long-term care infection prevention
long-term care infection prevention
By Buffy Lloyd-Krejci , DrPH , MS , CIC , LTC-CIP
Handle a COVID-19 Outbreak at Your Long-Term Care Facility With This Multi-Pronged Approach
Over the past few months , my team and I have been to several long-term care facilities facing COVID-19 outbreaks . It ’ s no surprise : like the flu , COVID is now endemic in our population . However , given that their residents often have multiple comorbidities and live in a congregate setting , it ’ s crucial that long-term care facilities act swiftly and decisively to both reduce the risk of an outbreak and address one if it occurs .
If you run a long-term care facility or are part of a facility ’ s infection prevention and control ( IP & C ) program , there are several ways you can help mitigate the risk of a COVID outbreak among your residents . Encouraging all staff and visitors to wear masks , reminding personnel and residents of the importance of hand hygiene , and promoting COVID vaccinations are all good places to start . 1 Making sure the infection preventionist ( IP ) regularly reviews the guidance issued by the Centers for Disease Control and Prevention ( CDC ) is also important , as their recommendations are updated frequently with the latest information about how to stay safe from infectious diseases like COVID . 2
To reduce the risk of transmission , your facility should also take steps to keep symptomatic visitors and staff from exposing your vulnerable residents . One simple and effective way to do this is by posting signs at all entrances and in high-traffic areas that clearly outline symptoms of COVID . 3 Signs can also be posted reminding staff and visitors that residents are particularly vulnerable to infectious disease , so if they have any of the mentioned symptoms they should go home or ( at the very least ) put on a mask before interacting with residents .
While taking steps to keep potentially sick people out of the facility can go a long way towards preventing an outbreak , if one does occur , it ’ s important to test staff and residents who may be exhibiting symptoms to determine the extent of the outbreak . If anyone tests positive , contact tracing should be employed . 4 It is important to note here that , while you may have tests on hand , your IP should verify the tests have not expired , as that could impact their efficacy .
The IP can also take time to educate facility personnel — including environmental services staff and CNAs — about what symptoms to watch out for . Many times , people in these roles interact with residents every single day , so they are in a good position to pick up on potential symptoms before an outbreak spreads . This is especially true when it comes to COVID , as one positive case is considered an outbreak . By catching outbreaks quickly , your IP & C team can take steps to stop or slow the spread before it moves through the entire facility . 5
To show you how important this type of decisive action is , one of the facilities my team and I worked with that had an outbreak followed this guidance . Thirty-three of their residents and five staff members tested positive for COVID after only
one resident was symptomatic and tested positive . Thirty-eight positive infections are a lot , however , it could have been more had they not immediately tested and proactively implemented control measures to prevent the further spread .
Along with educating staff and visitors , testing , and contact tracing , your IP should also ensure your facility ’ s policies for dealing with an outbreak are up to date and reflect the most recent CDC guidance . 6 If any policies are obsolete , the IP should update them , and then educate staff members about the new guidance . At the same time , the IP should make sure the written policies are in alignment with what their facility can do , and work with leadership to enforce them . They can even create an emergency plan for handling potential outbreaks if they are short-staffed . These steps should not be overlooked : state and federal surveyors will review your facility ’ s policies and , if your facility is noncompliant with the written policies , it will be cited .
Finally , if an outbreak occurs , your IPC team must contact your county ’ s health department and report it . This should be done at the same time that contact tracing and further testing are being done . Working with your county ’ s epidemiologist or state ’ s healthcare-associated infection ( HAI ) epidemiologist will support your efforts in containing any outbreaks , get appropriate testing materials , and so on .
While a COVID outbreak is the last thing any long-term care facility wants , there are ample resources and practical strategies to help address any that occur . It takes everyone ’ s active participation to get through an outbreak successfully , though : visitors and staff should get vaccinated , mask up , and stay home if they are sick ; everyone in the facility should practice good hand hygiene and follow appropriate CDC precautions ; and the IP must educate , coordinate testing , and ensure that steps are taken to contain the virus before it spreads .
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 . Stay Up to Date with COVID-19 Vaccines 2 . Interim Infection Prevention and Control Recommendations for Healthcare
Personnel During the Coronavirus Disease 2019 ( COVID-19 ) Pandemic 3 . Symptoms of COVID-19 4 . Contact Tracing 5 . Testing and Management Considerations for Nursing Home Residents with Acute Respiratory Illness Symptoms when SARS-CoV-2 and Influenza Viruses are Co-circulating
6 . Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 ( COVID-19 ) Pandemic
28 november 2023 • www . healthcarehygienemagazine . com