Addressing environmental infection risks in long-term care facilities
Lori Strazdas, Clorox Healthcare
In recent years, significant steps have been taken to enhance patient safety and combat healthcare-associated infections in long-term care facilities. Between tightened regulatory requirements, increased public awareness of infection issues and an ever-growing body of research on infection prevention and control, the emphasis on HAI-prevention at the industry-wide and individual facility level is greater today than ever before.
Still, fighting infections can feel like an endless uphill battle, and what a lot of people outside the industry don't fully appreciate is that in long-term care facilities, it often is. Long-term care facilities and their residents are all at an inherently increased risk of infection, for a myriad of reasons that I won't get into here because McKnight's readers know them all too well. Instead, I'll take a closer look at cleaning and disinfecting and how the right products, paired with the right protocols can help long-term care facilities fight back.
For high-risk patients in high-risk settings, thorough facility-wide cleaning and disinfection is often the first line of defense against everything from the common cold and seasonal flu, to C. difficile, MRSA and CRE. Below are a few things to keep in mind when evaluating cleaning and disinfecting products to help fight the spread of infections:
- Look for EPA-registered healthcare disinfectants with broad antimicrobial efficacy. In high-risk environments, you want a product with kill claims against common germs and high-concern pathogens including bacteria, enveloped and non-enveloped viruses and fungi.
- Think about ease of use, speed and versatility. Ready-to-use products with short contact times (e.g., 30 seconds – three minutes) that allow for one-step cleaning and disinfecting can help promote compliance because frankly, the easier a product is to use, the greater the likelihood it will be used correctly.
- Try to balance efficacy and aesthetics. In residential care, the way things look and smell really matter. Look for products that deliver efficacy against key pathogens and compatibility with common surfaces without harsh chemical fumes or odors. With disinfectants that can strike that balance, such as the Clorox Healthcare Fuzion Cleaner, which kills C. difficile spores in two minutes, but has the aesthetics and compatibility required for use facility-wide, you can enhance infection prevention while maintaining a comfortable, residential environment of care.
Reducing environmental reservoirs of infectious pathogens helps interrupt the chain of transmission and reduce the risk of infection from spreading from resident to resident, but even the best products and protocols can't alone adequately address the problem if they are not used correctly.
In fact, new data suggests that ongoing training may be the secret to success. A recent national survey of nursing homes took a closer look at the associations between staff training methods, frequency and timing, and infection-related quality measures. The results, published in the American Journal of Infection Control, showed that nursing homes that conducted staff training – and not just for infection prevention and control professionals – at both new employee orientation and when outbreaks occurred, had better ratings for key infection-related quality measures, a finding which the authors note supports existing evidence “that a tailored and continuous training program was better than a single intervention in reducing HAIs.”
The survey also showed significant variations in infection prevention and control practices and in the resources devoted to these efforts, extending to everything from dedicated time and staff to support infection prevention and control, training and knowledge of best practices, to even foundational activities like environmental cleaning and disinfection. This isn't unique to long-term care, but in today's increasingly interconnected healthcare landscape where patients move between multiple settings throughout the course of their care, the reality is that failures in infection control anywhere can threaten patients everywhere.
The challenges long-term care facilities face are significant, but there is also reason to feel encouraged: most HAIs are preventable and we know more about how to prevent them than ever before. By focusing on proven infection prevention and control practices, committing to ongoing education and training to promote compliance, and pursuing a more coordinated, regional approach that prizes collaboration over individual excellence, long-term care professionals can make a big difference, not only for their residents, but for all of us.
Lori Strazdas, MPH, is a Public Health Liaison with Clorox Healthcare. For more tips on infection prevention and control, visit http://www.cloroxprofessional.com/industry/health/long-term-care/.