Long-Term Care

Almost half of nursing homes and assisted living facilities are operating at a loss, while 84% of nursing homes are losing revenue this year because fewer post-acute patients are coming to them from hospitals.

Karen Jones MPH, RN, CIC: “It’s really key to have a good written infection prevention and control plan at the hospital level but then also at the nursing home level. And what keeps that up to date? It’s an infection preventionist who’s knowledgeable, who’s been educated, who’s been trained, who’s certified.”

A five-year survey in Michigan seeks to determine if enhanced relationships between nursing homes and hospitals might facilitate better infection prevention in nursing homes.

Take 5 minutes to catch up on Infection Control Today®’s highlights for the week ending June 25.

Here's one method of containing COVID-19 at nursing homes: Pair long-term care facilities (LTCF) staff and residents who've recovered with susceptible residents to help reduce transmission. It seems to work, says a study.

Investigators with Columbia University School of Nursing found that COVID-19 infections were 13.6 percentage points higher in nursing homes with 50% or more Black residents, and deaths were 3.5 percentage points higher, compared with nursing homes with no Black residents.

Nursing homes, already strapped for employees, lost about 19,500 workers last month, according to government figures. Question: What’s happened to all the funding nursing homes have gotten because of COVID-19?

MIT professors argue that many variables should be included when determining just how much social distancing is needed in different indoor settings.

Investigators University of Michigan-Flint, School of Nursing noted that the Cooper Tool and the Stone criteria are similar but use different methods to arrive at a UTI diagnosis.

One thing that will haunt me and many health care personnel in both acute care and LTCFs forever is that so many people died without a family member at their bedside.

SARS-CoV-2 is aerosolized. If a non-vaccinated person who is shedding the virus visits a vaccinated relative in a nursing home, he can easily spread the virus to all who reside in the facility.

COVID-19 outbreak hits Kentucky nursing home a week after CMS relaxes visiting restrictions.

The CMS update on when nursing home residents can have visitors raises grave concerns. The recommendation appears to assume that herd immunity is reached at 70%.

In CMS’ official announcement easing restrictions for visiting nursing homes, no mention was made of the year anniversary—marked today—of when the WHO officially labeled COVID-19 a global pandemic. Still, in so many words, the agency said enough is enough.

Difficulties in communicating with the elderly necessitate close speaking. These circumstances are a ripe atmosphere for spreading respiratory diseases. While residents were largely isolated from the broader population, their caretakers were not.

The Association for Professionals in Infection Control and Epidemiology (APIC) argues that nursing homes in New York should have a fulltime IP on staff.

“Infection control measures, including surveillance, education, cleaning/disinfection, patient cohorting, isolation, and hand hygiene, effectively contained the outbreak; it was declared over within 2 months.”

Though tough months lie ahead for infection preventionists and other healthcare professionals, hope remains that at some point in 2021 things will begin to settle down. In the end, it comes down to a simple formula: We win, COVID-19 loses.

CDC’s Jay Butler, MD: “It is critical that every healthcare worker in the United States has the training, information, and resources they need to protect themselves, their patients, colleagues, families, and communities from infections, and Project Firstline is designed to meet that need.”

There are 4 “moments” involved as a healthcare professional at a long-term care facility (LTCF) weighs whether to prescribe an antibiotic to a patient or resident.

Cedric Steiner: “We had to address the ability to say good-bye to loved ones. A big guy, with tears in his eyes. He was so thankful that they had a place to go for their mother, because at the hospital they couldn’t see her. He wanted to give me a bear hug, but we did the ‘elbow thing’ instead.”

Despite a clear record of violations across the country, amid a culture where sick staff were asked to show up for work, lawmakers in several states have also potentially disincentivized improvement of infection control standards in long-term care facilities by providing legal liability protections ahead of time.

Nancy Moureau, PhD, RN, CRNI, CPUI, VA-BC: “We see the competency of a vascular access specialist or team validated by the outcomes, by the level of infection with their patients, with other complications that may be present.”

Infection control at LTCFs needs to be a balanced approach that addresses the risk of infection, and not just the treatment of infection. Money is saved when this approach is used.

Many healthcare facilities, not only LTCFs, have turned to online training for staff and then designate the employee as competent to do their job. Online training does not prove competency; it provides training.