Residential Care Facilities Research Articles

Genotyped cluster investigations versus standard contact tracing: comparative impact on latent tuberculosis infection cascade of care in a low-incidence region

BackgroundCluster and contact investigations aim to identify and treat individuals with tuberculosis (TB) and latent TB infection (LTBI). Although genotyped cluster investigations may be superior to contact investigations in generating additional epidemiological links, this may not necessarily translate into reducing infections. Here, we investigated the impact of genotyped cluster investigations compared to standard contact investigations on the LTBI care cascade in a low incidence setting.MethodsA matched case-control study nested within a cohort of 6,921 TB cases from Florida (2009–2023) was conducted. Cases (n = 670) underwent genotyped cluster investigations, while controls (n = 670) received standard contact investigations and were matched 1:1 by age. The LTBI care cascade outcomes were compared using Pearson’s chi-square tests.ResultsOf the 5,767 identified contacts, 3,230 (56.0%) were associated with the case group, while 2,537 (44.0%) were identified in the control group. A higher proportion of contacts were evaluated in the control group (85.5%) than in the case group (81.5%, p < 0.001). While the proportion of evaluated contacts diagnosed with LTBI did not significantly differ between the groups (case: 20.4%, control: 21.5%, p = 0.088), a higher percentage of LTBI-diagnosed contacts initiated TB preventive treatment (TPT) in the control group (95.9%) than the case group (92.9%, p = 0.029). TPT completion rates were similar, with 65.2% in the case group and 66.3% in the control group (p = 0.055). TB patients in the case group were more likely to be males, U.S.-born, Asians, residents of long-term care or correctional facilities, with past year histories of alcohol use, homelessness, and drug use.ConclusionDespite the demographic and epidemiological differences between cases and controls, cluster investigations identified more contacts, with no significant difference in contacts diagnosed with LTBI, but were less effective than standard contact investigations in evaluating contacts, initiating LTBI treatment, and ensuring completion.

Integrating Dental Professionals Into Aged Care With Focus on Australia: A Scoping Review.

To summarise the current evidence on the involvement of dental hygienists (DHs) in residential aged care facilities (RACFs) with respect to the feasibility of integration improved oral health for residents with dementia and multidisciplinary collaboration. The oral health of RACF residents with dementia is reported to be poor. However, little is known about how DHs can be integrated into RACFs to improve oral health, particularly as part of a multidisciplinary team. A scoping review was undertaken in accordance with the Joanna Briggs Institute (JBI) method. Multiple databases were searched for peer-reviewed articles and grey literature that included a DH working in a RACF with dementia patients, or as part of a multidisciplinary team. Data were charted using a modified version of the JBI source of evidence template. Fifty-eight studies were identified for inclusion. Integration strategies were categorised as support-focused or service-focused, but there was little evaluation of their feasibility. Five key facilitators to multidisciplinary collaboration were identified: using multiple strategies; clearly defining roles; changes to existing administrative systems; fostering multidisciplinary collaboration skills; and encouraging innovation. However, no examples of collaboration within RACFs were identified. There has been limited effort in multidisciplinary collaboration or integration of DHs into RACFs with some evidence that both support-focused and service-focused strategies can improve the oral health of residents with dementia.

'I've heard of it but had nothing… not much to do with it': The experience of older people and their families with the Resident of the Day (ROD) process in Victorian aged care facilities.

To explore the experiences of older people living in Australian residential aged care facilities (RACFs) and families of older people living in RACFs, regarding the process of Resident of the Day (ROD; sometimes referred to as a resident review) and their knowledge of how these assessments inform care planning. Semi-structured interviews were used to engage residents and families in conversations about their experiences and knowledge of the assessment associated with ROD and subsequent care planning. A reflexive thematic analysis was used to generate findings. Twenty-six interviews were conducted in four RACFs across Victoria, diverse in terms of geographic location and provider type. Those residents who had some awareness of the ROD described the process only in superficial terms. Connections between ROD and care planning were unable to be made by most residents. Family members had a greater level of awareness of the ROD, although they were unable to describe the process or purpose and did not connect it to care planning. Despite being undertaken in all Victorian RACFs, residents and families have little or no knowledge of the ROD process, purpose or what happens to the information collected.

Pneumococcal Vaccination Coverage Among Adults at Risk in the Russian Federation

Relevance. Pneumococcal infection remains one of the most significant health problems worldwide. Vaccination of adults against it has been carried out in the Russian Federation for over 10 years. During this time, more than 9 million people have been vaccinated. However, data on the level of coverage among adults of certain risk categories are not routinely collected. Our study in 2019 showed that it was low in most groups. Given the significant increase in the volume of vaccination over the past five years, it seems appropriate to conduct a study to assess changes in the level of coverage.Aim. To study the level of vaccination coverage against pneumococcal infection in adult risk groups in the Russian Federation.Materials and methods. An observational descriptive retrospective epidemiological study was conducted. Information on the number and contingents of people vaccinated against pneumococcal infection was collected by sending a request to the executive authorities of the constituent entities of the Russian Federation in the field of healthcare. The depth of data collection was 8 years (from 2015 to 2023 inclusive), information was received from 74 out of 89 regions. In addition, federal statistical observation forms were used: No. 5 «Information on preventive vaccinations» and No. 6 «Information on the contingents of children and adults vaccinated against infectious diseases», data from the Unified Interdepartmental Information and Statistical System. The results obtained were compared with the indicators obtained in the 2019 study, which was conducted according to a similar design. The analysis was carried out using descriptive statistics methods.Results. The coverage rate of vaccination against pneumococcal infection among the adult population in the Russian Federation increased from 1.5% in 2018 to 7.7% in 2023. The most significant coverage rates were achieved among persons subject to conscription for military service (78.5%) and persons over 60 years old, living in residential care facilities (87.7%). By 2023, vaccination coverage has increased among the following risk categories: individuals with chronic bronchopulmonary diseases (from 15.1% in 2018 to 47.9% in 2023), chronic heart diseases (from 3.8% to 17.0%), patients with endocrine diseases (from 1.1% to 17.6%), liver diseases (from 4.0% to 12.0%), healthcare workers (from 4.9% to 19.7%), school and preschool employees (from 3.1% to 12.9%), employees of residential care facilities (homes for elderly, nursing homes, ect.) (from 0.1% to 26.9%), the elderly population as a whole (from 1.4% to 12.7%), and working-age men (from 1.4% to 7.0%). There was virtually no increase in coverage among all groups of immunocompromised patients (1.0% in 2018, 6.2% in 2023), the working population with risk factors harmful to the respiratory system (0.9% in 2018, 5.0% in 2023), workers in the oil and gas and chemical industries (1.3% in 2018, 1.8% in 2023).Conclusion. The obtained results indicate the need to develop a strategy of measures to promote increased vaccination coverage in risk groups that are insufficiently covered by vaccination against pneumococcal infection.

Equipping residential aged care facilities for acute respiratory illness: The Western Sydney experience of improving outbreak management.

Acute respiratory illnesses have a disproportionate impact on older people, and especially those living in residential aged care facilities where transmission risks are heightened. Additionally, staff in these facilities have been working under challenging conditions, often ill-equipped in terms of both training and resources to successfully manage the outbreaks of these illnesses. This paper examines the actions of an Australian public health unit to improve influenza outbreak management in residential aged care facilities and critiques the outcomes through a contemporary lens. A naturalistic case study using critical thematic analysis was used to study the Western Sydney Public Health Unit's work with the residential aged care facilities under their jurisdiction in the management of influenza outbreaks during 2014-2019. Key to the Public Health Unit's approach to improving outbreak management in residential aged care facilities was their sustained engagement with aged care stakeholders, activities to build outbreak management capacity in this setting, and an investment in research to inform ongoing action. This engagement was mutually beneficial, as the Public Health Unit and residential aged care facilities became more attuned to each other's needs and challenges. Supporting facility staff in difficult situations resulted in a timelier public health response and improved outbreak management. In Australia, Public Health Units are important partners in the cumulative development of outbreak management capacity and responsiveness in the residential aged care setting; particularly considering the challenges posed by novel pathogens and in establishing an evidence base for best practice and future preparedness.

Protective factors promoting participatory rights for early childhood children in residential care facilities in Harare, Zimbabwe

ABSTRACT This qualitative study explored protective factors in implementing participatory rights for six-to-seven-year-old children living in seven residential care facilities in Harare, Zimbabwe. The study consisted of seven semi- structured interviews using open-ended questions with seven directors. The residential care facilities were purposefully sampled based on the style they adopted, namely five homes adopted the household unit and two the dormitory style. Through thematic data analysis, four themes were identified that promoted protective factors for implementing participatory rights of children in the early years of development residing at the homes, namely: the use of an open-door policy, the household unit style, foster care intervention programmes, and the availability of mass media. Based on the findings several recommendations are made on how to further protect the participatory rights of the children. Although the study was conducted in Zimbabwe, it has global value because there are residential care facilities in all countries.

Social Participation of the Elderly Living in Residential Care Facilities in Malaysia

Social participation plays a crucial role in the overall well-being and quality of life of elderly, especially those residing in residential care facilities. In Malaysia, the aging population has increased, and many elderly individuals now live in institutional settings due to various socio-economic factors. This study explores the level of social participation among elderly residents in Malaysian residential care facilities, identifying key barriers and enablers to active involvement in social activities. A quantitative approach was employed to assess participation levels of elderly residents. The findings suggest that while some elderly individuals actively engage in recreational, social, and cultural activities, others face challenges such as physical limitations, lack of stimulating activities, and limited interaction with external communities. Factors such as staff support, facility infrastructure, and family involvement were found to significantly impact the extent of social participation. The study emphasizes the importance of designing inclusive and engaging environments within residential care facilities to promote social participation and improve the mental, emotional, and social well-being of the elderly. Recommendations for policy, practice, and future research are provided to address the identified gaps and enhance the social integration of elderly residents in Malaysian care settings.

Shifting Student Attitudes of Gerontology Nursing: A Quasi-Experimental Evaluation of a Clinical Educator Programme.

Enduring shortages in the gerontology nursing workforce are projected to increase as demand for services for older persons grows. Recruitment of Registered Nurses in gerontology is further hindered by negative perceptions held by students towards nursing older people. To determine whether a professional development activity designed to assist clinical supervisors to build the mentorship capacity of care staff in residential aged care facilities could positively improve their clinical learning environment and improve student attitudes towards working with older adults. A quasi-experimental, non-equivalent pretest-posttest control group design. Clinical settings in which participants were undertaking an older person-focused clinical placement. A purposive sample of 466 first-year undergraduate nursing students. Forty-seven students responded to both the pre- and post-placement surveys. The intervention comprised four professional development sessions delivered to clinical supervisors supervising nursing students during clinical placement across three residential aged care facilities. Pre- and post-placement surveys measured Student Perceptions of Working with Older People (SPWOP). The modified Clinical Learning Environment Inventory (CLEI) was included in the post-placement survey to measure student perceptions of the clinical placement learning environment. Control group participants reported higher pre-placement SPWOP scores yet showed no significant improvement in score post-placement; however, the intervention group reported a statistically significant increase in SPWOP score post-placement. Modified CLEI results revealed the control group reported higher levels of engagement in the learning environment, yet the intervention group reported greater motivation to learn. An intervention designed to build staff mentorship capacity in gerontology care settings can positively influence student perceptions of working in gerontology. Despite these positive gains, results indicated that students who undertook placement at the intervention sites were less engaged. This disparity illuminates the need for continued efforts to build staff mentorship capacity in older person-focused clinical learning environments to improve student experiences and perceptions of gerontology nursing. Further research that engages directly with unregulated healthcare workers in geronotological care settings could provide new insights into what this cohort need to become effective mentors and shift student nurse attitudes towards caring for older adults.

Drivers of extended spectrum β-lactamase (ESBL)-producing Enterobacterales colonization among residents of long-term health care facilities: a European multicentric prospective cohort study.

ESBL-producing Enterobacterales (ESBL-PE) are highly prevalent in long-term healthcare (LTCF) settings. In order to estimate the acquisition rate of ESBL-producing Escherichia coli and Klebsiella pneumoniae in LTCF settings and identify clinical and environmental risk factors, a multicentric, prospective cohort study was conducted in six LTCFs in Germany, France, Spain and the Netherlands. Longitudinal screening of residents was performed over 32 weeks, collecting epidemiological and clinical data and environmental samples. The primary outcome was rate of new acquisition of ESBL-PE among LTCF residents. Molecular epidemiology was studied using whole genome sequencing and risk factor analyses using logistic and Poisson regression models. 299 residents provided 1958 samples during follow-up. Prevalence of ESBL-PE colonization at baseline was 16.4%, incidence rate of acquisition was 0.79 per 1000 resident-days, both with high variability among centres. Age ≥80 years, vascular disease, and antibiotic consumption within one year were risk factors for baseline colonization. Lack of hand sanitizers and low nurse to resident ratio were associated with colonization. Presence of medical devices was associated with risk of acquisition. Vascular disease, hemiplegia, antibiotic consumption, and non-availability of private bathrooms were associated with multiple ST carriage. Prevalence of ESBL-PE among environmental samples was 2%, exclusively in centres with high prevalence among residents. Genetic analysis showed a high prevalence of ST10 E. coli and ST405 K. pneumoniae at two study sites. Infection prevention including availability of hand sanitizers, the number of nurses per resident, and antimicrobial stewardship interventions constitute important measures to control ESBL-PE in LTCFs. Genome-based surveillance could guide targeted interventions.

Implementation of an automatic skin disease identification system using convolutional neural network for scabies in long-term care facility residents

Implementation of an automatic skin disease identification system using convolutional neural network for scabies in long-term care facility residents

END-OF-LIFE CARE PROCESSES IN ASSISTED LIVING COMMUNITIES SPECIALIZING IN MEMORY CARE

Abstract Assisted living (AL) is a common site of death. Many AL communities offer specialized memory care (MC), yet we know little about how their end-of-life (EoL) care practices might differ. We conducted a nationally representative survey of 2,084 AL administrators (43% response rate) about EoL care between 2021-2023. Over half offered MC, with 41.7% of AL communities offering both general AL and MC (combined AL), and 9.3% MC only. Combined ALs were larger (44.7% had 100+ beds, compared to 2.3% in MC only and 14.1% in general AL). ALs offering MC were more likely to report having residents who died in the prior 12 months (88.4% combined AL, 90.0% MC only, 68.9% general AL), which is consistent with a majority reporting a policy of retaining residents in need of EoL care (82.9% combined ALs, 84.6% MC only, and 58.1% general AL only). AL communities offering MC were more likely to have staff available 24/7 to administer subcutaneous injections (67.3% combined AL, 71.1% MC only, 55.8% general AL). Similar opportunities to improve hospice care were reported, with only 32.0% of administrators answering “all of the time” when asked if residents referred to hospice were assessed within 24 hours. Important differences in key processes of care exist between AL offering MC and those providing general AL. Future research is needed to examine how these impact the quality of end-of-life care.

ASSISTED LIVING STAFF VIEWS OF FAMILY INVOLVEMENT IN PALLIATIVE CARE FOR RESIDENTS WITH DEMENTIA

Abstract Of the close to 300,000 residents in assisted living (AL) living with dementia, an estimated 40% will die there and be in need of end-of-life care. Family of residents living with dementia are an important part of the care convoy in AL. This qualitative study aimed to understand staff perspectives about family involvement in end-of-life care. The Palliative Care Education in Assisted Living for Dementia Care Providers intervention study (2019-21) included a sample of 17 AL staff from six treatment sites in Florida who completed four homework assignments. Two of the assignments were writing assignments that 1) asked about a good death for residents and 2) asked staff specifically to identify one resident with dementia who they could do one thing to make them comfortable. A priori codes were used based on the physical, emotional, social and spiritual care domains of palliative care asked about in the homework assignments. The data was coded using Atlas.ti version 23. Family was involved in all four domains of palliative care. Social and emotional aspects of care were the most prominent (e.g., playing music, visits, care coordination, delivery of food) followed by spiritual care (e.g., pray together, attend religious services). Physical care tasks by family were reported less often. Less physically demanding care tasks were performed by the family (e.g., grooming, dressing) with family reliance on direct care staff and hospice providers for more physically demanding care (bathing, transfers), and for pain management. We will discuss the role family play in AL care provision.

QUALITATIVE STUDY IDENTIFIES DEMENTIA TRAINING NEEDS OF CARE WORKERS IN ASSISTED LIVING AND PERSONAL CARE AGENCIES

Abstract Caring for individuals with dementia can be overwhelming, especially when direct care workers lack knowledge and skills to respond to changing needs of those with dementia. Burnout and turnover are common problems. To better understand wishes for dementia training, we interviewed direct care workers, supervisors and administrators in 4 assisted living facilities (ALFs) and personal care agencies (PCAs). Funded by the NIA, we collected data from 23 direct care workers, 7 supervisors, 8 administrators. Questions focused on needs for dementia training topics and solutions for delivering content. Interviews were recorded, transcribed, and evaluated by two independent raters to identify all topics discussed. These topics were then further analyzed by a second group of raters who specialize in training of direct care providers. Commonalities and thematic differences across direct care workers, supervisors, and administrators were reviewed qualitatively to identify highest priorities. For both ALFs and PCAs, priority topics for training overlapped between administrators, supervisors, and direct care workers and included skill development (e.g., de-escalation strategies), knowledge areas (e.g., bathing, distress), and workforce goals (e.g., training certifications). Direct care workers further mentioned that training should be interactive, fit into their work schedules, and give solutions in real time. PCAs added that greater effort is needed to assure that training is relevant (e.g., current topics often are too pedantic and not practical to daily activities). Real-time, flexible, content meeting identified needs, and individualized to caregiving settings, learner knowledge and experience should be the focus of future improvements in dementia training.

FAMILIAL VISITATION OF LONG TERM CARE FACILITY RESIDENTS: DIFFERENTIATING SOCIAL BEHAVIORS FROM CARE COORDINATION

Abstract High rates of loneliness persist among residents of long-term care (LTC) facilities despite frequent familial visitation. Most studies on LTC visitation do not differentiate social behavior (e.g., talking to the resident about their interests) from care coordination (e.g., attending the resident’s care conferences). It is possible but unknown if these distinct forms of visitation impact resident loneliness differently. Past research has identified barriers to overall LTC facility visitation, such as family member demographics (e.g., gender, income) and relational factors (e.g., closeness, history of care provision). The aim of the present study was to determine whether these demographic and relational factors related to social behavior and care coordination differently. Community-dwelling adults aged 18 and older who endorsed having a close friend or relative currently residing in a LTC facility (N = 175) recruited via ResearchMatch completed an online survey regarding their demographics, LTC visiting behaviors, and relationship with the resident. Overall, results indicated demographic variables were not significantly associated with either social behavior or care coordination, but relational factors were significant predictors of both outcomes. Individuals who reported higher closeness with the resident and who had been their primary caregiver demonstrated significantly greater care coordination involvement and social behavior involvement. Immediate family members were more likely to be involved in care coordination than friends or extended family, but they were not more likely to socially interact with the resident. These findings imply there are distinct facilitators and barriers for care coordination and social involvement that warrant further investigation.

Incomplete documentation of β-lactam allergy in long-term care facility residents increases risk of high-risk antibiotic use for Clostridioides difficile infection.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Revealing the freedom of movement of youngsters in residential youth care: towards the creation of a socio-spatial citizenship climate

ABSTRACT Recent research shows the relevance of a socio-spatial citizenship climate in residential youth care to shift the focus from youngsters as objects of care due to their challenging behaviour to youngsters as citizens in their own right who give meaning to the various circumstances in their everyday lives. A socio-spatial citizenship climate acknowledges the synergy between residential youth care and the wider living environment, as residential youth care is embedded in a wider living environment in which youngsters practise and experience their freedom of movement by navigating socially and physically through different socio-spatial relationships, circumstances and pedagogical milieus. Based on a qualitative study in a residential youth care facility in Flanders (the Dutch-speaking part of Belgium), we explore how residential youth care can create circumstances for youngsters to realise their freedom of movement as part of the development of a socio-spatial citizenship climate. This article discusses three key findings: (1) creating local coalitions and partnerships, (2) creating circumstances for spatial appropriation, and (3) creating space for complexity and convivial encounters. The findings show that creating circumstances for a socio-spatial citizenship climate requires a critical and reflexive social and pedagogical professional discretion and orientation on different levels of the organisation.

Longitudinal prevalence and co-carriage of pathogens associated with nursing home acquired pneumonia in three long-term care facilities.

Nursing home acquired pneumonia (NHAP), and its subset - aspiration-associated pneumonia, is a leading cause of morbidity and mortality among residents in long-term care facilities (LTCFs). Understanding colonization dynamics of respiratory pathogens in LTCF residents is essential for effective infection control. This study examines the longitudinal trends in prevalence, persistence, bacterial load, and co-colonization patterns of five respiratory pathogens in three LTCFs in Phoenix, Arizona. Anterior nares and oral swabs were collected every other week and tested using qPCR for Haemophilus influenzae, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus aureus , and Chlamydia pneumoniae . Weekly average positivity rates were 17.75% for H. influenzae (0% - 39.39%), 9.95% for P. aeruginosa (0% - 37.74%), 31.89% for S. pneumoniae (1.79% - 41.67%), and for 28.00% for S. aureus (0% - 55.36%). C. pneumoniae was not detected. H. influenzae and S. pneumoniae predominantly colonized the oral cavity, while P. aeruginosa and S. aureus predominantly colonized the nasal cavity. S. pneumoniae and S. aureus colonizations were significantly more persistent than H. influenzae and P. aeruginosa , with persistence correlating with significantly higher bacterial loads. Co-colonization did occur in ∼20% of positive samples, but appeared to be due to random chance. This study reveals distinct colonization patterns among respiratory pathogens in LTCF residents, highlighting differences in site-specific prevalence, persistence, and bacterial load. These findings underscore the importance of longitudinal monitoring to inform targeted infection control strategies in LTCFs.

Quality of life and quality of care experience in Australian residential aged care: a retrospective cohort study of 1,772 residents

BackgroundIn April 2023, quality of life (QOL) and quality of care experience (QCE) indicators were introduced as mandatory indicators in Australian residential aged care (RAC) to measure and monitor wellbeing and consumer experience respectively. In this study, we used data for the initial four months after their introduction to describe QOL and QCE scores, explore related factors and assess variations by completion mode and facility.MethodsA retrospective cohort study using electronic data (Mar–Jun 2023) from 1,772 residents in 22 RAC facilities in metropolitan Sydney, Australia. QOL was measured by the Quality of Life-Aged Care Consumer (QOL-ACC) scale, and QCE by the Quality of Care Experience-Aged Care Consumer (QCE-ACC) scale, both through three completion modes: self, interviewer-facilitated and proxy completion. Propensity score matching was used to compare QOL/QCE differences by completion mode; multilevel ordinal logistic regression to investigate QOL-/QCE-related factors; and funnel plots to explore facility-level score variations.ResultsOf 1,772 residents, 1,706 completed the QOL-ACC survey and 1,686 the QCE-ACC. The median score was 21 (interquartile range 18–24) for QOL and 23 (interquartile range 20–24) for QCE, both indicating ‘excellent’ outcomes. The leisure activities component of QOL, and social relationships and complaint lodging of QCE, were rated relatively lower than other dimensions. The scores of both indicators were significantly higher for self-completion versus other completion modes. Significant variation in QOL and QCE scores by facility were also observed, with seven and four facilities with lower-than-expected proportions of residents with ‘excellent’ or ‘good’ ratings of QOL and QCE, respectively. A longer length of stay (odd ratio [OR] = 0.70, 95% CI: 0.53–0.92 for ≥ 3 years of stay versus < 1 year of stay) and fall history (OR = 0.74, 95% CI: 0.60–0.91) were associated with lower QOL, while having a visual impairment (OR = 0.74, 95% CI: 0.55–0.99) and fall history (OR = 0.80, 95% CI: 0.64–0.99) were associated with lower QCE.ConclusionWe found high QOL and QCE across the 22 Australian RAC facilities. Enhancing residents’ leisure activities, social relationships, and addressing specific needs (e.g., visual impairment and fall history) may enhance QOL and QCE.

Simulating a travel-related origin of Candida auris in New York-New Jersey.

Candida auris is an emerging fungal pathogen, with resistance to several antifungal drugs. Serious C. auris infections affect hospitalized patients and residents of long-term care facilities, although the pathogen can also be present on a healthy individual's skin. Many studies have shown international introductions of C. auris to the United States. Here, we present a simulation that supports the hypothesis that the earlier introductions of C. auris in the New York-New Jersey area are not random but related to travel networks.

Food, nutrition and dining information on residential aged care facility websites: A website analysis.

High-quality food, nutrition and dining are essential tenets of residential aged care facilities (RACF). Residential aged care facilities provide website information on their services for prospective residents, which may offer insight into food, nutrition and dining practices. This study aimed to describe the food, nutrition and dining information on RACF websites. A cross-sectional website analysis was conducted on Southeast Queensland (SEQ) RACF websites. Food, nutrition and dining data were extracted verbatim under domains of nutrition care processes, food and menu planning, eating assistance and mealtime experiences, with further subdomains under each. Quantitative content analysis was conducted to describe the information reported on websites, descriptive statistics were used to describe RACF characteristics, and Pearsons χ2 analyses were performed to detect associations between different food, nutrition and dining practices and RACF characteristics. A total of 268 websites were reviewed. Food, nutrition and dining information were limited, with no subdomains mentioned by all websites. The most frequently mentioned subdomains were the foodservice model (64%, n = 171), allied health services (72%, n = 173) and communal dining (73%, n = 193). Assistive/adaptive equipment to support independence (0%, n = 0), personalised nutrition care plan (0%, n = 1) and reference to food, nutrition or food safety standards (2%, n = 5) were the least mentioned subdomains. Facility characteristics had minimal associations with subdomains. There are opportunities for RACF to improve the information on food, nutrition and dining information on websites to increase transparency to future residents. The subdomains developed in this study could provide guidance to RACF to enhance online information.