ENTANGLED PRACTICES, ENTANGLED EPIDEMICS: ANTIBIOTIC PRACTICES AND HEALTHCARE ASSOCIATED INFECTIONS IN NURSING HOMES AND HOSPITALS

Each year ~388,000 deaths occur due to infections in nursing homes. The U.S. Department of Health and Human Services 2013 National Action Plan to Prevent Healthcare-Associated Infections ranked long-term care as the next priority setting in which to reduce healthcare-associated infections. The changing nature of U.S. nursing homes to increasingly post-acute, skilled nursing facilities has created a “revolving door” between hospitals and nursing homes which increases the potential for spread of healthcare-associated infections. We provide a review of what is known about antibiotic use and infections in both hospital and nursing home settings. A review of the extent of healthcare-associated infections in hospitals and nursing homes underscores the importance of the problem. Taken together, the information provided in this article highlights an acute and growing need for practical, foundational knowledge about transitions among healthcare settings across institutions within networks sharing care for vulnerable older adults. The interconnectedness of nursing homes and hospitals must be considered when devising sustainable strategies to reduce healthcare-associated infections in both settings.