Original Research
Monday, October 14, 2024
01:00 PM–02:30 PM
Abstract
Introduction:
Over 1 million Americans live in skilled nursing facilities (SNFs). Antibiotic transition errors among patients transferred from hospital to SNF pose a safety risk and may lead to poor clinical outcomes, but data on such errors are limited.
Research Question or Hypothesis:
We hypothesized that patients transferred from hospital to SNF will have identifiable characteristics associated with antibiotic transition errors, including treatment-level (e.g., expensive antibiotic choice), patient-level (e.g., demographics, co-morbidities), and/or SNF-level (e.g., quality rating) factors.
Study Design:
Retrospective cohort study.
Methods:
We reviewed data from infectious diseases clinics at LA County Department of Health Services, a large safety net health system from 06/01/20-11/30/23. We performed logistic regression analyses to identify independent factors associated with antibiotic transition errors and poor infection outcomes.
Results:
We reviewed 6865 clinic patients’ records, of which 112 were SNF residents on antibiotics. Mean age was 62 years, 37% were female, and 57% were Hispanic. Among our population, 32 (29%) had transition errors. Among errors, common medications were carbapenems (28%), cephalosporins (19%) and daptomycin (19%). In our multivariable model of antibiotic transition errors that included age, Charlson Comorbidity Index, number of medications, CMS SNF rating, and therapy duration, we found no significantly associated factors. In our multivariable model of poor infection outcome, older age was the only independent predictor (p=0.02) and there was a non-significant trend for an association with antibiotic transition errors (OR 1.63, 95%CI 0.58-4.81).
Conclusion:
In our large system, nearly one-third of patients transitioning from hospitals to SNFs on antibiotics experienced >1 antibiotic transition error. We did not identify risk factors associated with antibiotic transition errors, suggesting that all patients transferred to SNFs are at risk. We found a non-significant trend of an association between transition errors and poor infection outcomes, suggesting larger data sets may be able to firmly establish this important relationship.
Presenting Author
Amy Kang PharmD
Chapman UniversityAuthors
Richard Beuttler PsyD, MS
Chapman University
Andrew Bishop DO
Harbor-UCLA Medical Center
Evelyn Flores BS
Lundquist Institute
Guarina Garcia Delgado MS
Lundquist Institute at Harbor-UCLA
Loren Miller MD, MPH
Harbor-UCLA Medical Center
Ashley Nguyen BS
Lundquist Institute
Abisay Ortega BS
Lundquist Institute
Donna Phan Tran MPH
Lundquist Institute
Charis Tjoeng MD
Lundquist Institute