long-term care infection prevention
long-term care infection prevention
By Buffy Lloyd-Krejci , DrPH , MS , CIC , LTC-CIP
The Key to Significantly Improving Your Facility ’ s IP & C Program : Getting Creative
When resources are limited , creativity is often the key to making improvements . Not only does using ingenuity circumvent any potential lack of resources , but it also demonstrates to leadership that staff members are implementing cost-effective solutions to very real problems . “
Over the past several years , my team and I have helped hundreds of long-term care facilities find unique and cost-effective ways to improve their infection prevention and control ( IP & C ) programs and reduce their risk of getting cited by the Centers for Medicare and Medicaid Services ( CMS ) surveyor . In the process , we ’ ve found one thing to be almost universally true : no matter where a facility is located or how large it is , the key to creating real change is to start small .
If this sounds counter-intuitive , I understand . It ’ s easy to spend time focusing on the big , sweeping changes we think need to be made . However , far too often , this approach either costs too much or would take too long to implement . That ’ s why spending your time and resources making small but significant changes is far more effective .
One good example : in several of the facilities I ’ ve visited recently , staff were concerned because they didn ’ t have a contained area in the shower rooms to store clean towels . This significantly increased the chances they ’ d be contaminated by the environment . Staff knew it was a risk , but they were at a loss as to how to fix the situation . What they needed were cupboards to place the clean textiles , however , this is costly and could take time for approval . But we had a solution for them ( and it ’ s the same solution I would suggest to you if your facility struggles with similar issues ) — get creative .
My guess is that most facilities in the country have a stockpile of three-tiered , plastic PPE bins . We had so many during the pandemic that many facilities have stockpiles left . So , grab some bins that aren ’ t being used , put them in your shower rooms , and use them to hold clean towels ( and linens ). This solution eliminates the risk of contamination , keeps everything neatly organized , and best of all , doesn ’ t require a lot of expensive resources to set up .
This is far from the only situation where a little ingenuity can lead to significant improvements . Take another common problem we see in facilities where we work with an overwhelming amount of laundry that needs to go into the utility room . Many of the facilities we work with only have laundry attendants available for part of the day ( for example , from 6 a . m . until 2 p . m .). Outside of those hours , soiled laundry piles up and overflows out of the hampers , which increases the risk of cross-contamination throughout the facility . Hiring additional laundry attendants isn ’ t a possibility for many facilities , but there are other solutions . For example , facilities can assign volunteers or environmental services staff to regularly take soiled laundry to the appropriate area in the utility room , which prevents dangerous overflow .
When resources are limited , creativity is often the key to making improvements . Not only does using ingenuity circumvent any potential lack of resources , but it also demonstrates to leadership that staff members are implementing cost-effective solutions to very real problems . That in turn can make it easier for staff to go to leadership when there are problems that innovation and ingenuity can ’ t fix . For example , if a facility is low on alcohol-based handrub , leadership may be more likely to approve the necessary expenditures to maintain sanitizer at appropriate levels if staff has implemented cost-saving measures elsewhere .
Even with ABHR , though , ingenuity and creativity can lead to improved hand hygiene , which is , after all , one of the most important aspects of IP & C 1 . How ? Well , you may already know that the Centers for Disease Control and Prevention ( CDC ) recommends keeping ABHR both inside and outside every resident ’ s room 2 . Many vendors supply sanitizer dispensers for free , so facilities should be able to put them both inside and outside resident rooms at no additional cost . Of course , the ABHR itself will still be an expense , but making it easy for staff to use it when appropriate will reduce the risk of infectious outbreaks which lead to a host of other expenses . There are so many ways to make significant improvements to your residents ’ health and quality of life without spending large amounts of money or waiting to implement sweeping changes . So , take a look at your facility . Consider where there are problems or where you aren ’ t in compliance with CDC / CMS requirements , then work with your staff and engage your resident ’ s families to come up with new and innovative solutions to address these areas . When you do , I think you ’ ll find — as the facilities we ’ ve worked with have found — your staff will be happier , your residents will be healthier and happier , and your costs ( not to mention your risk for citations ) will decrease significantly .
Buffy Lloyd-Krejci , DrPH , CIC , LTC-CIP , is a leading authority on infection prevention in the long-term care industry . Her firm , IPCWell , delivers in-person gap analysis , training , and support to nursing homes across the country .
References :
1 . Hand hygiene : Back to the basics of infection control
2 . CMS Announces New Measures to Protect Nursing Home Residents from COVID-19
april 2024 • www . healthcarehygienemagazine . com •
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