long-term care infection prevention
long-term care infection prevention
By Buffy Lloyd-Krejci , DrPH , MS , CIC , LTC-CIP
The Importance of Staff Education and Training in Infection Prevention and Control
For the past several years , infection prevention and control ( IP & C ) programs in long-term care facilities have come under increased scrutiny from a variety of governmental agencies and other groups . In November 2019 , for example , just prior to the COVID-19 pandemic , the Centers for Medicare & Medicaid Services ( CMS ) began requiring all facilities that receive CMS funding to have , at minimum , a part-time infection preventionist ( IP ) onsite . 1 More recently , the Biden administration has proposed
The best way to achieve these outcomes is to build a facilitywide culture focused on IP & C . That means all staff , including non-clinical employees , must be educated about how they can mitigate infection risk and avoid inadvertently spreading infections among residents .” minimum staffing levels for long-term care facilities , 2 and the Association for Professionals in Infection Control and Epidemiology ( APIC ) has pushed for full-time IPs in all long-term care facilities . 3
Regardless of whether these and other proposals pass , the fact remains that long-term care facilities have a responsibility to keep their residents as healthy as possible . Unfortunately , this isn ’ t always easy ; infections are a major health risk to this vulnerable population . Many residents have comorbidities that make them especially vulnerable to infections and disease . On top of that , they live in a congregate setting , which increases the chances that infections will spread more quickly .
To counteract these threats and keep their residents safe , facilities must prioritize IP & C . The good news is that implementing effective IP & C measures does not mean facilities must take on an institutional feel . In fact , if they approach IP & C correctly , long-term care facilities can maintain a homey , comfortable feel for their residents , while still ensuring they are taking every precaution to prevent and control infections .
The best way to achieve these outcomes is to build a facility-wide culture focused on IP & C . That means all staff , including non-clinical employees , must be educated about how they can mitigate infection risk and avoid inadvertently spreading infections among residents . Environmental services staff must be trained to follow cleaning best practices . 4 Food service staff need education around food prep and safety best-practices . Laundry staff must be taught what steps they should take to reduce the chances of cross-contamination . 5 The list goes on ; in short , because every team member at the facility — no matter their role — touches some aspect of resident care , every team member must be trained in proper IPC measures for their respective role . Team members must also be monitored to ensure they remain compliant with those standards .
If training and monitoring your staff in proper IP & C procedures feels daunting , I have a solution for you : enlist your facility ’ s infection preventionist . In addition to surveillance , overseeing your facility ’ s antibiotic stewardship program , overseeing water management , and more , your IP can educate staff in IP & C best practices and audit them to make sure they are adhering to best practices . They can also help build and foster a culture that prioritizes infection prevention and control , while simultaneously ensuring your facility maintains a home-like environment for your residents .
To be successful in these endeavors , IPs need three things . First , they must be allowed to focus fully on their IP role . Asking them to take on additional responsibilities ( for example , asking them to be your director of nursing , as well ) will set them up for failure in both roles . The job of infection preventionist is a big one ; give them the time they need to do it properly .
Secondly , your IP needs the full support of the facility ’ s leadership and ownership . No matter how competent they are , without that support , it ’ s likely they will be pulled in other directions and / or be unable to enforce the measures they implement .
Finally , to meet all their responsibilities , IPs must be willing and able to delegate some of their tasks to other staff members . For example , we covered earlier that staff must be trained in IP & C measures , then audited to ensure they comply with those requirements . IPs can delegate those audits to department supervisors , or even train staff to audit each other . Along with freeing up time for the IP to focus on other duties , delegating in this way will help foster a culture focused on infection prevention and control throughout the facility .
When facilities ensure their IPs are supported in these three ways , a multitude of positive outcomes occur , and most importantly , infections are reduced . As a result , the facility doesn ’ t need as much personal protective equipment ( PPE ), which reduces costs . On top of that , staff are happier , families are happier , and the residents themselves are happier .
Want to replicate these outcomes in your facility ? Give your IP the time , resources , and support they need to educate staff and build a culture focused on infection prevention and control . If you do , chances are high you will enjoy similar success .
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 . Updated Guidance for Nursing Home Resident Health and Safety 2 . Biden ’ s nursing home staff mandates expected soon 3 . APIC calls for Dedicated Infection Prevention Staff at all Long-Term Care
Facilities to Prevent Deaths of Seniors 4 . Best Practices for Environmental Cleaning in Healthcare Facilities 5 . Linen and laundry management
32 july 2023 • www . healthcarehygienemagazine . com