Nosocomial infection rates during a one-year period in a nursing home care unit of a Veterans Administration hospital

Abstract

Infections in long-term care institutions are a constant source of morbidity in residents in these facilities. We report our experience with infection rates during a 1-year surveillance period in a 120-bed nursing home care unit of a Veterans Administration hospital. Our purpose was (1) to establish our own infection rate and (2) to ascertain the relationships (a) between infection rate and level of required nursing care and (b) between infection rate and staffing adequacy. Our overall nosocomial infection rate for 1987 was 4.6 infections/1000 patient days. The majority of infections were urinary tract infections, with the predominant pathogen Proteus mirabilis. One ward in the nursing home care unit had a significantly higher infection rate compared with that of the other wards (p less than 0.05), and there was a significantly higher infection rate in residents who required total nursing care versus less dependent residents (p less than 0.05). We were unable to find a direct relationship between the degree of staff shortages and infection rate. This prolonged infection control surveillance indicated our nosocomial infection rates were similar to those in previously published reports. We also identified problem infections in certain areas, which led us to develop staff in-service programs to address these problems. In summary, we believe this information is useful not only for us but for others involved in the care of residents in long-term care facilities inasmuch as there are little published data on yearly infection rates per patient days.