-care (PAC) facility before returning home. Older people often need extra time in a PAC facility for rehabilitation after common procedures, such as hip and knee replacements.
The researchers studied 357 such seniors who were discharged from the hospital and admitted to several PAC facilities in southeastern Michigan. One-quarter of these patients (24.1%) had at least one multidrug-resistant organism (MDRO), or superbug, on their hands when they checked in.
Researchers tested the same patients’ hands after two weeks and then monthly for up to six months or until their discharge home from the PAC facility. During the follow-up visits, the researchers found that not only did these organisms persist, but even more seniors acquired superbugs on their hands––up from one in four to more than one in three (34.2%).
“We’ve been educating health care workers for decades about hand hygiene, and these numbers [in the new study] show it’s time to include patients in their own hand hygiene performance and education,” said lead author Lona Mody, MD, MSc.
A high level of MDROs on patients’ hands increases the chance that these superbugs will be transmitted to other frail patients and to health care workers. Frequent antibiotic use in PAC patients also increases the probability that MDROs introduced to a PAC facility will flourish.
Mody noted that today’s aging patients want to be active, much more than in the past. They often choose to stay in facilities that offer group activities and social events. However, when people leave their rooms, they are likely to touch areas of a care facility’s environment, health care workers, and other patients––which puts them at risk for acquiring new MDROs.
The increasing number of seniors bringing hospital superbugs into PAC facilities for short stays (as opposed to living long-term) means that new policies and innovations are needed to stop superbugs from spreading in these facilities, Mody said.
“Patient hand washing is not a routine practice in hospitals,” Mody remarked. “We need to build on the overarching principles we’ve already developed with adult learning theories and bring them to patients.”
One strategy includes physically showing the superbugs that grow on people’s hands, by growing them in the lab.
“People are always surprised when they see how much can grow on their hands––and how they can effectively clear these organisms by simply washing hands appropriately,” Mody said.
She and her colleagues have developed a toolkit for PACs to use in training employees to control infections, called the TIP Study toolkit.
Source: University of Michigan; March 14, 2016.