January 4, 2024
During a recent JAMDA On-The-Go podcast, Jonathan L. Temte, MD, PhD—lead author of an insightful study on the rapid detection of influenza outbreaks in the December issue of JAMDA—talked about the power of prompt action and teamwork.
Referring to the article Rapid Detection of Influenza Outbreaks in Long-Term Care Facilities Reduces Emergency Room Visits and Hospitalization: A Randomized Trial, Dr. Temte said, “This essentially was a study about timing. We came up with our basic hypothesis: For individuals living in long-term care facilities, the use of broadened surveillance criteria for influenza-like illnesses, coupled with rapid on-site diagnostic testing compared to usual care results in increased early antiviral treatment for influenza and increased use of antiviral prophylaxis, as well as reduced hospitalizations and mortality and decreased health care utilization during influenza season.”
Dr. Temte mentioned four key findings from the study. First, they found that swabs collected for rapid influenza testing could be repurposed in this high-risk population. Second, rapid influenza diagnostic tests performed much better in this population. Third, the director of nursing and infection control nurses had high levels of satisfaction with the intervention; and fourth, the intervention had some profound outcomes, including a significant decline in hospitalizations and ER visits, as well as shorter lengths of stay when hospital admission was necessary.
The key take-home message from the study, Dr. Temte suggested, is that “time is of the essence—from the time the patient becomes symptomatic to the time the institution takes action [e.g., medications and/or quarantine]. Increased awareness and implementation of appropriate measures to reduce the time from onset to response is important.” He stressed that the key to this is delegating authority to nursing staff and nurse aides to identify symptoms, collect specimens, and start taking action without waiting for lab results to come back.
Barbara Resnick, PhD, CRNP, JAMDA co-editor-in-chief and another guest on the podcast, observed, “The interdisciplinary perspective the researchers took was important.” She noted that no one discipline can resolve all respiratory issues in long-term care facilities. However, she offered a caveat about placing too much emphasis on numbers related to hospitalization. She noted there are many reasons—including family demands—why someone might be admitted to the hospital.
JAMDA On-The-Go host Karl Steinberg, MD, HMDC, CMD, and Dr. Resnick also highlighted a few other studies published in the December issue of JAMDA, specifically:
- Balance Confidence Modulates the Association of Gait Speed with Falls in Older Fallers: A Prospective Cohort Study. This involved the study of older, community-dwelling adults who could walk for 10 meters independently and had one or more falls in recent years. The researchers found that balance confidence modulated the association between gait speed and falls.
- Evaluation of Montreal Cognitive Assessment (MoCA) Administered via Videoconference. This study aimed to evaluate the agreement between MoCA assessed face-to-face versus videoconference using a mobile phone. The authors concluded that conducting a MoCA by videoconference is another valid method of providing medical care to people without significant visual or hearing impairment that restricts their mobile phone use.
Association between Dental Diseases and Oral Hygiene Care and the Risk of Dementia: A Retrospective Cohort Study. This study sought to investigate the associations of dental diseases and oral hygiene care with the risk of dementia. The authors concluded that periodontal disease, dental care, and a high number of missing teeth were independently associated with a higher risk of dementia. They also found that improved oral hygiene care may modify the risk.
Access the full podcast for more of this enlightening discussion.
