As many as 15% of U.S. nursing homes are issued citations for deficient infection control practices per year, a new study asserts.

Researchers from the University of Pittsburgh’s Graduate School of Public Health analyzed Medicare/Medicaid deficiency citation data collected between 2000 and 2007, which account for almost 96% of nursing homes in the United States. The investigators noticed a strong link between staffing levels and deficiency citations. According to the report, infections are the No. 1 cause of almost 400,000 deaths per year in nursing homes. It also notes that more empirical research is still needed on the issue.

“Most significantly, the issue of staffing is very prominent in our findings; that is, for all three caregivers examined (i.e., nurse aides, LPNs and RNs) low staffing levels are associated with F-Tag 441 citations,” the study authors said. “With low staffing levels, these caregivers are likely hurried and may skimp on infection control measures, such as hand hygiene.”

“F-Tags 441” refers to infection control procedures examined by surveyors.

States such as Illinois have proposed legislation aimed at addressing infection rates by requiring long-term care facilities to have an infection preventionist in each skilled nursing facility. The report was published in the May issue of the American Journal of Infection Control.