The Centers for Disease Control and Prevention (CDC) estimates that 1 to 3 million serious infections occur every year in nursing homes, skilled nursing facilities, and assisted living facilities.
This alarming statistic makes infection prevention extremely important for those 8 million+ residents of the 65,000+ registered long-term facilities around the country.
Infections in long-term care facilities have taken on greater meaning during the COVID-19 pandemic where older residents of these facilities have been susceptible to serious illness and death from the coronavirus.
Data.cms.gov says that in the past two years, 1,025,242 long-term care facility residents have gotten COVID-19 with 152,324 deaths, and 1,083,378 staff have become infected with 2,375 deaths.
“Many long-term care facilities across the country are taking actions to implement CDC guidance and keep residents and staff safe during the COVID-19 pandemic,” says the CDC.
Why Infection Prevention is Important for Long-Term Care Residents
Even without the current COVID-19 pandemic, infections in long-term care facilities can have life-and-death consequences.
International Infection Prevention Week says that if you or a loved on is staying in a long-term care facility, the are some important things you need to know to prevent infections, including why the issue is important:
- When people are living closely together, they are more likely to become sick with infections that are transmitted from person to person.
- Because residents in long-term facilities may have open wounds, devices such as urinary catheters or intravenous catheters, or be incontinent of urine or stool, it is especially important for the staff, visitors, and other patients to practice good infection prevention and control techniques.
- Good infection prevention and control techniques include cleaning hands before and after touching another resident, cleaning and disinfecting environmental surfaces, removing soiled items (like used tissues or adult diapers from the environment), or wearing personal protective equipment (such as gloves, a gown, or a mask).
- Bacteria and viruses that can be transmitted to others in long-term care facilities include methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C. diff), norovirus, and other bacteria, fungi, or viruses.
- Infections, like influenza or the common cold, can spread when the sick person talks, coughs, or sneezes and releases droplets of saliva and mucus. These droplets can travel through the air and can be inhaled through the nose and mouth of another person or contaminate their hands.
10 Questions that Residents Should Ask Their Long-Term Care Facility About Infection Prevention
CDC, in its “Core Elements for Antibiotic Stewardship in Nursing Homes”, has put together a list of 10 questions that residents should ask their long-term care facility about infection prevention:
- What infections commonly occur among residents in this facility?
- When was the last outbreak (i.e., infection spreading among residents) in this facility? What was the cause (e.g., flu, norovirus, other)? Did the facility request assistance from local public health authorities or any other partners?
- How does the facility communicate with residents, family, and visitors when an outbreak occurs?
- Is the flu vaccine mandatory for all staff working in this nursing home? What percentage of your staff received the flu vaccine this year (or last year)?
- If a staff member is sick, is he/she allowed to stay at home (or go home from work) without losing pay or time off?
- How are facility staff trained to respond to questions about hand hygiene from residents and family?
- Are residents with new diarrhea given separate toilet facilities until the cause of their diarrhea is determined and/or the diarrhea is resolved?
- How is shared equipment (e.g., objects in the therapy area or common room) managed to prevent the spread of germs?
- Does the facility have private rooms for residents who develop signs or symptoms of a potentially contagious infection like new cough and fever or new vomiting and abdominal pain? If the facility does not have private rooms, what precautions are taken?
- Does the facility provide educational materials for residents and families on the following topics?
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- Hand hygiene
- Use of gowns/gloves and other equipment to prevent the spread of germs
- Antibiotic use policies/practices in this facility
- C. difficile
What Long-Term Care Facility Residents Can Do
The International Infection Prevention Week says that residents, in addition to the questions above, can take the following actions to control infections:
- Clean your hands before you eat and after using the bathroom. It should take at least 20 seconds to thoroughly wash your hands. Using an alcohol-based hand sanitizer is a good option if your hands are not visibly dirty.
- If you have open sores, cover them with a bandage. Do not pick at your sores or remove your bandage.
- Cover your mouth with the inside of your elbow when you cough or sneeze. Throw away any used tissues and wash your hands afterwards.
- Don’t share your personal items with other residents.
- Remind your care providers to wash their hands frequently. It’s OK to ask if a care provider has cleaned their hands before caring for you.
- If your doctor prescribes an antibiotic for an infection, take the medication exactly how it is prescribed.
- Follow directions if you are asked to stay in your room.
- Don’t touch any food that will be eaten by someone else.
Questions to Ask When You Have Been Prescribed Antibiotics
If your healthcare provider has prescribed you antibiotics, the International Infection Prevention Week says it is important to ask the following questions:
- “Do I really need an antibiotic?”
- “Can I get better without this antibiotic?”
- “What side effects or drug interactions can I expect?”
- “What side effects should I report to you?”
- “How do you know what kind of infection I have?
Also, make sure that everyone (residents, care providers, and visitors) wash their hands when they enter the room and when they leave the room.
And make sure your care provider is wearing gloves if they are removing a dressing. A gown might be necessary if the wound is large.
