Adverse Events in Italian Nursing Homes During the COVID-19 Epidemic: A National Survey
Older people living in nursing homes (NHs) are particularly vulnerable in the ongoing COVID-19 pandemic, due to the high prevalence of chronic diseases and disabilities (e.g., dementia). The phenomenon of adverse events (AEs), intended as any harm or injury resulting from medical care or to the fail...
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Frontiers Media S.A.
2020-09-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2020.578465/full |
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| author | Flavia L. Lombardo Emanuela Salvi Eleonora Lacorte Paola Piscopo Flavia Mayer Antonio Ancidoni Giulia Remoli Guido Bellomo Gilda Losito Fortunato D’Ancona Marco Canevelli Marco Canevelli Graziano Onder Nicola Vanacore The Italian National Institute of Health Nursing Home Study Group Antonio Ancidoni Ilaria Bacigalupo Guido Bellomo Luigi Bertinato Marco Canevelli Patrizia Carbonari Maria Grazia Carella Annamaria Confaloni Alessio Crestini Fortunato D’Ancona Carla Faralli Simone Fiaccavento Silvia Francisci Flavia L. Lombardo Eleonora Lacorte Cinzia Lo Noce Paola Luzi Tania Lopez Flavia Mayer Maria Masocco Monica Mazzola Graziano Onder Ilaria Palazzesi Luana Penna Daniela Pierannunzio Paola Piscopo Maria Cristina Porrello Giulia Remoli Emanuela Salvi Giulia Scaravelli Andrea Siddu Sabrina Sipone Lucia Speziale Andrea Tavilla Nicola Vanacore Mauro Palma Gilda Losito Gianluca Pucciarelli Daniela Accorgi Catia Bedosti Gabriella Carraro Maria Mongardi Gianluca Ferrari |
| author_facet | Flavia L. Lombardo Emanuela Salvi Eleonora Lacorte Paola Piscopo Flavia Mayer Antonio Ancidoni Giulia Remoli Guido Bellomo Gilda Losito Fortunato D’Ancona Marco Canevelli Marco Canevelli Graziano Onder Nicola Vanacore The Italian National Institute of Health Nursing Home Study Group Antonio Ancidoni Ilaria Bacigalupo Guido Bellomo Luigi Bertinato Marco Canevelli Patrizia Carbonari Maria Grazia Carella Annamaria Confaloni Alessio Crestini Fortunato D’Ancona Carla Faralli Simone Fiaccavento Silvia Francisci Flavia L. Lombardo Eleonora Lacorte Cinzia Lo Noce Paola Luzi Tania Lopez Flavia Mayer Maria Masocco Monica Mazzola Graziano Onder Ilaria Palazzesi Luana Penna Daniela Pierannunzio Paola Piscopo Maria Cristina Porrello Giulia Remoli Emanuela Salvi Giulia Scaravelli Andrea Siddu Sabrina Sipone Lucia Speziale Andrea Tavilla Nicola Vanacore Mauro Palma Gilda Losito Gianluca Pucciarelli Daniela Accorgi Catia Bedosti Gabriella Carraro Maria Mongardi Gianluca Ferrari |
| author_sort | Flavia L. Lombardo |
| collection | DOAJ |
| description | Older people living in nursing homes (NHs) are particularly vulnerable in the ongoing COVID-19 pandemic, due to the high prevalence of chronic diseases and disabilities (e.g., dementia). The phenomenon of adverse events (AEs), intended as any harm or injury resulting from medical care or to the failure to provide care, has not yet been investigated in NHs during the pandemic. We performed a national survey on 3,292 NHs, either public or providing services both privately and within the national health system, out of the 3,417 NHs covering the whole Italian territory. An online questionnaire was addressed to the directors of each facility between March 24 and April 27, 2020. The list of NHs was provided by the Dementia Observatory, an online map of Italian services for people with dementia, which was one of the objectives of the implementation of the Italian National Dementia Plan. About 26% of residents in the Italian NHs for older people listed within the Dementia Observatory site had dementia. The objective of our study was to report the frequency of AEs that occurred during the months when SARS-CoV-2 spreading rate was at its highest in the Italian NHs and to identify which conditions and attributes were most associated with the occurrence of AEs by means of multivariate regression logistic analysis. Data are referred to 1,356 NHs that participated in the survey. The overall response rate was 41.2% over a time-period of six weeks (from March 24 to May 5). About one third of the facilities (444 out of 1,334) (33.3%) reported at least 1 adverse event, with a total of 2,000 events. Among the included NHs, having a bed capacity higher than the median of 60 beds (OR=1.57, CI95% 1.17–2.09; p=0.002), an observed increased in the use of psychiatric drugs (OR=1.80, CI95% 1.05–3.07; p=0.032), adopting physical restraint measures (OR=1.97, CI95% 1.47–2.64; p<0.001), residents hospitalized due to flu-like symptoms (OR =1.73, CI95% 1.28–2.32; p<0.001), and being located in specific geographic areas (OR=3.59, CI95% 1.81–7.08; OR = 2.90, CI95% 1.45–5.81 and OR = 4.02, CI05% 2.01–8.04 for, respectively, North-West, North-East and Centre vs South, p<0.001) were all factors positively associated to the occurrence of adverse events in the facility. Future recommendations for the management and care of residents in NHs during the COVID-19 pandemic should include specific statements for the most vulnerable populations, such as people with dementia. |
| first_indexed | 2024-12-14T21:43:57Z |
| format | Article |
| id | doaj.art-0f618f36cec144a5b5d619f89cb3e7d0 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-14T21:43:57Z |
| publishDate | 2020-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-0f618f36cec144a5b5d619f89cb3e7d02022-12-21T22:46:24ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402020-09-011110.3389/fpsyt.2020.578465578465Adverse Events in Italian Nursing Homes During the COVID-19 Epidemic: A National SurveyFlavia L. Lombardo0Emanuela Salvi1Eleonora Lacorte2Paola Piscopo3Flavia Mayer4Antonio Ancidoni5Giulia Remoli6Guido Bellomo7Gilda Losito8Fortunato D’Ancona9Marco Canevelli10Marco Canevelli11Graziano Onder12Nicola Vanacore13The Italian National Institute of Health Nursing Home Study GroupAntonio AncidoniIlaria BacigalupoGuido BellomoLuigi BertinatoMarco CanevelliPatrizia CarbonariMaria Grazia CarellaAnnamaria ConfaloniAlessio CrestiniFortunato D’AnconaCarla FaralliSimone FiaccaventoSilvia FrancisciFlavia L. LombardoEleonora LacorteCinzia Lo NocePaola LuziTania LopezFlavia MayerMaria MasoccoMonica MazzolaGraziano OnderIlaria PalazzesiLuana PennaDaniela PierannunzioPaola PiscopoMaria Cristina PorrelloGiulia RemoliEmanuela SalviGiulia ScaravelliAndrea SidduSabrina SiponeLucia SpezialeAndrea TavillaNicola VanacoreMauro PalmaGilda LositoGianluca PucciarelliDaniela AccorgiCatia BedostiGabriella CarraroMaria MongardiGianluca FerrariNational Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, ItalyNational Center for Drug Research and Evaluation, Italian National Institute of Health, Rome, ItalyNational Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, ItalyDepartment of Neuroscience, Italian National Institute of Health, Rome, ItalyNational Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, ItalyNational Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, ItalyDepartment of Human Neuroscience, Sapienza University of Rome, Rome, ItalyNational Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, ItalyUnit of Health Care and Deprivation of Liberty, Rome, ItalyDepartment of Infectious Diseases, Italian National Institute of Health, Rome, ItalyNational Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, ItalyDepartment of Human Neuroscience, Sapienza University of Rome, Rome, ItalyDepartment of Cardiovascular, Endocrine-metabolic Diseases and Aging, Italian National Institute of Health, Rome, ItalyNational Center for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, ItalyOlder people living in nursing homes (NHs) are particularly vulnerable in the ongoing COVID-19 pandemic, due to the high prevalence of chronic diseases and disabilities (e.g., dementia). The phenomenon of adverse events (AEs), intended as any harm or injury resulting from medical care or to the failure to provide care, has not yet been investigated in NHs during the pandemic. We performed a national survey on 3,292 NHs, either public or providing services both privately and within the national health system, out of the 3,417 NHs covering the whole Italian territory. An online questionnaire was addressed to the directors of each facility between March 24 and April 27, 2020. The list of NHs was provided by the Dementia Observatory, an online map of Italian services for people with dementia, which was one of the objectives of the implementation of the Italian National Dementia Plan. About 26% of residents in the Italian NHs for older people listed within the Dementia Observatory site had dementia. The objective of our study was to report the frequency of AEs that occurred during the months when SARS-CoV-2 spreading rate was at its highest in the Italian NHs and to identify which conditions and attributes were most associated with the occurrence of AEs by means of multivariate regression logistic analysis. Data are referred to 1,356 NHs that participated in the survey. The overall response rate was 41.2% over a time-period of six weeks (from March 24 to May 5). About one third of the facilities (444 out of 1,334) (33.3%) reported at least 1 adverse event, with a total of 2,000 events. Among the included NHs, having a bed capacity higher than the median of 60 beds (OR=1.57, CI95% 1.17–2.09; p=0.002), an observed increased in the use of psychiatric drugs (OR=1.80, CI95% 1.05–3.07; p=0.032), adopting physical restraint measures (OR=1.97, CI95% 1.47–2.64; p<0.001), residents hospitalized due to flu-like symptoms (OR =1.73, CI95% 1.28–2.32; p<0.001), and being located in specific geographic areas (OR=3.59, CI95% 1.81–7.08; OR = 2.90, CI95% 1.45–5.81 and OR = 4.02, CI05% 2.01–8.04 for, respectively, North-West, North-East and Centre vs South, p<0.001) were all factors positively associated to the occurrence of adverse events in the facility. Future recommendations for the management and care of residents in NHs during the COVID-19 pandemic should include specific statements for the most vulnerable populations, such as people with dementia.https://www.frontiersin.org/article/10.3389/fpsyt.2020.578465/fulldementiaadverse eventsnursing homesLong-Term Care FacilitiesCOVID-19public health |
| spellingShingle | Flavia L. Lombardo Emanuela Salvi Eleonora Lacorte Paola Piscopo Flavia Mayer Antonio Ancidoni Giulia Remoli Guido Bellomo Gilda Losito Fortunato D’Ancona Marco Canevelli Marco Canevelli Graziano Onder Nicola Vanacore The Italian National Institute of Health Nursing Home Study Group Antonio Ancidoni Ilaria Bacigalupo Guido Bellomo Luigi Bertinato Marco Canevelli Patrizia Carbonari Maria Grazia Carella Annamaria Confaloni Alessio Crestini Fortunato D’Ancona Carla Faralli Simone Fiaccavento Silvia Francisci Flavia L. Lombardo Eleonora Lacorte Cinzia Lo Noce Paola Luzi Tania Lopez Flavia Mayer Maria Masocco Monica Mazzola Graziano Onder Ilaria Palazzesi Luana Penna Daniela Pierannunzio Paola Piscopo Maria Cristina Porrello Giulia Remoli Emanuela Salvi Giulia Scaravelli Andrea Siddu Sabrina Sipone Lucia Speziale Andrea Tavilla Nicola Vanacore Mauro Palma Gilda Losito Gianluca Pucciarelli Daniela Accorgi Catia Bedosti Gabriella Carraro Maria Mongardi Gianluca Ferrari Adverse Events in Italian Nursing Homes During the COVID-19 Epidemic: A National Survey Frontiers in Psychiatry dementia adverse events nursing homes Long-Term Care Facilities COVID-19 public health |
| title | Adverse Events in Italian Nursing Homes During the COVID-19 Epidemic: A National Survey |
| title_full | Adverse Events in Italian Nursing Homes During the COVID-19 Epidemic: A National Survey |
| title_fullStr | Adverse Events in Italian Nursing Homes During the COVID-19 Epidemic: A National Survey |
| title_full_unstemmed | Adverse Events in Italian Nursing Homes During the COVID-19 Epidemic: A National Survey |
| title_short | Adverse Events in Italian Nursing Homes During the COVID-19 Epidemic: A National Survey |
| title_sort | adverse events in italian nursing homes during the covid 19 epidemic a national survey |
| topic | dementia adverse events nursing homes Long-Term Care Facilities COVID-19 public health |
| url | https://www.frontiersin.org/article/10.3389/fpsyt.2020.578465/full |
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