Nurse, CNA cares for nursing home resident, woman

When community influenza rates rise, acute-care readmissions follow suit for residents of skilled nursing facilities, according to a new study.

Investigators analyzed Medicare claims, plus climate and viral testing data for older adults who were hospitalized and then discharged to SNFs between 2012 and 2015. They found that increased community activity for certain influenza strains and respiratory syncytial virus (RSV) was linked to greater odds of cardiorespiratory rehospitalizations from these settings.

The data showed a 1% overall increase in readmission rates for every 5% increase in circulating influenza A(H3N2), influenza B and respiratory syncytial virus (RSV). And the numbers rose substantially higher during the respiratory virus season when compared to the off-season. During flu season, acute-care readmissions increased by approximately 6% for influenza A(H3N2), 3% for influenza B and 5% for RSV, the researchers reported.

The outlier was influenza A(H1N1pdm09), for which rehospitalization decreased when prevalence rose — both on- and off-season. This flu type tends to lead to greater severity in younger adults, and vaccination among SNF residents may be protective, the authors noted.

The takeaway? “The respiratory season is a particularly important period to implement interventions that reduce cardiorespiratory hospitalizations among SNF residents,” the authors wrote. 

They recommend that SNF care providers surveille community viral activity and then employ infection control and prevention measures to match activity levels. Measures should include use of personal protective equipment, improving environmental cleaning measures, screening and testing residents and staff, and quarantining, they concluded.

The study was published in JAMDA.