An Educational Resource for Long-Term Care

​​Welcome to the latest issue of The Lowdown. This issue is going “back to basics.” With so much focus on the pandemic and the frequently-changing infection prevention measures, it is easy to overlook the basic building blocks of a strong infection prevention program. Happy reading!

Environmental cleaning is a fundamental principle of infection prevention. Environmental services (EVS) is a critical part of the healthcare team to prevent and control the spread of infection! Practicing good environmental hygiene will help make your facility safe for residents, healthcare workers, and families. The environment can help spread pathogens, like bacteria and viruses, which can survive on surfaces for days or months.^1,2

Incorporate cleaning and disinfection into the facility infection prevention plan, including properly training staff and emphasizing high-touch surfaces. High-touch surfaces increase the chance that microorganisms will spread. While surfaces may look clean, pathogens may be lurking.

Use a checklist to document the completion of terminal and scheduled cleanings, and monitor cleaning practices to ensure they are performed correctly and consistently. Always use an EPA-registered disinfectant labeled for use in healthcare and follow the manufacturer’s instructions when using any cleaning or disinfecting product. ^1,2

Look for the following information on the label:

Use the right size wipe for the size of the surface being cleaned and disinfected. Small wipes are fine for bedside tables and use larger wipes for mattress covers. Proper use and storage of disinfectants is key!^1,2

Environmental cleaning tools and resources are available from Centers for Disease Control and Prevention (CDC) at www.cdc.gov/hai/toolkits/appendices- evaluating-environ-cleaning.html​

Are you unknowingly transmitting pathogens on equipment? Is the equipment you use a “fomite”? A fomite is an object, such as clothing, linens, furniture, or medical equipment (blood pressure cuff, glucometer, stethoscope, etc.) that can carry and transmit disease-causing pathogens.

Healthcare workers should be careful not to transmit pathogens on equipment. Studies have shown equipment to harbor serious pathogens, such as MRSA (methicillin-resistant Staphylococcus aureus), Pseudomonas aeruginosa, and Clostridioides difficile (C. diff.), making them a potential source for transmission. CDC guidelines state that reusable equipment, such as stethoscopes, must be disinfected between residents.²

It all starts with you! Make it a habit to disinfect equipment immediately after use and before storage. Follow the manufacturer’s instructions for use (IFU) to clean and disinfect equipment. Device manufacturers have the responsibility to provide written instructions to properly clean their

products. Facility cleaning policies should follow the IFU.^2,3

Laundry can also be a transmission source. Use Standard Precautions when handling contaminated linen and avoid shaking or agitating it. Bag or contain the contaminated linen where it is collected and hold it away from your clothing/body during transport. Always transport and store clean linens safely to ensure cleanliness. Cover linen carts or store in closed closets designated for clean linen only.^2,4

​​​

Hand hygiene is the most important measure you can use to prevent the spread of infection! Many studies show that improved hand hygiene reduces infection rates. As healthcare workers, it is important to reinforce the importance of hand hygiene with everyone: staff, physicians, residents, family members, and visitors.^5,6

May 5, 2021 is the annual global Hand Hygiene Day led by the World Health Organization (WHO). WHO has defined the 5 key moments for hand hygiene:⁶

Caregivers, are you aware of the important role you play in infection prevention each day? Research shows good oral hygiene not only reduces the risk of cavities, but it also reduces the risk of developing infections. Infections in the mouth can spread and lead to severe complications such as endocarditis (inflammation of your heart’s inner lining), as well as sepsis.7 Providing residents with good personal hygiene, such as bathing, handwashing, and shampooing, helps to stop the spread of germs and illnesses, such as gastroenteritis (stomach infection) and the common cold.⁸

Hydration and nutrition help the immune system function well. Water helps the body absorb nutrients and minerals and assists in removing body waste.9 A healthy diet is essential in maintaining a strong immune system. Poor nutrition can affect heart health, weaken bones and muscles, and weaken the immune system. The American Academy of Nutrition and Dietetics recommends including foods rich in protein, zinc, and vitamins A, C, and E to strengthen immune system health.⁹

Catheter-associated urinary tract infection (CAUTI) can be life-threatening for residents. It’s important to follow proper catheter care maintenance to help prevent infection.

Perform hand hygiene and wear gloves when coming in contact with the indwelling urinary catheter or the drainage system. It is recommended to use soap and water for peri-care, and do not scrub vigorously. Keep the urinary catheter and tubing from kinking and becoming obstructed. Maintain a closed catheter system and do not change catheters at routine intervals. Disinfect the sampling port before obtaining a urine sample. When emptying the catheter bag, avoid contaminating the catheter outlet valve.^10-12

​