January 1, 2013 | Aging Services Risk, Quality, & Safety Guidance
Infections can spread easily in long-term care due to several factors, including residents’ compromised ability to fight infections related to their health conditions or decreased immunity due to older age; resident socialization and sharing of living space, staff, and equipment; and exposure to antimicrobials and drug-resistant organisms. An estimated 1.64 million to 3.83 million endemic infections, such as lower respiratory tract, symptomatic urinary tract, and skin and soft-tissue infections, occur in U.S. long-term care organizations each year. Because studies of endemic infections often do not count outbreak-related infections, the total burden of infectious disease in these settings is believed to be even higher. (Strausbaugh and Joseph) Infection poses major morbidity and mortality risks to residents. Many infections can be transmitted to personnel as well, posing risks to their well-being, productivity, and ability to safely provide care.
Although infection prevention and control measures should be tailored to the needs of the individual institution, several infections are of special concern in many aging services organizations. Reasons may include their high rates of incidence, morbidity, or mortality; ease of transmission or difficulty of eradication; and limitations in treatment (e.g., due to antimicrobial resistance). Many laws, regulations, and standards also address particular infections. For a discussion, see Laws, Regulations, and Standards Addressing Specific Infections. Further, high-profile infections may be especially likely to threaten an organization’s reputation. For example, law or regulation may require the organization to publicly report its infection rates for specific healthcare-associated infections, and both publicly reported rates and individual cases may gain the attention of the media.
This Risk Analysis reviews guidelines and other resources that address the following high-profile infections:
Certain other types of infections, including bloodborne pathogen infections, infections associated with peripherally inserted central catheters and other central lines, and infections related to skin breakdown and pressure ulcers, are covered elsewhere in the Continuing Care Risk Management(CCRM)System.
General infection control measures—including periodic organizational infection control risk assessments, routine surveillance, hand hygiene, other standard and transmission-based precautions, environmental infection control, disinfection and sterilization, and immunization of healthcare personnel—are vital to preventing the transmission of infection. Antimicrobial stewardship may help prevent the selection of drug-resistant pathogens and decrease the incidence of certain antimicrobial-associated diseases (e.g., C. difficile). For more information on these topics, see the Risk Analyses...