By: Lisa Chambers, MSCCC, SLP, CHC
In the congregative settings of nursing facilities, fragile populations are obviously highly susceptible to typical infections but especially to respiratory infection outbreaks. Amid the national emergency caused by COVID-19, infection control in long term care facilities has come under intense scrutiny by both the media and the government for past issues and penalties and current outbreaks. Now, more than ever, it is important for facilities to review their protocols, practices, and programs for infection control to ensure that all standards are exceeded and that residents are protected to the extent able.
Have You Recently Updated Your Infection Control Policy?
The general goals of an infection prevention and control policy in the long-term care setting are to:
- Minimize the risk of infection in individual residents to the extent that it is possible.
- Reduce the risk of transmission of infectious agents among and between residents and healthcare workers.
- Reduce risks of infections developing in residents related to the use of devices and procedures required in care.
There are many components to this but given the pandemic and the needed response to it, this is a good time to re-evaluate the policies you have in place, the lessons you have learned through the first few months of responding to COVID-19 in your facility, and how you can implement those best practices moving forward.
Do You Employ an Infection Prevention Specialist?
Since 2016, all long-term care facilities are required to have a designated infection control and prevention leader, or infection preventionist per CMS mandate. The duties and responsibilities of the infection preventionist include:
- Coordinating and overseeing the infection control and prevention program.
- Contributing to quality reports.
- Ensuring staff immunizations are up to date.
- Environmental rounds.
- Dietary, maintenance, and water programs.
- Audits and training.
It has been commonplace for the facility’s infection preventionist to hold other titles and have other responsibilities outside of infection control. Moving forward, it is paramount given the scrutiny long-term facilities will be facing around infection control that there is a dedicated infection prevention specialist whose responsibility is only infection prevention.
Are You Utilizing the Infection Prevention and Control Assessment Tool for Nursing Homes?
CDC’s COVID-19 Infection Control Assessment and Response (ICAR) tool was developed to help nursing homes prepare for coronavirus disease 2019 (COVID-19). Nursing homes and other long-term care facilities can take steps to assess and improve their preparedness for responding to COVID-19. This ICAR tool should be used as one tool to develop a comprehensive COVID-19 response plan. This tool may also contain content relevant for assisted living facilities.
Are All Team Members Receiving Continuing Education around Infection Control?
Infection protocols continue to evolve as more information about COVID-19 is learned. It is important to regularly review the CDC’s Infection Control Guidance for Healthcare Professionals about COVID-19 for current information and ensure staff are updated when this guidance changes. Again, much like the other items, it may be time to designate a person on your staff to providing these updates daily, so all information is distributed in a uniform and consistent manner. Beyond educating your team members, it is also important to educate your residents and their families on topics including information about COVID-19, actions the facility is taking to protect them and/or their loved ones, any visitor restrictions that are in place, and actions residents and families should take to protect themselves in the facility, emphasizing the importance of hand hygiene and source control.
Are You Tracking and Increasing Inventory of PPE and Other Essentials?
One of the biggest issues at the start of the pandemic was the dwindling supply of adequate PPE. Now that the pandemic has reached relative stability in many places, a revised focus should be on obtaining new medical supplies, PPE, cleaning, and disinfecting equipment, etc. that will all be essential for residents, staff and visitors moving forward. One way to assist in obtaining PPE and other items is to identify your health department or healthcare coalition contacts for getting assistance during PPE shortages. The Supplies and Personal Protective Equipment pathway in the NHSN LTCF COVID-19 Module can be used to indicate critical PPE shortages (i.e., less than one week supply remaining despite use of PPE conservation strategies). It may also be time to put an employee in place, if you do not already, who tracks inventory daily and can order from suppliers when necessary.
Should You Considering Working with a Third-Party Infection Control Group?
Third-party infection control specialist groups conduct site visits, assess weaknesses and pain points in a building, operations and protocols, establishes guidance for safe reopening, executes infection control plans and follows-up with clients to update the plans with new CDC and state guidance as it becomes available. Working with respected third-party infection control experts could also reasonably reassure residents, families, and others during this uncertain time.
About Blue Sky Therapy
Blue Sky Therapy delivers innovative physical, occupational, and speech therapy services in skilled nursing homes, assisted living facilities, home health care, in-home therapy, and outpatient therapy clinics. Our newest service line, Teletherapy, allows our therapists to work with patients virtually at home instead of in the clinic.