Nursing homes should be safe places. They should be warm, caring environments where residents can age with grace and enjoy a high quality of life.
Unfortunately, they’re often breeding grounds for infections leading to serious illness and even death for many residents.
Understanding and implementing the best practices for infection prevention in nursing homes can help you and your team create a healthier environment and protect residents.
The Situation with Healthcare-Associated Infections (HAIs)
Healthcare-associated infections, or HAIs, are frighteningly common in the United States. According to the CDC, “1 in 43 nursing home residents contracts at least one infection in association with their healthcare”. Across all long-term care facilities in the US, the CDC estimates that between 1 and 3 million serious infections occur.
All of this points to one single issue: HAIs continue to be a leading cause of morbidity and mortality in America’s nursing homes. To help prevent HAIs and to protect these at-risk populations, you and your team must pay constant attention to following proven best practices. Of course, doing so is not without its challenges.
Key Challenges in Nursing Home Infection Prevention
While nursing homes share similarities with hospitals, medical clinics, and other healthcare facilities, they face unique challenges when it comes to infection prevention. These issues include the following:
Staff Education and Hand Hygiene to Reduce Infection Risks
Perhaps the single most common cause of healthcare-associated infections within nursing homes is due to poor handwashing habits, particularly for staff members. Staff members also often lack proper education when it comes to infection prevention. What can you do? The answer is deceptively simple –– implement stringent handwashing requirements and provide your team with access to ongoing training related to HAIs and their prevention.
Visitor Management for Infection Prevention within Nursing Homes
Visitors to nursing homes can introduce a broad range of risks. A single visitor with an infectious virus can go on to infect dozens of residents and staff members, and then they can go on to infect even more. It’s important to establish visitor health protocols and then enforce them (temperature taking and the use of touch-free technology, for instance). During active outbreaks, you should also limit the number of visitors allowed into the facility even with preventative measures in place.
Personal Protective Equipment (PPE) Usage to Mitigate Risks
Personal protective equipment, usually abbreviated as PPE, is one of the most important preventative measures available to you. For instance, some PPE can help protect against pathogens in blood, mucous, and other bodily fluids. Enhanced barrier precautions (EBP) can help reduce the chance of transfer during high-contact activities, like bathing and dressing.
Commonly used PPE for nursing homes includes gloves, gowns, goggles, facemasks, and N-95 masks. Nursing homes face two challenges here: ensuring they have the right PPE on hand and requiring all staff members to use it.
Now that we’ve discussed some of the key challenges nursing homes face when it comes to dealing with infection prevention, let’s talk about best practices. These are proven solutions that will help you keep your residents and staff members safe.
Best Practices for Infection Prevention
Most of the best practices we discuss below relate directly to the challenges we just discussed.
Focus on Staff Education and Hand Hygiene
Poor handwashing is a primary cause of pathogen transfer within facilities like yours. Thankfully, that’s relatively simple to solve. Require your staff members to frequently wash their hands. If necessary, post reminder signage around the facility. It’s also important that everyone understands how to properly wash their hands.
Training in handwashing techniques should be part of your broader education on infection prevention. Create and implement a training program, enroll all your staff members, and then track their progress through each module. Refresher training should be required periodically, too.
Use PPE Effectively
PPE is a critical layer in your nursing home infection prevention strategy. However, for it to be effective, it must be worn correctly and at the right times. It’s also important that it’s stored properly when not in use. To help reduce infections:
- Ensure that your entire team is trained in how to put on and take off PPE to avoid compromising protection and avoid contamination.
- Ensure that the right PPE is available for each situation. Gloves, goggles, facemasks, and N-95 masks play different roles and are not always applicable in all situations.
- Ensure that your team members understand how to fit PPE correctly. A loose-fitting facemask provides little in the way of protection against airborne pathogens, for instance. Ensure that your team understands how to store PPE when not in use. Note that storage procedures vary depending on the type of PPE, but most should be stored in a cool, dry place away from direct sunlight and other threats.
Manage Linens and Waste
Proper laundering of linens and correct disposal of human waste can help prevent infections from spreading in a nursing home environment.
- Bed linens should be washed weekly at a minimum. However, if the resident has accidents or spills, they should be washed more frequently. Note that pillows should be washed every six months (pillowcases should be washed weekly).
- Care should be taken with soiled linens because blood, mucous, stool, and other bodily fluids/waste could be present. Wear PPE when changing bedding, transporting soiled linens, and laundering.
- Wash soiled linens in hot water and use the appropriate detergent, along with chlorine bleach to help kill any potential contaminants.
- Store clean linens in a clean, central location away from any potential contaminants.
- Dispose of human waste (blood, urine, fecal matter, etc.) correctly according to facility procedures and policies. Note that you should create guidance documents and then train employees on both waste disposal and handling linens.
Visitor Screening and Education
Each visitor that enters your nursing home is another potential vector. Infection prevention in nursing homes relies on active visitor screening and education.
- Require all visitors to submit to a temperature check before entering the facility. This helps catch visitors who are running fevers and prevents the spread of infection. Use a touch-free system like Advanced Entry to simplify this process.
- Require all visitors to complete a questionnaire before entering the nursing home. Questionnaires can probe for information about their current and recent health, their recent travel, and more. This information can be very helpful in determining whether to allow a visitor into the facility, but also in tracking infection if it appears.
- Inform visitors of your health requirements. For instance, during peak flu season, you may require all visitors to wear masks. If a new strain of COVID-19 is particularly relevant, distancing and masking may also be required for infection prevention in nursing homes.
- Provide hand sanitation for visitors. Hand sanitizer located at the touch-free temperature station offers convenience and ensures that all visitors have the opportunity to disinfect their hands before entering, which is an important step in infection prevention for nursing homes.
Environmental Hygiene
While resident’s rooms might not be considered “high traffic” areas, many other spaces within your facility are. Regular cleaning and sanitizing can help reduce the chance of infection in these areas.
- Focus on frequent cleaning and disinfecting of high-touch surfaces. This includes any surface that multiple people might use within a short period, including door handles, information booths, and more.
- Regularly clean and sanitize common areas, such as waiting areas/lobbies, hallways, cafeterias, libraries, game rooms/tables, etc.
Ensure Visitors Are Vaccinated
Vaccinations play a key role in infection prevention. Nursing homes must verify that visitors are vaccinated before allowing them into the facility. This is particularly important during outbreaks and peak season for flu and COVID-19 strains. Providing proof of vaccination would allow a visitor into the nursing home.
However, note that this guidance varies by state. For example, Florida’s government states that a lack of vaccination should prevent someone from visiting. Florid is not the only state to set rules like this. Understand your state’s rules and regulations and then create a vaccination strategy based on those specifics.
Regulatory Compliance for Infection Prevention in Nursing Homes
Much of what we’ve discussed thus far will help ensure that your facility complies with rules and regulations. However, make sure that you’re familiar with the CDC’s recommendations for infection prevention within nursing homes, as well as state and federal rules that apply to your facility.
Not only will this help reduce infection in your nursing home, but it will also make it less likely that an inspector might find a violation during a surprise inspection. Surprise inspections are on the rise across the country as nursing homes continue to experience violations, and some fail their inspections completely.
The Role of Advanced Entry Systems in Infection Control
Infection prevention in nursing homes requires the right combination of preventative strategy, knowledge, and tools/technology. At Advanced Entry, we design and manufacture real-time visitor intelligence solutions that can make a difference in infection prevention and preventing pathogens from spreading within your nursing home.
Enhancing Visitor Screening
Our touchless entry system provides a seamless, touch-free solution to taking visitor temperatures and even delivering questionnaires to verify health status before allowing a person into your facility. They also automate visitor management and allow feedback on resident health.
Ensuring Compliance with Health Protocols
Following your health protocols is important, and we understand the difference that can make in infection prevention in nursing homes. Our systems remind visitors of your entry protocols and require them to agree to your terms before they’re allowed into the facility. During active outbreaks and high-risk periods, our systems can also restrict entry for infection prevention within a nursing home.
Encouraging Feedback
Finally, Advanced Entry’s tools also encourage visitors to provide feedback. This can include details of their experience, but it also allows them to detail any concerns about resident health, ensuring that your team can act on accurate, up-to-date information.
Infection Prevention for Nursing Homes: It’s Possible with a Proactive Stance
Infections within long-term care facilities like nursing homes continue to rise. Millions of them occur every single year. However, your nursing home doesn’t have to be on the list. A proactive stance, coupled with vigilance and the right technology, can help with infection prevention. Nursing home administrators and staff members also need to understand and follow the best practices highlighted within this guide to reduce the chance of contamination and the potential for infection to spread.
However, it’s not enough to rest on your accomplishments once you have a plan in place. Viruses and other pathogens continue to evolve. Your mitigation strategy must do the same. Continuous improvement in infection prevention within nursing homes is essential if you want to protect vulnerable residents.
