Highlighting an “astonishing lack of attention to infection prevention and control in nursing homes,” the nation’s infection preventionists, in advance of expected federal action on nurse staffing requirements in these facilities, are calling on Congress and the Biden Administration to require minimum infection prevention staffing to protect seniors from deadly infectious diseases.
In a letter to Congress, the Association for Professionals in Infection Control and Epidemiology (APIC) noted that multiple government reports have highlighted infection control failings in nursing homes:
•From 2013 to 2017, 82% of all inspected nursing homes had an infection prevention and control (IPC) deficiency. [GAO Letter to Senator Wyden Regarding IPC Deficiencies in Nursing Homes]
•During the height of the pandemic, one-third of all deaths from COVID-19 were associated with nursing homes. [Coronavirus disease 2019 and clinical research in U.S. nursing homes]
•“Too many continue to provide poor, sub-standard care that leads to avoidable resident harm. [White House Fact Sheet: Protecting Seniors by Improving Safety and Quality of Care in the Nation’s Nursing Homes]
“The lack of infection prevention and control staffing, infrastructure, and surveillance in nursing homes is astounding, and the time for change is long overdue. How many more seniors must die before we act?” said APIC CEO, Devin Jopp, EdD. “We urge the Biden Administration and Congress to ensure that residents of these facilities receive at least the level of protection from deadly infections as they would in the hospital.”
In the letter to Congress, APIC strongly recommends:
•Each nursing home should have at least one full-time infection preventionist on staff who is dedicated (meaning that infection prevention is their sole function), not the current requirement of having a staff member designated to handle infection prevention.
o Infection prevention work, when designated, often falls to a director of nursing who is already overburdened with a myriad of tasks and may have little background and training in the field. Equating this work with “other duties as assigned” leaves patients vulnerable to often fatal, healthcare-associated infections (HAIs).
•The Centers for Medicare & Medicaid Services (CMS) Surveyor workforce – the federal inspectors of the long-term care industry – should be adequately funded, and the surveyors themselves properly trained in identifying infections.
o Through proper surveys, the public will know which long-term care facilities are meeting requirements set forth by CMS.
o Current CMS surveyors lack expertise in infection prevention and control (IPC). Surveyors should be equipped with basic IPC content knowledge to ensure that facilities adhere to evidence-based practices and their own IPC plans.
•Long-term care facilities should have systems to track HAIs like hospitals.
o For too long CDC’s HAI tracking system, the National Healthcare Safety Network (NHSN), has not required surveillance of infection outbreaks in nursing homes. To adequately prevent and control infections that impact elderly Americans, long-term care facilities must be required to track, monitor, and address infections as thoroughly as hospitals.
“While having the appropriate level of nurses is important in nursing homes, that alone is not enough to keep patients safe from harm,” said 2023 APIC president Patricia Jackson, RN, MA, CIC, FAPIC. “These facilities must be required to have at least one full-time, dedicated infection preventionist to ensure they have the necessary protections and safeguards in place to keep our loved ones safe from preventable infections and other emerging infectious diseases.”
Source: Association for Professionals in Infection Control and Epidemiology (APIC)