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Table 1 Characteristics of nursing homes and residents participating in the Belgian HALT surveys, 2010-2016

From: Healthcare-associated infections and antimicrobial use in Belgian nursing homes: results of three point prevalence surveys between 2010 and 2016

  All NHs participating in at least one of the surveys Cohort of NHs participating in all three consecutive surveys
NH characteristics HALT-1 (2010) HALT-2 (2013) HALT-3 (2016) p value a HALT-1 (2010) HALT-2 (2013) HALT-3 (2016) p value a
Participating facilities [N] 107 87 158   25 25 25  
Ownership [% public] 34.6 43.7 33.5 0.264 48.0 48.0 48.0 1.000
Rooms [median N, (IQR)] 97 (74-123) 94 (73-123) 100 (76-124) 0.603 101 (79-129) 99 (82-133) 99 (82-145) 0.925
Single rooms [%] 85.7 89.3 *** 92.2 *** <0.001 88.7 90.6 * 90.2 0.069
Beds [median N, (IQR)] 103 (76-144) 100 (76-130) 106 (82-131) 0.592 110 (90-144) 101 (86.5-152) 103 (90-169) 0.941
Infection prevention and control (IPC) resources within the facilities
Person with IPC training available [%] 50.5 65.5 * 71.3 *** 0.002 40.0 72.0 * 84.0 ** 0.003
Help and expertise from an external IPC team (e.g. from a nearby hospital) on a formal basis [%] 77.1 77.6 80.3 0.806 79.2 83.3 84.0 0.894
Hand hygiene training in the previous year [%] 74.8 70.9 76.1 0.676 80.0 83.3 72.0 0.615
Surveillance program for HAIs [%] 43.0 39.8 39.7 0.852 44.0 58.3 60.0 0.461
Written protocol available in the NH for         
Management of MRSA and/or other MDRO [%] 98.1b 100.0 100.0 0.092 100.0 100.0 100.0 1.000
Hand hygiene [%] 99.1 97.6 100.0 0.122 100.0 100.0 100.0 1.000
Management of urinary catheters [%] 64.6 63.5 61.2 0.858 70.8 66.7 70.8 0.937
Management of venous catheters/lines [%] 37.8 31.7 30.0 0.464 36.4 36.4 34.8 0.992
Management of enteral feeding [%] 51.6 55.8 47.9 0.506 65.2 52.0 56.5 0.642
Antimicrobial stewardship elements in place in the facilities
Restrictive list of antimicrobials to be prescribed [%] 10.5 14.5 16.1 0.418 8.0 16.7 16.0 0.587
Antimicrobial committee within the facility [%] 2.8 6.0 9.0 0.104 4.0 0.0 12.0 0.112
Annual training on appropriate antimicrobial prescribing provided [%] 11.2 9.5 12.3 0.812 16.0 12.5 20.0 0.775
 A therapeutic formulary, comprising a list of antimicrobials [%] 62.6 70.2 52.3 0.019 80.0 83.3 68.0 0.412
Advice from a pharmacist for antimicrobials not included in the formulary [%] 15.0 20.2 22.6 0.297 24.0 16.7 20.0 0.815
Written therapeutic guidelines present in the NH for         
Respiratory tract infections [%] 35.5 56.9 ** 49.5 * 0.018 60.0 68.4 78.9 0.399
Urinary tract infections [%] 32.7 59.6 ** 54.0 ** <0.001 52.0 61.1 80.0 0.135
Wound and soft tissue infections [%] 43.9 68.4 ** 45.4 0.006 56.0 77.8 65.0 0.324
Surveillance of antimicrobial consumption [%] 13.3 23.2 18.9 0.209 29.2 28.0 41.7 0.538
Surveillance of resistant microorganisms [%] 67.0 72.8 59.1 0.092 72.0 75.0 84.0 0.565
NH population characteristics on survey day
Eligible residents [total N (median N; IQR] 11 911
(100; 74-140)
8 756
(93; 67-127)
16 215
(96; 75-122)
0.206 2 804
(106; 89-139)
2 748
(100; 87-136)
2 757
(100; 80-139)
0.977
Age ≥ 85 year [%] 52.9 60.3 *** 56.0 *** <0.001 52.0 58.7 *** 54.7 * <0.001
Gender [%] 25.6 24.9 25.5 0.486 27.1 26.7 27.6 0.758
Disoriented (in time and/or space) [%] 49.7 52.5 *** 55.0 *** <0.001 55.3 56.2 58.1 0.095
Impaired mobility (wheelchair bound or bedridden) [%] 41.7 39.1 *** 38.3 *** <0.001 45.6 42.4 * 40.9 *** 0.001
Incontinent for urine and/or faeces [%] 61.2 58.9 *** 55.9 *** <0.001 66.0 61.7 ** 63.4 * 0.004
Urinary catheter present [%] 2.4 2.8 3.1 *** 0.003 3.0 3.1 3.0 0.983
Vascular catheter present [%] 0.1 0.3 ** 0.3 ** 0.002 0.2 0.3 0.3 0.866
Pressure sore [%] 3.3 4.0 * 3.3 0.013 3.1 4.2 * 4.1 * 0.052
Wound other than pressure sore [%] 7.6 8.7 ** 9.1 *** <0.001 7.1 9.4 ** 8.9 * 0.005
Surgery in the previous 30 days [%] 1.0 1.4 * 1.0 0.022 0.9 1.7 * 1.0 0.025
  1. NH nursing home, N Number, IQR interquartile range, IPC infection prevention and control, HAI healthcare-associated infection, MRSA methicillin resistant Staphylococcus aureus, MDRO multidrug resistant microorganisms; a Regression analysis estimates significantly different from the reference (HALT-1) are indicated with asterisks. *: p ≤ 0.05, **: p ≤ 0.01, ***: p ≤ 0.001; b Management of MRSA only