Results from the survey “Human Factors and the Future of Infection Prevention” indicate we can employ new strategies to improve our infection prevention efforts in long-term care. Despite obstacles, we believe technology and support from leadership are among the ways to help keep our nursing home residents safer.
The survey was conducted by a third-party research firm and commissioned by 3M in April 2018. It polled 650 U.S.-based infection preventionists and clinicians across the healthcare continuum to collect attitudes, beliefs and perceptions of the current and future-state of infection prevention.
Respondents reported key challenges they face in their fight to reduce healthcare-associated infections in their facilities. Major findings include:
- Deficiencies in technology adoption and leadership-support are among top hurdles to infection prevention success:
Infection preventionists identified the key barriers to preventing HAI as occurring at a strategic level, such as a lack of adopting new technology and processes (51%) and insufficient support from senior leadership (51%). These were followed closely by poor protocol compliance rates (50%). Clinicians, on the other hand, indicated struggles with more tactical execution of infection control practices, including compliance with infection prevention protocols (46%t) and lack of training for proper product use (46%).
- Despite barriers, respondents are optimistic about their ability to improve infection rates:
One-third of all survey respondents (34%) believed infections can be avoided when providing healthcare today and nearly half (42 percent) believe that their facility could be doing more to prevent HAI. Survey data also indicated both infection preventionists and other clinicians are seeking technological advances that will help them reduce preventable infections.
So, what do these findings mean for the burgeoning role of infection prevention in long-term care settings?
First, we need to explore some of the top differences between the hospital and outpatient care settings – in which a vast majority of survey respondents work – and LTC settings.
Infection prevention in the LTC setting is unique and complicated – and isn’t as extensively studied as it is in hospital or outpatient settings. LTC residents are indeed residents, remaining indefinitely, and often have multiple chronic diseases, some of which result in the resident being debilitated. The age demographic skews higher too. As residents age, their skin becomes more susceptible to damage, including greater vulnerability to skin tears and skin stripping from the improper selection or use of adhesive-containing products. Collectively, the combination of chronicity, fragility and a high incidence of both antibiotic and device use – particularly indwelling catheters – can allow multiple sources of infection to exist and spread to other residents within a facility. This means LTC staff can find themselves in a situation reminiscent of a multifocal recurring outbreak, making infection prevention all the more difficult.
Focused efforts to reduce the incidence of Clostridium difficile and catheter associated urinary tract infections (CAUTI) are gradually earning infection prevention research funding in LTC environments, while being supported through a number of hand hygiene and antimicrobial stewardship initiatives.
While the responses to the survey were primarily collected from clinicians outside of the LTC setting, these datapoints could be helpful in:
- identifying educational training gaps on implementing advanced technology and new industry guidelines specific to LTC’s unique challenges
- making the case for more senior-leadership support for infection prevention-related programs, including those that fund research or new product trials
- inspiring more voluntary infection-related reporting to strengthen data collection and analysis that will support more standardized infection reporting and
- strengthening protocols and best practices for LTC settings in the future.
The good news is, even though LTC residents’ needs and the requirements for reporting infections vary considerably from the care settings featured in the survey, attention to infection prevention is gaining increased attention in LTC environments. Attitudinal data like this can be adapted to the specific challenges faced in this care setting and used to drive continued attention to prevention efforts.
Pat Parks, M.D, Ph.D., is the medical director for 3M Medical Solutions Division. He is also an Adjunct Associate Professor in the Department of Experimental and Clinical Pharmacology at the University of Minnesota.
For more results and insights from the “Human Factors and the Future of Infection Prevention” survey, please visit 3MSM Health Care Academy’s free medical education resource and register for the following on-demand webinars:
- Human Factors and the Future of Infection Prevention
- Cut Through the Clutter – A Focused Approach to Infection Prevention (earn free CE contact hours)