Lower respiratory tract infections (LRTIs) and influenza-like illnesses (ILIs) are on the rise in Pennsylvania nursing homes. But multipronged approaches to treatment and prevention can help, according to a new report. The study should be helpful for providers nationwide, experts say.

Elder care facilities that required workers to have influenza vaccinations had a 21.5% lower combined seasonal LRTI/ILI infection rate from October 2010 through March 2011, according to data published in the 2011 “Pennsylvania Patient Safety Advisory.” What’s more, facilities with mandatory vaccination programs have 42% lower mortality rates than nursing homes without mandatory programs, according to the report.

Other strategies that could prevent respiratory illnesses in long-term care facilities should focus on the special needs of frail residents, experts say. Long-term care residents have increased risk factors for respiratory illnesses, such as swallowing difficulties, smoking, immobility, poor oral care and lack of influenza and pneumococcal vaccination, they note.

“Pneumonia cases can be decreased over 20% with adequate oral care and swallowing difficulty interventions,” said Sharon Bradley, RN, senior infection prevention analyst from the Pennsylvania Patient Safety Authority. “Mandatory vaccination programs also can reduce influenza virus by 60% when 100% of staff are vaccinated,” Bradley added.