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Infections in Older Adults: A Case-Based Discussion Series Emphasizing Antibiotic Stewardship.

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Date
2018-09-21
Authors
Michener, Alyson
Heath, Barbara
Crnich, Christopher J
Moehring, Rebekah
Schmader, Kenneth
Mody, Lona
Branch-Elliman, Westyn
Jump, Robin LP
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Abstract
Introduction:Compared with younger populations, adults 65 years and older are more likely to suffer infection-related morbidity and mortality, experience antibiotic-related adverse events, and acquire multidrug-resistant organisms. We developed a series of case-based discussions that stressed antibiotic stewardship while addressing management of common infections in older adults. Methods:Five 1-hour case-based discussions address recognition, diagnosis, and management of infections common in older adults, including those living in long-term care settings: urinary tract infections, upper respiratory tract infections, lower respiratory tract infections, skin and soft tissue infections, and Clostridium difficile infection. The education was implemented at the skilled nursing centers at 15 Veterans Affairs medical centers. Participants from an array of disciplines completed an educational evaluation for each session as well as a pre- and postcourse knowledge assessment. Results:The number of respondents to the educational evaluation administered following each session ranged from 68 to 108. Learners agreed that each session met its learning objectives (4.80-4.89 on a 5-point Likert scale, 5 = strongly agree) and that they were likely to make changes (2.50-2.89 on a 3-point scale, 3 = highly likely to make changes). The average score on the five-question knowledge assessment increased from 3.6 (72%) to 3.9 (78%, p = .06). Discussion:By stressing recognition of atypical signs and symptoms of infection in older adults, diagnostic tests, and antibiotic stewardship, this series of five case-based discussions enhanced clinical training of learners from several disciplines.
Type
Journal article
Subject
Antibiotic Stewardship
Antimicrobial Stewardship
Asymptomatic Bacteriuria
Bronchitis
Cellulitis
Clostridium Difficile Infection
Clostridium Infections
Editor's Choice
Nursing Homes
Older Adults
Pneumonia
Urinary Tract Infections
Permalink
https://hdl.handle.net/10161/18186
Published Version (Please cite this version)
10.15766/mep_2374-8265.10754
Publication Info
Michener, Alyson; Heath, Barbara; Crnich, Christopher J; Moehring, Rebekah; Schmader, Kenneth; Mody, Lona; ... Jump, Robin LP (2018). Infections in Older Adults: A Case-Based Discussion Series Emphasizing Antibiotic Stewardship. MedEdPORTAL : the journal of teaching and learning resources, 14. pp. 10754. 10.15766/mep_2374-8265.10754. Retrieved from https://hdl.handle.net/10161/18186.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Moehring

Rebekah Moehring

Associate Professor of Medicine
Schmader

Kenneth Edwin Schmader

Professor of Medicine
Dr. Schmader’s areas of research include herpes zoster, infections, and vaccines in older adults.  He conducts translational, clinical trials and observational studies of zoster, influenza, and other infections funded by grants from the National Institute on Aging (NIA), National Institute of Allergy and Infectious Diseases (NIAID), Centers for Disease Control (CDC), VA Office of Research and Development, and Industry sources.  He has played a pivotal role in the development o
Alphabetical list of authors with Scholars@Duke profiles.
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