Study Reveals Infection Control Challenges in Long-Term Care Facilities

By on 4:25 AM

Researchers have concluded that long-term care facilities (LTCFs) require infection control policies specific to their setting and should not mirror those used in acute care hospitals.

The study, titled "Paramyxovirus Outbreak in a Long-Term Care Facility: The Challenges of Implementing Infection Control Practices in a Congregate Setting," was published in Infection Control & Hospital Epidemiology, the journal for the Society for Healthcare Epidemiology of America (SHEA). It examined an 16-day outbreak of respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) at a long-term dementia care facility in Tennessee.

Of the facility's 41 patients, 30 (73 percent) contracted at least one of the viruses, 15 had to be hospitalized and five died. Here are some of the challenges the facility faced in controlling the outbreak, as identified by the researchers:
  • Offsite testing of patients with suspected illness delayed results and response.
  • Separation of sick and healthy residents and staff proved difficult because of widespread illness among staff.
  • Due to their dementia, patients were unable to report symptoms and adhere to recommended restrictions.
  • Lack of alcohol-based hand rub limited success of infection control precautions.
  • The number of isolation carts needed quickly exceeded the number available.
  • Reduction in available staff due to illness hindered efforts.

Following the outbreak, the facility made a number of changes to its infection control protocols, including active screening; improved separation of ill and healthy residents and staff during cold and flu season; and renewed emphasis on the importance of hand hygiene and personal protective equipment. The facility also partnered with a private lab to provide faster respiratory viral testing.

LTCFs continue to face challenges as patients are discharged from hospitals far earlier than in past decades. Patient acuity has resulted in nursing homes and other LTCFs requiring additional human and fiscal resources in order to provide appropriate services, including those pertaining to long-term infection control and prevention, to the growing population of residents.

Phenelle Segal, RN, CIC, FAPIC

Phenelle Segal, RN, CIC, FAPIC, is the founder and president of Infection Control Consulting Services LLC (ICCS). Phenelle has more than 30 years' experience providing customized comprehensive infection control and prevention services to healthcare facilities nationwide. Her services focus on assisting hospitals, ambulatory surgery centers, dental office and oral surgery practices, doctor's offices, nursing homes and other organizations with implementing and maintaining an infection control program that: complies with The Joint Commission, AAAHC, Centers for Medicaid and Medicare Services (CMS) and other regulatory agencies; respond to situations of noncompliance; and improve the processes for reducing risk.