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. We hypothesize that specific ADL disability patterns in nursing home (NH) residents will predict acquisition risk for new AROs, and will examine whether disability and risk of acquisition are proportional to healthcare worker (HCW) contact time and contact intensity. We will develop a risk-stratification model utilizing resident-, HCW- , and environmental-level factors. Using this risk-stratification model, we will then develop and evaluate the effectiveness of a multi-component intervention to reduce the risk of new ARO acquisition in highest-risk functionally-disabled NH residents.
Project Start: September 2013