Impact of Healthcare-Associated Infections in Post-Acute and Long-Term Care Settings

Posted on by CDC's Safe Healthcare Blog
Dr. Hudson Garrett Jr.
Dr. Hudson Garrett Jr.

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
Master Trainer

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 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.

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11 comments on “Impact of Healthcare-Associated Infections in Post-Acute and Long-Term Care Settings”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    Very Informative post. Thanks for sharing. Great…If you want senior people to be informed about their health and medical reports electronically, here is Senior insight’s Senior Living EHR solutions with a robust SaaS application. Senior should feel independent.

    Very good information and thanks for offering your service to many people. I hope they will be happy from you.

    Very good information and thanks for offering your service to many people. I hope they will be happy from you.

    I agree this discussion is timely. I have found that changing the culture in LTC is a good first step. After a couple of months training on the AMDA Choosing Wisely recommendations and on UTIs(what really constitutes a UTI), our facility incidence of UTIs decreased because staff and practitioners were only ordering urine cultures on symptomatic patients and not treating cultures already obtained on asymptomatic patients.

    please can you help me to know and site the answer of the following question :
    what is the prevalence of central line- associated bloodstream infection (CLABSI) among adult patients in intensive care unit all over the world or in developing countries ?
    what is the association between corticosteroid or cyclosporin and CLABSI ?
    what is the association between CLABSI and prolonged use of mechanical ventilation?

    Although there is no direct link between uniforms and HAI’s, has anyone looked at incorporating protective uniforms (not to be confused with PPE) as a part of a horizontal approach in reducing HAI’s? It only makes sense considering uniforms represent the largest mobile surface that doesn’t get cleaned between patients. Anxious to get feedback and thoughts.

    I think this focus has been a long time coming . I will be eager to participate and learn from my peers.

    I would like to know specifics ad top how to care for a resident who had c-diff in a nursing home; eg, what exactly to red bag for linen and trash, are shoe covers necessary.

    Thank you for all your work. It would be great for hospitals and other facilities to support time to the ‘sharing’ the knowledge of infection prevention. This will take some time and effort, but well worth it.
    I am curious about the credential of IP-BC. Is this in place of CIC? Is there a different program or test to apply for to attain IP-BC? Thank you.

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Page last reviewed: November 18, 2016
Page last updated: November 18, 2016