Infection outbreak strikes in LTC Facilities

Infection outbreak strikes in LTC Facilities

Two residents died, 18 others were admitted to the hospital, and a total of 54 (out of 263) patients at the Greenspring Retirement Community, in Springfield VA, were diagnosed with Legionnaires’ disease this July, according to a CNN report.

“Greenspring has cooperated with health officials, who are conducting tests according to the department. The facility has been closed to new patients, while group activities have been canceled and ill residents are quarantined in their rooms,” the health department said.

Another instance

This September, Candida Auris, a deadly fungus, was discovered at the Palm Gardens Center for Nursing and Rehabilitation in Brooklyn. In Palm Gardens, the outbreak resulted in severe illness and later death to some patients.

In fact, the original outbreak began in the state in 2016, and 881 people have been afflicted to date,  resulting in nearly 200 deaths.

In Numbers:

Though recent data is limited, it is estimated that approximately 380,000 people in LTC facilities die of infections each year, adding around $673 million in health care costs!

On top of that, since 2012 there have been many outbreaks of Legionnaires’ disease reported by the media. These cases occurred across ten plus facilities, and over 200 cases documented, with nearly 20 deaths were confirmed.

When outbreaks like these occur, media publicity, unsubstantiated rumors, and the panic of patients, employees, and families, leads to significant disruption of services.

Why LTC facilities?

As healthcare in nursing homes evolve and hospital readmissions are reduced, nursing and rehab centers are seeing a greater number of patients requiring more intense medical care.

This directly results in increased potential for infections, as well as higher antimicrobial use.In addition, patients getting infusion therapy, residents with peripherally inserted central catheters, and the elderly population in general, are more prone to infection.

Common Infections

  • Urinary tract infections (UTIs)
    • Including both catheter-associated and non-catheter associated UTIs
  • Lower respiratory tract infections
    • primarily influenza and pneumonia
  • Gastroenteritis
    • primarily caused by Clostridium difficile or Norovirus infection
  • Skin Infection
    • Infections of the skin and soft tissue

The repercussions
For affected facilities, these outbreaks are not only cause for patient illness, and in many cases, death; infection outbreak often hits facilities with devastating financial, practical, and competitive losses.

This, along with the feat of reassuring terrified patients and their worried families, add a significant burden to the hardworking facility staff members.

Effects in a nutshell

Spiked hospital readmissions → Strained relations with referring hospitals → Decreased five-star ratings → Lowered patient intake

Survey tags → Possibility of Civil Monetary Penalties → Decreased five-star ratings → Lowered patient intake

In English → a dent on your bottom line.

Enough about the morbid stuff.

The good news is that there are many simple, preventative measures out there. And they’re proven to greatly decrease the chances and severity of outbreaks.

Steps have already been taken by the CDC to implement these measures in hospitals, outpatient centers, and later LTC facilities.

As indicated on the table below, expanding infection control efforts to nursing homes, skilled nursing centers, and long term care facilities is included in the National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination; phase three.

1. Proper Hand Hygiene

Perhaps hard to believe, but good ol’ washing of hands has proven to be the single, most important aspect of infection prevention and control.

Despite that, studies show that well below 50% of nursing home staff actually comply with the published regulations. However, a significant increase of hand washing was displayed by employees who participated in multifaceted hand hygiene training.

2. Care Transition Caution

During transitions between hospitals, outpatient facilities, and nursing centers, care must be taken to ensure proper communication between the medical staff of the respective facilities.

At the time of transfer, residents are susceptible to pathogens transmitted between patients and caregivers, as well as to medical miscommunication regarding antibiotic dosage and duration details, or isolation instructions.

3. Infection Surveillance and Control

A system for infection data collection should be implemented, and the information frequently reviewed by the facility administration. This can allow trends to be identified and thereby controlled.

4.  Isolation and Precautions

Policies and procedures regarding isolation and precaution policies should be developed and implemented in accordance with recent CDC/HICPAC guidance.

Standard resident care programs should include skin care, urinary catheter, feeding tube and immunization protocols and be in compliance with federal, state and local regulations.

5. Education

Regular Infection control in-services should include all staff members. There are amazing resources made available, including a full preventative training package Partnering to Heal.

Associated Safety Measure; Antibiotic Stewardship
Though this may seem unrelated, the safe use of antibiotics directly impacts infection control by increasing the chances of successfully fighting infections.

Antibiotic stewardship has proven to:

  • Optimize clinical outcomes
  • Minimize unintended consequences
  • Increase patient safety
  • Improve cost effectiveness reducing inappropriate antibiotic use

In conclusion

Education is available, and prevention procedures maintainable.
Take the time today to save your facility from an infected tomorrow.