Nurses working together in hospital

In partnership with providers, a nursing home infection control peer coaching program has been been piloted and refined to facilitate its use amid competing facility priorities and staffing shortages.

Brown University in Providence, RI, developed the Infection Control Amplification in Nursing Centers (I CAN) program in early 2021. I CAN is a shift coaching program originally designed to strengthen nursing facility infection control practices in Connecticut during the pandemic. It is now used in facilities across the United States, the program designers said. 

In a study of the I CAN pilot program, published online in January, facility infection preventionists (IPs) in seven Connecticut nursing homes told Brown researchers that COVID-19 outbreaks and pandemic-exacerbated staffing shortages had interrupted program implementation.

The developers used this feedback to refine the program and meet providers’ needs, study lead Rosa Baier, MPH, director of Brown’s Center for Long-Term Care Quality & Innovation told McKnight’s Clinical Daily. Tweaks included a team-based approach versus having IPs implement the program solo. This allows broadened strategies for feedback — from team huddles and one-on-one feedback to emails — and more staff member flexibility to tailor the program to each facility’s needs and constraints.

“Participants’ feedback and pilot test experiences underscore the importance of actively engaging nursing home staff as partners in designing and implementing interventions that reflect their context, workflow and needs,” Baier and colleagues wrote in an article published in JAMDA.

The program uses a network of peer coaches who observe units and shifts in order to foster a “see something, say something” culture. Coaches and secret shoppers within the facility are encouraged to speak up about IP precautions and share data. 

This “empowers staff throughout facilities to speak up about infection precautions … and creates audit and feedback loops that provide leaders with knowledge they can use to target their infection control efforts,” Baier told McKnight’s.

Nursing center leaders may adopt the free I CAN program independently. The information is available on the Brown University website. The researchers ask those using the program for feedback in order to further study and improve the program.

Brown University’s Center for Long-Term Care Quality & Innovation tests interventions in real-world conditions with the goal of improving senior care, and with an emphasis on residents of long-term care settings. 

Editor’s note: This story has been corrected to emphasize that the current program was refined during the original pilot study in 2021.

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