Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA

It seems like we are now making a bigger deal out of infections in long-term post-acute care settings than before. What is the prevalence of infections in LTPAC? What is the No. 1 infection? Who is ultimately in charge of the infection control problem at the facility?

You have some great questions and I am sure some of these answers may surprise you. There are approximately 1 million to 3 million infections reported annually in LTC, the most common being urinary tract infections (UTIs).

One of the reasons for this UTI problem is the 40% hand hygiene compliance rate. Not washing before and after using the bathroom, blowing the nose inappropriately, etc., lowers this compliance number significantly.

Some facilities allow staff to bring in aromatic alcohol gel products that they pick up at their local store. 

Take a close look at such products. Alcohol-based hand hygiene agents should have concentrations of alcohol of 60% to 90% in order to meet the evidence-based recommendations from the U.S. Centers for Disease Control and Prevention.

You asked who is ultimately responsible facility-wide for hand hygiene. While many people would answer that it is the infection prevention practitioner, it is actually the administrator or executive director. 

Since this person has ultimate control over the facility, he or she is in control of the whole facility. 

The infection preventionist, by comparison, serves as a consultant, coach and partner to all departments within the facility. 

Everyone needs to work together where infection prevention is concerned to make the program work efficiently and effectively.