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Infection control in Maryland nursing homes
1Department of Medicine, University of Maryland School of Medicine, Baltimore.
Abstract:
We surveyed 53 randomly chosen Maryland nursing homes for infection control policies and practices. The majority had written infection control policies, an infection control committee, and a designated practitioner for infection control; in most facilities, however, the infection control practitioner had other major duties, spent little time on infection control, and had no specific training in the field. Thirty-four percent of homes in the survey performed routine environmental cultures, and more than half had insufficient or no isolation policies for infected decubiti and acute diarrhea. In general, the intensity of infection surveillance and the extent of infection control measures increased with the level of care provided, from domiciliary homes to homes providing chronic care. Employee health care fared generally well: 60% of homes offered influenza vaccine to employees and 66% had restriction policies for employees with upper respiratory infections. While the majority of homes offered the influenza vaccine to residents, acceptance of other vaccines recommended for the elderly was less widespread. We conclude that infection control efforts are made in most Maryland nursing homes; however, appropriate guidelines and more effort to educate nursing home personnel in proper infection control practices are badly needed.
Insights
Most Maryland nursing homes have infection control policies, but staff training and specific practices like isolation policies need improvement. Enhanced education is crucial for better infection control in these facilities.
Area of Science:
- Gerontology
- Infectious Disease Prevention
- Healthcare Management
Background:
- Nursing homes are critical settings for vulnerable elderly populations.
- Effective infection control is paramount to prevent outbreaks in long-term care facilities.
- Previous assessments of infection control in nursing homes highlight varying levels of compliance and resource allocation.
Purpose of the Study:
- To assess the current state of infection control policies and practices in Maryland nursing homes.
- To identify strengths and weaknesses in infection control implementation.
- To determine the need for improved guidelines and personnel education.
Main Methods:
- A survey of 53 randomly selected nursing homes in Maryland.
- Evaluation of written policies, committee structures, and practitioner roles.
- Assessment of specific practices including environmental culturing, isolation protocols, and employee/resident vaccination rates.
Main Results:
- Most facilities have written policies and infection control committees, but practitioners often lack dedicated time and training.
- Significant deficiencies exist in isolation policies for conditions like decubiti and diarrhea.
- Infection surveillance and control measures generally correlate with the level of care provided.
- Employee health measures, such as influenza vaccination and sick leave policies, are relatively strong.
- Resident vaccination acceptance for non-influenza vaccines is suboptimal.
Conclusions:
- While infection control efforts are present in most Maryland nursing homes, substantial gaps remain.
- There is a clear need for updated guidelines and enhanced training for nursing home personnel.
- Improving infection control requires a multi-faceted approach addressing policy, practice, and education.