Examining Nursing Home Information Technology Maturity and Antibiotic Use Among Long-Term Care Residents.
Catherine C Cohen, Kimberly Powell, Andrew W Dick and 4 others
PMID 35172166WHAT IT FOUND
In U.S. nursing homes, greater administrative IT integration was associated with more antibiotic use on resident assessments, not less.
The study cannot tell whether antibiotics were appropriate. Do not assume IT maturity reduces inappropriate antibiotics.
Key findings
01Administrative IT integration was associated with increased antibiotic use (AOR 1.072, 95% CI 1.025 to 1.122).
02The administrative IT integration association remained in models with nursing home fixed effects (AOR 1.061, 95% CI 1.022 to 1.101) and in the four-year panel (AOR 1.097, 95% CI 1.019 to 1.181).
03Antibiotic use was recorded on 8.1% of 219,461 assessments from 80,237 residents, but appropriateness was not measured.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study counted antibiotic use on assessments but could not determine whether prescriptions were appropriate, or identify drug class, defined daily doses, therapy days, or courses. The outcome depended on MDS days of antibiotic use and an assumption that days were consecutive. Survey respondents differed from nonrespondents by ownership and location, so weighting was used but may not remove all bias. Admissions assessments were excluded because antibiotics recorded there may have started outside the nursing home. The design is observational, so it cannot show that IT integration caused antibiotic use. MDS and survey data have reliability and validity issues, including moderate validity for other infections.
Declared interests
The authors reported no personal conflicts to disclose. The article is listed as supported by NIH extramural and U.S. government P.H.S. research support.
The easy way to misread this
Do not conclude that administrative IT integration causes more antibiotic use. The study is observational, and it could not determine whether antibiotic use was appropriate.