Infection control programs in skilled nursing long-term care facilities: an assessment, 1995

In 1989 the Health Care Financing Administration mandated that long-term care facilities (LTCFs) maintain infection control programs; however, few data are available to guide the design of these programs. The purpose of this study was to assess the current status of infection control programs in LTCFs by using methodology adapted from Phase I of the Centers for Disease Control and Prevention Study on the Efficacy of Nosocomial Infection Control.

A descriptive study of infection control programs in skilled nursing LTCFs was undertaken in a representative sample of 136 New England skilled nursing LTCFs that have >/=25 beds, with use of a self-report Infection Surveillance and Control Questionnaire.

Nearly all (98%) the LTCFs reported having personnel responsible for infection control, with a median of 8 hours per week spent on infection control activities. Ninety percent of these persons were registered nurses; 52% had formal training in infection control. Twenty-five percent of the respondents reported that their infection control program was either "inactive" or nonexistent in 1988, and 60% rated their programs as either "moderately active" (43%) or "very active" (17%) during that year. By 1994, most LTCFs (67%) rated themselves as "very active," and only 3% as inactive or nonexistent. The mean scores on the questionnaire's surveillance and control indices were 23 (out of a possible 30) and 47 (out of a possible 60), respectively, which indicates medium infection surveillance and control activity. On the basis of the data provided by 72% of the respondents (n = 98), a crude estimate of 13.97 infections per 1000 resident-days was calculated, which is a higher rate than previously reported for LTCFs.

Findings from the study indicate that it is feasible to use methodology adapted from Phase I of the Centers for Disease Control and Prevention Study on the Efficacy of Nosocomial Infection Control to assess infection control programs in LTCFs; however, further research into the efficacy of nosocomial infection control in skilled nursing LTCFs is needed.