Healthcare-Associated Adverse Events in Alternate Level of Care Patients Awaiting Long-Term Care in Hospital
Introduction: A growing number of Canadian older adults are designated alternate level of care (ALC) and await placement into long-term care (LTC) while admitted to hospital. This creates infrastructural challenges by using resources allocated for acute care during disproportionately long hospital s...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Geriatrics |
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| Online Access: | https://www.mdpi.com/2308-3417/7/4/81 |
| _version_ | 1797410038089777152 |
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| author | Guillaume J. Lim Fat Aquila Gopaul A. Demetri Pananos Mary-Margaret Taabazuing |
| author_facet | Guillaume J. Lim Fat Aquila Gopaul A. Demetri Pananos Mary-Margaret Taabazuing |
| author_sort | Guillaume J. Lim Fat |
| collection | DOAJ |
| description | Introduction: A growing number of Canadian older adults are designated alternate level of care (ALC) and await placement into long-term care (LTC) while admitted to hospital. This creates infrastructural challenges by using resources allocated for acute care during disproportionately long hospital stays. For ALC patients, hospital environments maladapted to their needs impart risk of healthcare-associated adverse events. Methods: In this retrospective descriptive study, we examined healthcare-associated adverse events in 156 ALC patients, 65 years old and older, awaiting long-term care while admitted to two hospitals in London, Ontario in 2015–2018. We recorded incidence of infections and antimicrobial days prescribed. We recorded incidence of non-infectious adverse events including delirium, falls, venothrombotic events, and pressure ulcers. We used a restricted cubic spline model to characterize adverse events as a function of length of stay. Results: Patients waited an average of 56 ALC days (ranging from 6 to 333 days) before LTC placement, with seven deaths occurring prior to placement. We recorded 362 total adverse events accrued over 8668 ALC days: 94 infections and 268 non-infectious adverse events. The most common hospital-acquired infections were urinary-tract infections and respiratory infections. The most common non-infectious adverse events were delirium and falls. A total of 620 antimicrobial days were prescribed for infections. Conclusions: ALC patients incur a meaningful and predictable number of adverse events during their stay in acute care. The incidence of these adverse events should be used to educate stakeholders on risks of ALC stay and to advocate for strategies to minimize ALC days. |
| first_indexed | 2024-03-09T04:24:05Z |
| format | Article |
| id | doaj.art-9349b40b645043618cf7fbf18f76f1ba |
| institution | Directory Open Access Journal |
| issn | 2308-3417 |
| language | English |
| last_indexed | 2024-03-09T04:24:05Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Geriatrics |
| spelling | doaj.art-9349b40b645043618cf7fbf18f76f1ba2023-12-03T13:43:48ZengMDPI AGGeriatrics2308-34172022-08-01748110.3390/geriatrics7040081Healthcare-Associated Adverse Events in Alternate Level of Care Patients Awaiting Long-Term Care in HospitalGuillaume J. Lim Fat0Aquila Gopaul1A. Demetri Pananos2Mary-Margaret Taabazuing3Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine, Western University, London, ON N6A 3K7, CanadaDivision of Geriatric Medicine, Department of Medicine, Schulich School of Medicine, Western University, London, ON N6A 3K7, CanadaDepartment of Epidemiology and Biostatistics, Western University, London, ON N6A 3K7, CanadaDivision of Geriatric Medicine, Department of Medicine, Schulich School of Medicine, Western University, London, ON N6A 3K7, CanadaIntroduction: A growing number of Canadian older adults are designated alternate level of care (ALC) and await placement into long-term care (LTC) while admitted to hospital. This creates infrastructural challenges by using resources allocated for acute care during disproportionately long hospital stays. For ALC patients, hospital environments maladapted to their needs impart risk of healthcare-associated adverse events. Methods: In this retrospective descriptive study, we examined healthcare-associated adverse events in 156 ALC patients, 65 years old and older, awaiting long-term care while admitted to two hospitals in London, Ontario in 2015–2018. We recorded incidence of infections and antimicrobial days prescribed. We recorded incidence of non-infectious adverse events including delirium, falls, venothrombotic events, and pressure ulcers. We used a restricted cubic spline model to characterize adverse events as a function of length of stay. Results: Patients waited an average of 56 ALC days (ranging from 6 to 333 days) before LTC placement, with seven deaths occurring prior to placement. We recorded 362 total adverse events accrued over 8668 ALC days: 94 infections and 268 non-infectious adverse events. The most common hospital-acquired infections were urinary-tract infections and respiratory infections. The most common non-infectious adverse events were delirium and falls. A total of 620 antimicrobial days were prescribed for infections. Conclusions: ALC patients incur a meaningful and predictable number of adverse events during their stay in acute care. The incidence of these adverse events should be used to educate stakeholders on risks of ALC stay and to advocate for strategies to minimize ALC days.https://www.mdpi.com/2308-3417/7/4/81delayed dischargewaiting for long-term care (LTC)healthcare-associated adverse eventshospital-acquired infectionshealthcare-associated infectionsdelirium |
| spellingShingle | Guillaume J. Lim Fat Aquila Gopaul A. Demetri Pananos Mary-Margaret Taabazuing Healthcare-Associated Adverse Events in Alternate Level of Care Patients Awaiting Long-Term Care in Hospital Geriatrics delayed discharge waiting for long-term care (LTC) healthcare-associated adverse events hospital-acquired infections healthcare-associated infections delirium |
| title | Healthcare-Associated Adverse Events in Alternate Level of Care Patients Awaiting Long-Term Care in Hospital |
| title_full | Healthcare-Associated Adverse Events in Alternate Level of Care Patients Awaiting Long-Term Care in Hospital |
| title_fullStr | Healthcare-Associated Adverse Events in Alternate Level of Care Patients Awaiting Long-Term Care in Hospital |
| title_full_unstemmed | Healthcare-Associated Adverse Events in Alternate Level of Care Patients Awaiting Long-Term Care in Hospital |
| title_short | Healthcare-Associated Adverse Events in Alternate Level of Care Patients Awaiting Long-Term Care in Hospital |
| title_sort | healthcare associated adverse events in alternate level of care patients awaiting long term care in hospital |
| topic | delayed discharge waiting for long-term care (LTC) healthcare-associated adverse events hospital-acquired infections healthcare-associated infections delirium |
| url | https://www.mdpi.com/2308-3417/7/4/81 |
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