An Educational Resource for Long-Term Care

​​​​Welcome to the spring edition of The Lowdown. This issue discusses some infection prevention “basics” that may be overlooked at times. But these basics are critical, as they are the building blocks of a strong infectio prevention program. Happy reading!

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, providers, residents, family members, and visitors should perform hand hygiene.¹ The Association for Professionals in Infection Control and Epidemiology (APIC) has developed a patient/resident hand hygiene toolkit available at apic.org/patient-hand-hygiene-toolkit/.

Were you aware that the care you provide to residents every day helps prevent infection? Research shows good oral hygiene not only reduces the risk of cavities, but 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) and sepsis.³ Helping residents achieve good personal hygiene, including bathing, handwashing, and shampooing, is critical. Keeping your residents’ hands, hair, and body clean helps stop the spread of germs and illnesses, such as gastroenteritis and the common cold.⁴

Encouraging fluids and maintaining adequate hydration in residents boosts their immune function, as water helps the body absorb nutrients and minerals, and remove body waste. A healthy diet is essential in maintaining a strong immune system. Poor nutrition can affect heart health, damage bones and muscles, and weaken the immune system. The Academy of Nutrition and Dietetics recommends including foods rich in protein; zinc; and vitamins A, C, and E to strengthen immune system health.⁵

Catheter-associated urinary tract infection (CAUTI) is a potentially life-threatening infection for residents. 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. Recommendations for perineal care include using soap and water and not scrubbing 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. Avoid contaminating the catheter outlet valve when emptying the catheter bag.6,7,8 Certified nursing assistants (CNAs) play a key role in infection identification because they provide most of the hands-on care. CNAs typically have keen observational abilities, are attuned to the resident’s baseline status, and are likely to note subtle changes quickly. Educate your CNAs on the signs and symptoms of infection as defined in the revised McGeer Criteria to leverage their often unique and important perspective.^9,10,11

Congregant living puts residents at risk of developing an illness and infection. They eat together, go to activities together, and may even share rooms. When people live together closely, they are more likely to become sick from infections that are transmitted from person to person. Some of these residents may have a cough or cold. Some may have sores or wounds. They could have invasive devices, such as urinary or intravenous (IV) catheters.¹²

Residents and healthcare workers can develop an infection when germs are spread from person to person. This can happen by touch (contact) or droplets traveling through the air when a person coughs, laughs, talks, or sneezes. Germs also spread through splashes or sprays.12

Germs are everywhere. They can be found on residents, staff, visitors, and indwelling medical devices, such as ventilators and urinary and IV catheters, or in the environment of care, such as on beds, tables, faucets, and sinks.¹²

Staff can protect residents and themselves by stopping the way germs are transmitted per- son to person or person to environment with two basic things: hand hygiene and environ- mental cleaning.

Patient Safety Authority has a free, online education platform that delivers high-quality patient safety education to healthcare professionals. One available course, “The Basics of Infection Prevention in Long-Term Care,” is ideal for infection preventionists practicing in a long-term care facility within Pennsylvania. This program consists of 10 modules focusing on legislative and regulatory requirements and basic concepts of disease processes, infection prevention principles, and process improvement. Access the Learning Management System at patientsafetyeducation.org/.

 

​References