As a Pennsylvania nursing home lawyer, I know that outbreaks of disease are distressingly common in nursing homes. Any situation where people live in close quarters increases the risk of a communicable disease, but in nursing homes, the situation is worse because the residents are usually elderly and not in peak health. As a result, the staff’s failure to take basic precautions like washing hands can cause a deadly outbreak. Now, a new study from the University of Chicago School of Medicine shows that outbreaks of norovirus–a virus that commonly causes the stomach flu–in nursing homes is associated with a risk of death or hospitalization from any cause. While it’s not surprising to find that norovirus causes norovirus-related hospitalizations, the study suggests that the virus may increase all risks to patients.
The study, reported in the online version of the Journal of the American Medical Association, was a retrospective analysis of two years’ worth of Medicare and CDC records from nursing homes in Oregon, Wisconsin and Pennsylvania. (These were the states with the greatest number of outbreaks, which is bad news here in Pennsylvania.) During the duration of the outbreaks, the study found, hospital admission rates were 124 per nursing home per year, higher than the 109.5 per home per year rate when there was no outbreak. Death rates during outbreaks were 53.7 per home per year and 41.9 per home per year when there was no outbreak. Significantly, the study found that the risk of death disappeared when the home had a high number of registered nurse hours per resident, but increased when the RN time dropped to 0.75 hour per resident per day.
Researchers suggested that the risks may stem less from norovirus itself than from the disruptions caused by the outbreaks. As a Philadelphia medical malpractice lawyer, I agree that this seems likely. Many nursing homes–especially private, for-profit homes–are perpetually understaffed because staff is very expensive. This is unfortunate for patients, because studies consistently show that care is better and risks are lower with a higher staffing ratio, especially when skilled staff has more hours. A viral outbreak undoubtedly strains those stretched resources, causing a higher risk of things going undone or unnoticed. As a Philadelphia injury lawyer, I’m familiar with the results: missed or wrong medications, inattention to basic food and water and bedsore needs, dementia patients permitted to wander and more kinds of Pennsylvania nursing home abuse.
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