Impact of Healthcare-Associated Infections in Post-Acute and Long-Term Care SettingsPosted on by
Author: J. Hudson Garrett Jr., PhD, MSN, MPH, FNP-BC, PLNC, VA-BC™, CDONA, IP-BC, FACDONA
The Director: Journal of the National Association of Directors of Nursing Administration in Long Term Care
Post-acute care settings such as skilled nursing facilities, long-term acute care hospitals (LTACHs) and acute inpatient rehabilitation facilities (IRFs) cater to an increasingly complex patient population transitioning out of the hospital, but still requiring significant care and support. Many of these individuals receive this care in a residential setting to foster social interactions and communal activities as part of the rehabilitation process. These special circumstances can make traditional infection prevention and control interventions difficult to implement. For example, in nursing homes, which provide a mixture of skilled nursing care and residential care, studies have estimated that 1 to 3 million serious healthcare-associated infections (HAIs) occur every year resulting in hospitalizations and associated mortality and morbidity.
Individuals receiving care in long-term care facilities, such as nursing homes and assisted living facilities, have unique challenges related to infection control. Luckily, there are evidence-based strategies to reduce infections in these patients. Basic interventions such as hand hygiene, maintaining a clean environment of care, safe injection practices, properly using personal protective equipment, and implementing a robust antibiotic stewardship program will dramatically reduce the risk of HAIs for these patients.
Specific data on the incidence of HAIs in post-acute care settings is currently limited to LTACHs and IRFs even though significantly more patients receive care in skilled nursing facilities. Participation in CDC’s National Healthcare Safety Network by skilled nursing facilities is crucial so we can better understand the impact and trends associated with HAIs in long-term care environments. These data provide useful tools to target infections and improve compliance with established evidence-based practices.
Infection preventionists and nursing leaders must work collaboratively across disciplines and partner with environmental services professionals and technicians, medical laboratory personnel, and clinical/consulting pharmacists to reduce HAIs. Sharing data and best practices along with championing HAI reduction initiatives will not only help reduce HAI rates, but more importantly, create a culture for sustained efforts to each Zero! One timely example of collaboration is improving antibiotic stewardship across the entire continuum of care. This requires interprofessional collaboration between both healthcare facilities (i.e. acute care hospitals and post-acute care facilities), providers, clinicians, and public health partners. Only through collaboration and a relentless focus on improving stewardship will healthcare benefit from the stewardship efforts. These focused efforts also will assist in reducing other HAI targets such as Clostridium difficile infections.
For more information about infection prevention and control training and certification related to Post Acute/Long-term Care Settings, please visit www.nadona.org. The 2016 NADONA Annual Educational Conference will feature multiple sessions dedicated specifically to improving infection prevention and control across post-acute care settings, as well as a special preconference session on infection prevention and control for all healthcare professionals.