Past Projects

PRIISM

This AHRQ R01 funded project (PI: Mody) aimed to develop a robust, integrated infection prevention program leveraging the increasingly close relationship between hospitals and their preferred referral nursing homes. This partnership is critical to prevent infections, decrease the use of antimicrobials, implement evidence-based policies to reduce multidrug-resistant organisms, and enhance resident safety. Resources can be found on the archived project page: 

M-ECHO

The AHRQ Nursing Home Network provides training and mentorship to nursing homes nationwide. M-ECHO, the Nursing Home COVID-19 Action Network at Michigan Medicine facilitated trainings to Michigan nursing homes during 2021. Resources can be found on the archived project page: 

CAUTI CUSP

Catheter-associated urinary tract infections (CAUTI) are the most common type of healthcare-associated infection. As many as one-fourth of all hospital inpatients may have a short-term, indwelling urinary catheter placed during their hospital stay. A significant portion of these catheters are placed without appropriate indications. Complications associated with CAUTI result in increased length of stay, patient discomfort, excess health care costs, and sometimes mortality. An estimated 13,000 deaths are associated with CAUTI each year. However, most cases of CAUTI are preventable.

On the CUSP: Stop CAUTI aims to reduce mean rates of CAUTI in U.S. hospitals. The initiative is working with state organizations and hospitals across the country to implement the Comprehensive Unit-based Safety Program (CUSP) and CAUTI reduction practices in hospital units.

https://www.ahrq.gov/hai/tools/cauti-hospitals/index.html

Pathway from Functional Disability to Antibiotic Resistance in Nursing Home Residents

Functional disability (in the activities of daily living, ADLs) has been shown to be a significant risk factor for the new acquisition of antimicrobial resistant organisms (AROs), and that contact-intense ADLs, such as bathing and toileting increase this risk.

Targeted Infection Prevention (TIP) Program to Reduce Antibiotic Resistance and Infections in Nursing Home Residents with Indwelling Devices

Antimicrobial resistance among common bacteria are adversely affecting the clinical course and exponentially increasing healthcare costs. This cluster randomized trial involved 12 nursing homes (NHs) will evaluate a novel focused approach between 'do nothing' and 'search all and destroy' strategies by targeting a subgroup of NH residents with indwelling devices who are high-risk for acquiring multi-drug resistant organisms (MDROs) and infections. Our multi-component TIP intervention includes: pre-emptive enhanced barrier precautions; active surveillance for infections and MDRO colonization to identify asymptomatic MDRO carriage with dissemination of results to clinical staff and administration; a hand hygiene promotion program; and a structured educational program for healthcare workers. 

Gown and Glove Use to Prevent the Spread of Infection in Community-Based Long-Term Care Facilities

Bacterial infections are a problem in nursing home residents and are predominantly spread from patient-to-patient by health care workers (HCW). Residents and healthcare workers will be enrolled to determine if bacteria from the resident are transferred to the gowns and gloves of HCW during episodes of usual care (i.e. wound dressing changes, bathing, etc.) The results will be used to inform when gowns and gloves should be worn or handwashing promoted to prevent transmission of the common bacteria which cause infections in nursing home residents while balancing patient safety and a home-like, patient-centered environment.

Project: 2012-2015

Collaboration with University of Maryland Baltimore, PI: Mary-Claire Roghmann

Body Site Colonization and Strain Variation in Nursing Home Residents with a New Acquisition of Methicillin-Resistant Staphylococcus aureus

Despite the fact that methicillin-resistant Staphylococcus aureus (MRSA) is the most common antibiotic-resistant organism (ARO) studied, there remain few prospective studies that document sites and strains of new acquisition among nursing home residents. We will assess multiple body site carriage dynamics and genotype diversity among high-risk nursing home residents who newly acquire MRSA colonization.

Characterization of Acinetobacter baumannii Colonization in Nursing Home Residents with Indwelling Devices

Acinetobacter baumannii is a pathogen of concern as it has become increasingly resistant to antibiotics, and infection has been associated with increased mortality, particularly in elderly patients and those with indwelling devices. We will evaluate the risk factors for A. baumannii colonization in nursing home residents with indwelling devices, such as urinary catheters and feeding tubes, and characterize the nature of co-colonization with other antibiotic resistant organisms.