Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-24T22:44:02.389Z Has data issue: false hasContentIssue false
  • English
  • Français

Infection Control Programs in Long-Term-Care Facilities: Structure and Process

Published online by Cambridge University Press:  02 January 2015

Barbara A. Goldrick
Barbara A. Goldrick*
Affiliation:
Georgetown University School of Nursing, Washington, DC
*
Georgetown University School of Nursing, 3700 Reservoir Rd NW, Box 571107, Washington, DC 20057-1107
Get access Rights & Permissions [Opens in a new window]

Abstract

Due to the rapid transfer of patients from the acute-care setting, the intensity of nursing care among residents in long-term-care facilities (LTCFs) has increased, transforming today's LTCFs into subacute healthcare facilities. Given the increased risk of infection among residents in LTCFs and the associated morbidity and mortality, evaluation of infection control programs in skilled nursing LTCFs is warranted. This article addresses the current structure and process of infection control programs in skilled nursing LTCFs.

Type
Topics in Long-Term Care
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 11 , November 1999 , pp. 764 - 769
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Hing, E. Nursing home utilization by current residents: United States, 1985. Publication no. 104. Washington, DC: Vital Statistics, US Department of Health and Human Services; 1989.Google Scholar
2. Kemper, P, Murtaugh, CM. Lifetime use of nursing home care. N Engl J Med 1991;324:595–600.Google Scholar
3. Freiman, MP, Murtaugh, CM. Interactions between hospital and nursing home use. Public Health Rep 1995;110:546–554.Google ScholarPubMed
4. Murtaugh, CM, Freiman, MP. Nursing home residents at risk of hospitalization and the characteristics of their hospital stays. Gerontologist 1995:35:35–43.Google Scholar
5. Strausbaugh, LJ. Infection control in long-term care: news from the front. Am J Infect Control 1999;27:1–3.CrossRefGoogle ScholarPubMed
6. Irvine, PW, Van Buren, N, Crossley, K. Causes for hospitalization of nursing home residents: the role of infection. J Am Geriatr Soc 1984;32:103–107.Google Scholar
7. Nicolle, LE, Strausbaugh, LJ, Garibaldi, RA. Infections and antibiotic resistance in nursing homes. Clin Microbiol Rev 1996;9:1–17.Google Scholar
8. Bonilla, HF, Zervos, MA, Lyons, MJ, Bradley, SF, Hedderwick, SA, Ramsey, MA, et al. Colonization with vancomycin-resistant Enterococcus faecium: comparison of a long-term-care unit with an acute-care hospital. Infect Control Hosp Epidemiol 1997;18:333–339.Google Scholar
9. Revuelta, MP, Nord, JA, Yarrish, RL, Kislak, JW, LaBombardi, V. Recycling of hospital-acquired colonization with vancomycin-resistant enterococci via nursing home residents. Clin Infect Dis 1995;21:730. Abstract.Google Scholar
10. Strausbaugh, LJ, Crossley, KB, Nurse, BA, Thrupp, LD. Antimicrobial resistance in long-term-care facilities. Infect Control Hosp Epidemiol 1996;17:129–140.Google Scholar
11. Garibaldi, RA, Brodine, S, Matsumiya, S. Infections among patients in nursing homes: policies, prevalence, problems. N Engl J Med 1981:305:731–735.Google Scholar
12. Price, LE, Sarubbi, F Jr, Rutala, WA. Infection control programs in twelve North Carolina extended care facilities. Infect Control 1985;6:437–441.Google Scholar
13. Crossley, KB, Irvine, P, Kaszar, DJ, Loewenson, RB. Infection control practices in Minnesota nursing homes. JAMA 1985;254:2918–2921.Google Scholar
14. Khabbaz, RF, Tenney, JH. Infection control in Maryland nursing homes. Infect Control Hosp Epidemiol 1988;9:159–162.CrossRefGoogle ScholarPubMed
15. Smith, PW, Rusnak, PG. Infection prevention and control in the long-term care facility. SHEA Long-Term-Care Committee and APIC Guidelines Committee. Infect Control Hosp Epidemiol 1997;18:831–849.Google Scholar
16. Nicolle, LE. Nursing home dilemmas. Infect Control Hosp Epidemiol 1997;18:806–808.Google Scholar
17. Omnibus Budget Reconciliation Act of 1987. Pub L No. 100-203, December 22,1987, subtitle C, part 1, §4201, pages 160–170.Google Scholar
18. US Department of Health and Human Services, Health Care Financing Administration. Medicare and Medicaid: requirements for LTCFs and nurse aide training and competency evaluation programs: final rules. Federal Register September 26,1991;56:48825–48922.Google Scholar
19. US Department of Health and Human Services, Health Care Financing Administration. State Operations Manual: Provider Certification. Rockville, MD: HCFA; 1992.Google Scholar
20. Pearson, DA, Checko, PJ, Hierholzer, W Jr, Jeckel, JF. Infection control practitioners and committees in skilled nursing facilities in Connecticut. Am J Infect Control 1990;18:167–175.CrossRefGoogle ScholarPubMed
21. Pearson, DA, Checko, PJ, Hierholzer, W Jr, Jeckel, JF. Infection control practices in Connecticut's skilled nursing facilities. Am J Infect Control 1990;18:269–276.CrossRefGoogle ScholarPubMed
22. Goldrick, B, Larson, E. Assessment of infection control programs in Maryland skilled-nursing long-term care facilities. Am J Infect Control 1994;22:83–89.Google Scholar
23. Goldrick, B. Infection control programs in skilled nursing long-term care facilities: an assessment, 1995. Am J Infect Control 1999;27:4–9.Google Scholar
24. Rusnak, PG. Long-term care. In: Olmstead, R ed. APIC Infection Control and Applied Epidemiology: Principles and Practice. St Louis, MO: Mosby Year Book, Inc; 1996.Google Scholar
25. Satterfield, N. Infection control in long-term care facilities: the hospital-based practitioner's role. Infect Control Hosp Epidemiol 1993;14:40–47.CrossRefGoogle ScholarPubMed
26. Crossley, K, Nelson, L, Irvine, P. State regulations governing infection control issues in long-term care. J Am Geriatr Soc 1992;40:251–254.CrossRefGoogle ScholarPubMed
27. Vlahov, D, Tenney, JH, Cervino, KW, Shamer, D. Routine surveillance for infections in nursing homes: experience at two facilities. Am J Infect Control 1987;15:47–53.Google Scholar
28. Haley, R, Quade, D, Freeman, H, Bennett, R, the CDC SENIC Planning Committee. Study of the Efficacy of Nosocomial Infection Control (SENIC Project): summary of study design. Am J Epidemiol 1980;11:472-485, 613–621.Google Scholar
29. Haley, RW, Culver, DH, White, JW, Morgan, WM, Emori, TG, Munn, VP, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in U. hospitals. Am J Epidemiol 1985;121:182–205.Google Scholar
30. Smith, PW. Consensus conference on nosocomial infections in long-term care facilities. Am J Infect Control 1987;15:97–100.Google Scholar
31. Smith, PW, Daly, PB, Rusnak, PG, Roccaforte, JS. Design and dissemination of a multiregional long-term care infection control training program. Am J Infect Control 1992;20:275–277.Google Scholar
32. Leinbach, RM, English, AJ. Training needs of infection control professionals in long-term care facilities in Virginia. Am J Infect Control 1995;23:73–77.Google Scholar
33. Daly, PB, Smith, PW, Rusnak, PG, Jones, MB, Giuliano, D. Impact on knowledge and practices of a multiregional long-term care facility infection control training program. Am J Infect Control 1992;20:225–233.Google Scholar
34. Crow, S. Training of personnel for infection control. Infect Control 1984;5:38–40.Google Scholar
35. Mylotte, JM. The hospital epidemiologist in long-term care: practical considerations. Infect Control Hosp Epidemiol 1991;12:439–442.Google Scholar
36. Gaynes, R. Surveillance of nosocomial infections: a fundamental ingredient for quality. Infect Control Hosp Epidemiol 1997;18:475–478.Google Scholar
37. Haley, RW, Culver, DH, White, JW, Morgan, WM, Emori, TG. The nationwide nosocomial infection rate. A new need for vital statistics. Am J Epidemiol 1985;121:159–167.Google Scholar
38. US Department of Health and Human Services, Health Care Financing Administration. Requirements for long-term care facilities. Federal Register February 2, 1989;54:5359–5373.Google Scholar
39. McGeer, A, Campbell, B, Emori, TG, Hierholzer, WJ, Jackson, MM, Nicolle, LE, et al. Definitions of infections for surveillance in long- term care facilities. Am J Infect Control 1991;19:1–7.Google Scholar
40. Mylotte, JM. Analysis of infection control surveillance data in a long-term-care facility: use of threshold testing. Infect Control Hosp Epidemiol 1996;17:101–107.CrossRefGoogle Scholar
41. Childress, JA, Childress, JD. Statistical test for possible infection outbreaks. Infect Control 1981;2:247–249.Google Scholar
42. Stevenson, KB. Regional data set of infection rates for long-term care facilities: description of a valuable benchmarking tool. Am J Infect Control 1999;27:20–26.Google Scholar
43. Gaynes, RP, Culver, DH, Emori, TG, Horan, TC, Banerjee, SN, Edwards, J. et al. The National Nosocomial Infection Surveillance System: plans for the 1990s and beyond. Am J Med 1991;91(suppl 3B):116S–120S.Google Scholar
44. Centers for Disease Control and Prevention. Pneumococcal and influenza vaccination levels among adults aged s65 years—United States, 1995. MMWR 1997;46:913–919.Google Scholar
45. Quick, RE, Hoge, CW, Hamilton, DJ, Whitney, CJ, Borges, M, Kobayashi, JM. Underutilization of pneumococcal vaccine in nursing home in Washington State: report of a serotype-specific outbreak and a survey. Am J Med 1993;94:149–152.CrossRefGoogle ScholarPubMed
46. Centers for Disease Control and Prevention. Outbreaks of pneumococcal pneumonia among unvaccinated residents in chronic-care facilities— Massachusetts, October 1995, Oklahoma, February 1996, and Maryland, May-June 1996. MMWR 1997;46:60–62.Google Scholar
47. McNeeley, DF, Lyons, J, Conte, S, Labowitz, A, Layton, M. A cluster of drug-resistant Streptococcus pneumoniae among nursing home patients. Infect Control Hosp Epidemiol 1998;19:476–477.Google Scholar
48. Centers for Disease Control and Prevention. Surveillance for penicillin-nonsusceptible Streptococcus pneumoniae—New York City, 1995. MMWR 1997;46:297–299.Google Scholar
49. Centers for Disease Control and Prevention. Prevalence of penicillin-resistant Streptococcus pneumoniae—Connecticut, 1992-1993. MMWR 1994;43:216-217,223.Google Scholar
50. Butler, JC, Hofmann, J, Cetron, MS, Elliott, JA, Facklam, RR, Breiman, RF. The continued emergence of drug-resistant Streptococcus pneumoniae in the United States: an update from the Centers for Disease Control and Prevention's Pneumococcal Sentinal Surveillance System. J Infect Dis 1996;174:986–993.Google Scholar
51. Centers for Disease Control and Prevention. Recommendations of the Immunization Practices Advisory Committee. Pneumococcal polysaccharide vaccine. JAMA 1989;261:1265–1267.Google Scholar
52. US Public Health Service. Healthy People 2000 Review, 1995-96. Washington, DC: US Department of Health and Human Services, Public Health Service; 1996.Google Scholar
53. Beck-Sague, C, Villarino, E, Giuliano, D, Welbel, S, Latts, L, Manangan, LM, et al. Infectious diseases and death among nursing home residents: results of surveillance in 13 nursing homes. Infect Control Hosp Epidemiol 1994;15:494–496.Google Scholar
54. Beck-Sague, C, Banerjee, S, Jarvis, W. Infectious diseases and mortality among U. nursing home residents. Am J Public Health 1993;83:1739–1742.Google Scholar
55. Kunin, CM. Care of the urinary catheter. In: Kunin, CM, ed. Detection, Prevention and Management of Urinary Tract Infections. Philadelphia, PA: Lea and Febiger; 1972.Google Scholar
56. Wong, ES. Guideline for prevention of catheter-associated urinary tract infections. Am J Infect Control 1983;11:28–31.CrossRefGoogle ScholarPubMed
57. Nicolle, LE, Muir, P, Harding, GK, Norris, M. Localization of urinary tract infection in elderly, institutionalized women with asymptomatic bacteri-uria. J Infect Dis 1988;157:65–70.Google Scholar
58. Nicolle, LE, Brunka, J, Mclntyre, M, Murray, D, Harding, GK. Asymptomatic bacteriuria, urinary antibody, and survival in the institutionalized elderly. J Am Geriatr Soc 1992;40:607–613.CrossRefGoogle ScholarPubMed
59. Nordenstam, G. Brandberg, CA, Oden, AS, Svanborg Eden, CM, Svanborg, A, Bacteriuria and mortality in an elderly population. N Engl J Med 1986;314:1152–1156.Google Scholar
60. Kunin, CM, Douthitt, S, Dancing, J, Anderson, J, Moeschberger, M. The association between the use of urinary catheters and morbidity and mortality among elderly patients in nursing homes. Am J Epidemiol 1992;135:291–301.Google Scholar
61. Garner, JS, Favero, MS. CDC Guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231–243.Google Scholar
62. Larson, EL. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251–269.Google Scholar
63. Thompson, BL, Dwyer, DM, Ussery, XT, Denman, S, Vacek, P, Schwartz, B. Handwashing and glove use in a long-term-care facility. Infect Control Hosp Epidemiol 1997;18:97–103.CrossRefGoogle ScholarPubMed
64. Crossley, K, SHEA Long-Term Care Committee. Vancomycin-resistant enterococci in long-term-care facilities. Infect Control Hosp Epidemiol 1998;19:521–525.Google Scholar
65. Nicolle, LE, Bentley, D, Garibaldi, R, Neuhaus, E, Smith, P. Antimicrobial use in long-term-care facilities. Infect Control Hosp Epidemiol 1996;17:119–128.Google Scholar
66. Smith, PW, Seip, CW, Schaefer, SC, Bell-Dixon, C. Microbiologic survey of long-term care. 36th Annual Meeting of the Infectious Diseases Society of America, November 1998; Denver, CO. Abstract 6435a.Google Scholar
67. Mylotte, JM. Antimicrobial prescribing in long-term care facilities: prospective evaluation of potential antimicrobial use and cost indicators. Am J Infect Control 1999;27:10–19.Google Scholar
68. Zimmer, JG, Eggert, GM, Treat, A, Bredows, B. Nursing homes as acute care providers. A pilot study of incentives to reduce hospitalizations. J Am Geriatr Soc 1988;36:124–129.Google Scholar