Infection prevention disaster preparedness planning for long-term care facilities

Abstract Background Little is known about hand hygiene (HH) policies and practices in long-term care facilities (LTCF). Hence, we decided to study the frequency of HH-related infection control (IC) gaps and the factors associated with it. Methods The Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) in collaboration with NE Department of Health and Human Services conducted in-person surveys and on-site observations to assess infection prevention and control programs (IPCP) in 30 LTCF from 11/2015 to 3/2017. The Centers for Disease Control and Prevention (CDC) Infection Prevention and Control Assessment tool for LTCF was used for on-site interviews and the Centers for Medicare and Medicaid (CMS) Hospital IC Worksheet was used for observations. Gap frequencies were calculated for questions (6 on CDC survey and 8 on CMS worksheet) representing best practice recommendations (BPR). The factors studied for the association with the gaps included LTCF bed size (BS), hospital affiliation (HA), having trained infection preventionists (IP), and weekly hours (WH)/ 100 bed spent by IP on IPCP. Fisher’s exact test and Mann Whitney test were used for statistical analyses. Results HH-related IC gap frequencies from on-site interviews are displayed in Figure 1. Only 6 (20%) LTCF reported having all 6 BPR in place and 10 (33%) having 5 BPR. LTCF with fewer gaps (5 to 6 BPR in place) appear more likely to have HA as compared with the LTCF with more gaps but the difference didn’t reach statistical significance (37.5% vs. 7.1%, P = 0.09). When analyzed separately for each gap, it was found that LTCF with HA are more likely to have a policy on preferential use of alcohol based hand rubs than the ones without HA. (85.7%, vs. 26.1% P = 0.008). Several IC gaps were also identified during observations (Figure 2) with one of them being overall HH compliance of <80%. LTCF that have over 90% HH compliance are more likely to have higher median IP WH/100 beds dedicated towards IPCP as compared with the LTCFs with less than 90% compliance (16.4 vs. 4.4, P < 0.05). Conclusion Many HH-related IC gaps still exist in LTCF and require mitigation. Mitigation strategies may include encouraging LTCF to collaborate with IP at local acute care hospitals for guidance on IC activities and to increase dedicated IP times towards IPCP in LTCF. Disclosures All authors: No reported disclosures.

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Long-term care and disaster preparedness: A study of organizational types and levels of preparedness for a disaster or emergency

Journal of Emergency Management ◽

10.5055/jem.2011.0052 ◽

2011 ◽

Vol 9 (2) ◽

pp. 39 ◽

Cited By ~ 1

Author(s):

Saher Selod, MA ◽

Janice Heineman, PhD ◽

Catherine O’Brien, MPH, MA ◽

Scott P. King, PhD

Keyword(s):

Cluster Analysis ◽

Hurricane Katrina ◽

Disaster Preparedness ◽

Urban Areas ◽

Long Term Care ◽

Disaster Plan ◽

Term Care ◽

Preparedness Planning ◽

Demographic Survey

Objectives: Although the consequences of Hurricane Katrina motivated considerable research into long-term care (LTC) facility preparedness, many questions still remain. This study examines the characteristics of LTC facility in relation to the level of preparedness to discern whether there are patterns that can inform future planning efforts. The data from PREPARE, a federally funded disaster preparedness program for LTC staff, are used in the analysis.Methods: More than 400 PREPARE participants completed both baseline and impact surveys as well as a demographic survey, allowing for an analysis of the characteristics and levels of disaster preparedness among participating LTC facilities. Crosstabs were run for the baseline and impact surveys against the demographic survey that the participants completed. Cluster analysis was performed to fit organizations into distinct groups based on their baseline responses to key preparedness domains.Results: The results of the crosstabs reveal the specific areas where LTC facilities have a more comprehensive disaster plan. For example, skilled nursing facilities appear to be more prepared than continuing care retirement communities (CCRCs); rural facilities seem to be more prepared than urban facilities; and facilities that are part of a chain did not emerge as being better equipped than independent facilities. Cluster analysis found three groups of organizations: “Resourceful but Hesitant,” “Unprepared,” and “Model Preparedness.”Conclusions: These findings have important implications for public health efforts surrounding disaster preparedness in LTC. The findings suggest that CCRCs deserve special attention in preparedness planning and that consideration in disaster planning is required in both rural and urban areas.

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How Maryland increased infection prevention and control activity in long-term care facilities, 2003-2008

American Journal of Infection Control ◽

10.1016/j.ajic.2010.09.004 ◽

2011 ◽

Vol 39 (4) ◽

pp. 292-295 ◽

Cited By ~ 13

Author(s):

Brenda J. Roup ◽

Joseph M. Scaletta

Keyword(s):

Prevention And Control ◽

Infection Prevention ◽

Long Term Care ◽

Infection Prevention And Control ◽

Control Activity ◽

Term Care ◽

Care Facilities ◽

And Control

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Infection Prevention Training Impacts Outbreak Recognition and Control in Long Term Care Facilities in Maryland

American Journal of Infection Control ◽

10.1016/j.ajic.2011.04.274 ◽

2011 ◽

Vol 39 (5) ◽

pp. E162

Author(s):

Brenda J. Roup

Keyword(s):

Infection Prevention ◽

Long Term Care ◽

Term Care ◽

Care Facilities ◽

Prevention Training ◽

And Control

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A Comparison of Emergency Preparedness Policies by Long-Term Care Setting Type in Ohio: Assisted Living Settings Lag Behind Nursing Homes in Key Areas

Journal of Applied Gerontology ◽

10.1177/0733464820902010 ◽

2020 ◽

pp. 073346482090201

Author(s):

Katherine A. Kennedy ◽

Cassandra L. Hua ◽

Ian Nelson

Keyword(s):

Assisted Living ◽

Emergency Preparedness ◽

Disaster Preparedness ◽

Long Term Care ◽

Nursing Facilities ◽

Community Based ◽

Term Care ◽

Skilled Nursing ◽

Care Facilities

Skilled nursing facilities (SNFs) have received regulatory attention in relation to their emergency preparedness. Yet, assisted living settings (ALs) have not experienced such interest due to their classification as a state-regulated, home- and community-based service. However, the growth in the number of ALs and increased resident acuity levels suggest that existing disaster preparedness policies, and therefore, plans, lag behind those of SNFs. We examined differences in emergency preparedness policies between Ohio’s SNFs and ALs. Data were drawn from the 2015 wave of the Ohio Biennial Survey of Long-Term Care Facilities. Across setting types, most aspects of preparedness were similar, such as written plans, specifications for evacuation, emergency drills, communication procedures, and preparations for expected hazards. Despite these similarities, we found SNFs were more prepared than large ALs in some key areas, most notably being more likely to have a backup generator and 7 days of pharmacy stocks and generator fuel.

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Implementation of antimicrobial stewardship and infection prevention and control practices in long-term care facilities—Pennsylvania, 2017

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.80 ◽

2019 ◽

Vol 40 (6) ◽

pp. 713-716

Author(s):

Nkuchia M. M’ikanatha ◽

Sameh W. Boktor ◽

Arlene Seid ◽

Allen R Kunselman ◽

Jennifer H. Han

Keyword(s):

Antimicrobial Stewardship ◽

Program Implementation ◽

Prevention And Control ◽

Infection Prevention ◽

Long Term Care ◽

Infection Prevention And Control ◽

Term Care ◽

Care Facilities ◽

And Control

AbstractIn 2017, we surveyed long-term care facilities in Pennsylvania regarding antimicrobial stewardship and infection prevention and control (IPC) practices. Among 244 responding facilities, 93% had IPC programs and 47% had antimicrobial stewardship programs. There was significant variation in practices across facilities, and a number of program implementation challenges were identified.

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Establishment of a Statewide Network for Carbapenem-Resistant Enterobacteriaceae Prevention in a Low-Incidence Region

Infection Control and Hospital Epidemiology ◽

10.1086/675605 ◽

2014 ◽

Vol 35 (4) ◽

pp. 356-361 ◽

Cited By ~ 15

Author(s):

Christopher D. Pfeiffer ◽

Margaret C. Cunningham ◽

Tasha Poissant ◽

Jon P. Furuno ◽

John M. Townes ◽

...

Keyword(s):

Acute Care ◽

Infection Prevention ◽

Long Term Care ◽

Term Care ◽

Carbapenem Resistant ◽

Care Facilities ◽

Low Incidence ◽

Acute Care Facilities ◽

Carbapenem Resistant Enterobacteriaceae

Objective.To establish a statewide network to detect, control, and prevent the spread of carbapenem-resistant Enterobacteriaceae (CRE) in a region with a low incidence of CRE infection.Design.Implementation of the Drug Resistant Organism Prevention and Coordinated Regional Epidemiology (DROP-CRE) Network.Setting and Participants.Oregon infection prevention and microbiology laboratory personnel, including 48 microbiology laboratories, 62 acute care facilities, and 140 long-term care facilities.Methods.The DROP-CRE working group, comprising representatives from academic institutions and public health, convened an interdisciplinary advisory committee to assist with planning and implementation of CRE epidemiology and control efforts. The working group established a statewide CRE definition and surveillance plan; increased the state laboratory capacity to perform the modified Hodge test and polymerase chain reaction for carbapenemases in real time; and administered surveys that assessed the needs and capabilities of Oregon infection prevention and laboratory personnel. Results of these inquiries informed CRE education and the response plan.Results.Of 60 CRE reported from November 2010 through April 2013, only 3 were identified as carbapenemase producers; the cases were not linked, and no secondary transmission was found. Microbiology laboratories, acute care facilities, and long-term care facilities reported lacking carbapenemase testing capability, reliable interfacility communication, and CRE awareness, respectively. Survey findings informed the creation of the Oregon CRE Toolkit, a state-specific CRE guide booklet.Conclusions.A regional epidemiology surveillance and response network has been implemented in Oregon in advance of widespread CRE transmission. Prospective surveillance will determine whether this collaborative approach will be successful at forestalling the emergence of this important healthcare-associated pathogen.

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