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Infection Prevention and Antimicrobial Stewardship Knowledge for Selected Infections Among Nursing Home Personnel

Published online by Cambridge University Press:  04 October 2016

Barbara W. Trautner ,
M. Todd Greene ,
Sarah L. Krein ,
Heidi L. Wald ,
Sanjay Saint ,
Andrew J. Rolle ,
Sara McNamara ,
Barbara S. Edson  and
Lona Mody
Barbara W. Trautner*
Affiliation:
Houston Veterans Affairs (VA) Health Services R&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas Department of Medicine, Baylor College of Medicine, Houston, Texas
M. Todd Greene
Affiliation:
VA Ann Arbor Healthcare System, Ann Arbor, Michigan Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
Sarah L. Krein
Affiliation:
VA Ann Arbor Healthcare System, Ann Arbor, Michigan Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
Heidi L. Wald
Affiliation:
Division of Health Care Policy Research, University of Colorado School of Medicine, Aurora, Colorado
Sanjay Saint
Affiliation:
VA Ann Arbor Healthcare System, Ann Arbor, Michigan Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
Andrew J. Rolle
Affiliation:
Health Research & Educational Trust, American Hospital Association
Sara McNamara
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
Barbara S. Edson
Affiliation:
Health Research & Educational Trust, American Hospital Association
Lona Mody
Affiliation:
VA Ann Arbor Healthcare System, Ann Arbor, Michigan Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
*
Address correspondence to Barbara W. Trautner, MD, PhD, Center for Innovations in Quality, Effectiveness, and Safety (151), 2002 Holcombe Blvd, Houston, TX 77030 ([email protected]).
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Abstract

OBJECTIVE

To assess knowledge about infection prevention among nursing home personnel and identify gaps potentially addressable through a quality improvement collaborative.

DESIGN

Baseline knowledge assessment of catheter-associated urinary tract infection, asymptomatic bacteriuria, antimicrobial stewardship, and general infection prevention practices for healthcare-associated infections.

SETTING

Nursing homes across 14 states participating in the national “Agency for Healthcare Research and Quality Safety Program for Long-Term Care: Healthcare-Associated Infections/Catheter-Associated Urinary Tract Infection.”

PARTICIPANTS

Licensed (RNs, LPNs, APRNs, MDs) and unlicensed (clinical nursing assistants) healthcare personnel.

METHODS

Each facility aimed to obtain responses from at least 10 employees (5 licensed and 5 unlicensed). We assessed the percentage of correct responses.

RESULTS

A total of 184 (78%) of 236 participating facilities provided 1 response or more. Of the 1,626 respondents, 822 (50.6%) were licensed; 117 facilities (63.6%) were for-profit. While 99.1% of licensed personnel recognized the definition of asymptomatic bacteriuria, only 36.1% knew that pyuria could not distinguish a urinary tract infection from asymptomatic bacteriuria. Among unlicensed personnel, 99.6% knew to notify a nurse if a resident developed fever or confusion, but only 27.7% knew that cloudy, smelly urine should not routinely be cultured. Although 100% of respondents reported receiving training in hand hygiene, less than 30% knew how long to rub hands (28.5% licensed, 25.2% unlicensed) or the most effective agent to use (11.7% licensed, 10.6% unlicensed).

CONCLUSIONS

This national assessment demonstrates an important need to enhance infection prevention knowledge among healthcare personnel working in nursing homes to improve resident safety and quality of care.

Infect. Control Hosp. Epidemiol. 2016;1–6

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 1 , January 2017 , pp. 83 - 88
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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