Infection Control Practices in Minnesota Nursing Homes

Abstract

Because infection is a major cause of hospitalization among nursing home residents, we assessed infection control activities and related employee health policies in Minnesota nursing homes, using a questionnaire. The majority of institutions (378/440, 85.9%) responded. We found traditional isolation techniques were widely used, but blood and urine precautions were employed in less than half of the homes. Infection surveillance tended to focus on chart review. Antibiotic utilization studies were done in 76% of homes. Procedures for urinary catheter care were often at variance with current recommendations. Employee health policies required a physical examination of a new employee in a minority of institutions. Policies required by Minnesota statute (eg, skin testing for tuberculosis and documentation of employee illness) were carried out by most institutions. Infection control policies and procedures in nursing homes should be redefined so that, where appropriate, they are more consistent with practices in acute-care hospitals.

SHEA/APIC Guideline: Infection prevention and control in the long-term care facility

“…Initial assessment of employees and education in infection control also are important, as is a reasonable sick-leave policy. 150 Ill employees may cause significant outbreaks in the LTCF. 124 Initial screening should include TB, also required by some states.…”

Infections and antibiotic resistance in nursing homes

“…In large facilities with greater numbers of skilled-care beds, increased prevalence of patients colonized with resistant pathogens has been observed (55). Several survey studies have documented deficiencies in the infection control programs of U.S. and Canadian long-term care facilities (26,41,84,133). Lastly, antibiotic usage seems to play a role in the persistence of resistant strains in long-term care facilities.…”

“…Most nursing homes have infection control programs, although the components of these programs vary among different institutions and reports repeatedly document widespread deficiencies in such programs (26,41,54,84). The overall goal of the infection control program is to prevent infections and, when that is not possible, to limit interpatient transmission of potential pathogens (112).…”

Infections in the Nursing Home

“…Dr. Norman Despite the magnitude of the problem of nursing home infections, the field of infection control in chronic care facilities has been hampered largely because of the lack of relevant studies 1,55 (see also Introduction). Infection control practices that may be effective in reducing infections in the acute care hospital may not be practical or effective in the nursing home setting.…”

“…Existing infection control practices are variable. In a survey of infection control practices in Minnesota nursing homes, Crossley et al 55 found that nearly one‐third of homes did not have extensive preemployment health screening other than tuberculosis skin tests. Furthermore, although 85% had infection control committees, less than five hours a week was spent on infection surveillance in three‐fourths of these institutions.…”