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Infections in Long Term Care
Understanding the Risk of Infections in Assisted Living

Resident health safety and risk is serious in long-term care facilities.

The Institute for Healthcare Improvement estimates that medical errors (hospitals) cost Medicare $8,800,000,000.00 resulting in 238,337 preventable deaths of Medicare patients.

Long-term care facilities defined as; skilled nursing facilities and homes that provide healthcare to people unable to manage independently at home. They give custodial or chronic care management care or short-term rehabilitative services. Approximately 3.2 million Americans lived in U.S. nursing homes and skilled nursing facilities participating in the Medicare and Medicaid programs at some point during 2008.

Nearly one million residents reside in Assisted Living Facilities. The growing complexity of care being delivered in long-term care facilities leads to expanding needs for improved infection control and prevention of healthcare-associated infections in long-term care facilities in the last 2 decades.

When seeking an assisted living facility, be sure to find out how they keep residents free of infections. The Center for Disease Control developed these Core Measures for All Acute and Long-term Care Facilities.

Before deciding where to live, find out if the facility follows these core measures.

The 8 Core Measures Assisted Living Should Follow

Hand Hygiene

Healthy Tips for Assisted living staff

Hand hygiene is a primary part of preventing multidrug-resistant organism (MDRO) transmission. Facilities should ensure that healthcare personnel are familiar with proper hand hygiene technique as well as its rationale.

Contact Precautions

Contact Precautions - Patients in acute care settings infected with Carbapenem-resistant Enterobacteriaceae be placed on Contact Precautions. Systems be in place to identify patients with a history of CRE colonization or infection at admission.

(What is CRE? Carbapenem-resistant Enterobacteriaceae (CRE) Infection - infections are commonly seen in people with exposure to healthcare settings like hospitals and long-term care facilities. In healthcare settings, CRE infections occur among sick patients who are receiving treatment for other conditions. Patients whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are among those at risk for CRE infections.)

Healthcare Personnel Education

Healthcare Personnel Education - Personnel who care for patients with MDROs, including CRE, be educated about preventing transmission of these organisms. At a minimum, include information on the proper use of Contact Precautions and hand hygiene.

(What is an MDRO? A multi-drug resistant organism (MDRO) is a bacteria that is resistant to many antibiotics.)

Use of Devices

Use of Devices - Central venous catheters, endotracheal tubes, urinary catheters puts patients at risk for device-associated infections and minimizing device use is an important part of the effort to decrease infections.

Patient and Staff

Patient and Staff - Patients infected with CRE be placed in single patient rooms. A dedicated staff be assigned to care for them.

Laboratory Notification

Laboratory Notification - Laboratories should have protocols in place that facilitate the rapid notification of appropriate clinical and infection prevention staff whenever finding CRE from clinical specimens.

Antimicrobial Stewardship

Antimicrobial Stewardship - a MDRO control. Multiple antimicrobial classes have shown a risk for CRE colonization and/or infection.

CRE Screening

CRE Screening - Screening to identify unrecognized CRE.

Patient and Family Engagement

Family Engagement
Family Engagement

Nursing homes, skilled nursing facilities, and assisted living facilities, (long-term care facilities) give older adults the medical and personal care services. There are 3 million plus Americans who receive care in the U.S. nursing homes and skilled nursing facilities and one million residents in assisted living facilities. The Center for Disease Control says there's limited data on infections in long-term care facilities, but medical literature show us:

Types of Infections that occur each year in these facilities:

  • Urinary tract infection
  • Diarrhea diseases
  • Antibiotic-resistant staph infections and many others

Infections increase hospitalization risks and death; as many as 380,000 people die of the infections in long-term care facilities each year.

The kind of infections that CDC refers to are those that patients acquire during the course of receiving healthcare treatment for other conditions. They're called Healthcare-associated infections (HAIs). These infections are devastating and deadly. As the nation's health protection agency, CDC strives to help all who receive healthcare services.

Every day, about 1 in every 20 hospitalized patients acquires an infection caused by receiving medical care.

For families, you can play a big part in the medical care team to help keep your loved one safe from infections in a long-term care setting.

Be informed. Be empowered. Be prepared.

10 Ways to Keep Resident Safe

  1. Speak up
  2. Talk to your doctor about any worries you have about your safety and ask them what they are doing to protect you.
  3. Keep hands clean.
  4. If you do not see your providers clean their hands, please ask them to do so. Also remind your loved ones and visitors to wash hands. This act alone prevents the spread of germs.
  5. Ask if you or your loved one needs a central line catheter or a urinary catheter. Leaving a catheter in place too long increases the chances of getting an infection.
  6. Ask your health care provider, "will there be a new needle, new syringe, and a new vial for this procedure or injection?" Know that medical providers should never reuse a needle or syringe on more than one patient.
  7. Be careful with medications - Tell your doctor about all the medicines you are taking. Avoid taking too much medicine (follow prescribed directions). Avoid harmful drug interactions,
  8. Get Smart about antibiotics - Help antibiotic resistance by taking all your antibiotics as prescribed, and not sharing your antibiotics with others. Remember that antibiotics don't work against viruses like the ones that cause the common cold.
  9. Prepare for surgery - Reduce your risk of getting a surgical site infection. Talk to your doctor to learn what you should do to prepare for surgery. Let your doctor know about other medical problems you have.
  10. Tell your doctor if you have severe diarrhea, especially if you are also taking an antibiotic.

Know the Signs and Symptoms of Infection

Some skin infections, like Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that causes infections in different parts of the body - commonly known as a staph infection. MRSA, appear as redness, pain, or drainage at an IV catheter site or surgical incision site, and a fever. Tell your doctor if you have these symptoms.

  • Get your flu shot - Protect yourself against the flu and other complications by getting vaccinated.
  • Key Strategies to Patient / Family Involvement
  • Get involved with your loved one's care plan
  • Engage in the care processes
  • Participate by asking questions and follow the care plan
  • Ask questions if you don't understand the care process or plan
  • Ask for user-friendly access to health records, whether they're paper-based or electronic
  • Get educated
  • Ask for shared decision-making

Patient and Family Engagement Goals and Strategies

  • Give feedback on your experience, which healthcare organizations and their staff will then use to improve care.
  • Gain access to tools and support systems that effectively help you and your loved one navigate and manage their care.
  • Gain access to information and assistance that enables them to make informed decisions about treatment options.

For a brochure on Preventing Health Care and Community Acquired Infections, visit Safecare Campaign.

Learn more about Patient Safety

Carol Marak
Carol Marak

After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.