The Department of Health and Human Services released a report in January of this year showing that more than 1,000 long-term care facilities in the United States had COVID-19 infection rates of 75% or higher during 2020.

As sobering as this finding is, COVID-19 is far from the only infection threat facing long-term care facility residents. For example, studies have also shown that C. difficile — identified by the Centers for Disease Control and Prevention (CDC) as a threat level “urgent” pathogen — affects one out of every 50 residents and leads to 29,000 deaths every single year. 

On a broader scale, the 2004 National Nursing Home Survey (2004 was the most recent year that the CDC conducted this survey) revealed that the approximately 1.5 million people who live in long-term care facilities experience, on average, about two million infections per year.

The data is clear: infections are one of the most pervasive threats facing nursing home residents. To help protect their vulnerable populations, facilities must prioritize implementing infection prevention and control (IPC) best practices. These tips are especially important as we enter the holiday season all while influenza, COVID-19, and RSV continue to circulate in our communities. 

One of the easiest and most effective ways to help protect your residents from infection is to educate every individual who walks into your building about the role they play in reducing the spread of communicable and infectious diseases. For example, this signage can describe when visitors should wear a mask or avoid visiting their loved ones (when they are ill). Placing this education where it can be easily seen when entering the facility can go a long way toward keeping your residents safe. 

To be the most effective, signage should also be accompanied by relevant personal protective equipment (PPE). In other words, if you post education advising individuals to wear a mask, ensure there are masks available right next to it. If your sign is about hand hygiene, make sure it’s near an alcohol-based hand sanitizer dispenser (and that the dispenser is fully stocked).

The CDC also has posters you can print out for free that can be hung outside of resident living quarters indicating what precautions people should take when entering and exiting a resident room. All visitors need to be made aware of what transmission-based signage means when it is posted on a resident’s door. 

This typically indicates that specific PPE needs to be worn before entering the resident’s room. It is important to have a restocking process in place so that there is always an adequate supply of PPE. If the bins are empty, individuals may go into the resident’s room without PPE which increases the transmission risk. Consider assigning this role to the environmental service employees as they enter each resident room every day. They can check the PPE bins before entering the rooms. In addition, you could consider assigning it to the other staff who may conduct frequent stocking of supplies. Consider avoiding assigning it to one individual such as the infection preventionist as they are not always in the facility.

This approach is far better than taking the stance that keeping PPE stocked is “everybody’s responsibility.” Too often, that leads to nobody checking PPE, because everyone assumes someone else will take care of it. Assigning people to handle this task is a simple way to avoid this problem.

Finally, one of the best ways that visitors can protect their loved ones during the holidays is to stay up to date on all recommended vaccinations. This can include COVID-19, influenza and Tdap vaccinations. It is important to remember that long-term care residents are a vulnerable population and that outbreaks spread rapidly within this congregate healthcare setting. Everyone who enters a facility has the potential to protect or infect this community. 

Taking measures like these will help reduce and prevent infections among your facility’s vulnerable population. Reminding everyone who comes into the facility of the importance of hand hygiene — which is demonstrably one of the most important elements of effective IPC — and giving them access to alcohol-based hand sanitizer, for example, can reduce rates of bacterial and viral infections. 

Placing informational signs, keeping relevant PPE within easy sight and access to visitors for at-risk or infected resident rooms, and staying current with all recommended vaccinations can similarly reduce the spread of pathogens and mitigate the risk of infection outbreaks among other residents and staff. 

Ultimately, these IPC best practices are highly effective and can be part of every facility’s IPC program. They don’t require a large investment or time and can be put into practice today. 

Buffy Lloyd-Krejci, DrPH, CIC, is the founder of IPCWell. Drawn to action to improve the infection prevention landscape for these communities, she utilized her over two decades of experience in the healthcare field and her doctorate in public health (DrPH) to launch IPCWell. She and her team have provided training, education, and technical assistance (both in person and virtually) to hundreds of congregate care facilities throughout the COVID-19 pandemic.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.

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