Identifying clues to infections in nursing home residents. The role of the nurses' aide.

1. Hospitalized elderly are being discharged to nursing homes earlier and with conditions that previously would have merited prolonged stay in the acute care facility; nurses' aides (NAs) provide the vast majority of direct care to nursing home residents. 2. With this change in resident acuity, it is increasingly important for the NA to develop skills to recognize "clues" to potential problems (eg, early signs and symptoms of infection). The consequences of failing to recognize a resident problem promptly can often result in rapid progression of a condition such as an infection. 3. The challenge to improve the work environment of the nursing home so that it is conducive to improved NA performance will be of increasing importance as we move into the next century with more elderly people, fewer resources per capita, and increasing regulatory demands to reduce complications in residents and improve safety for care providers.