Infection Prevention

Many of the best practices for identifying, tracking, and preventing infections are the same across various healthcare settings. Several of the tools listed below were developed for use in other settings but can be readily adapted to long-term care. Some are flagged as being specific to skilled nursing facilities.

Antimicrobial Stewardship

Core Elements of Antimicrobial Stewardship for Nursing Homes
Centers for Disease Control and Prevention

Sample policy for "Antibiotics Time-out" and sample SBAR format of a time-out request to send to the prescriber
Qualis Health

Public commitment to the wise use of antibiotics
Qualis Health

Nursing Home Antimicrobial Stewardship Guide
AHRQ

Antibiotics Stewardship Guide for Post-Acute and Long-Term Care Settings: Sample
JAMDA November 2017

Infection Prevention & Control Program: Sample Policy
Statewide Program for Infection Control and Epidemiology (SPICE)

AMS Implementation Resources for Inpatient and Long-Term Care Settings
Centers for Disease Control and Prevention

2016 Antimicrobial Stewardship Summit, Speaker Handouts
Northwest Hospital Alliance

Antibiotics are not typically recommended for upper respiratory infections, Yet, many Medicare beneficiaries receive this potentially unnecessary care. See current utilization rates. (Washington only)
Reported as part of the Choosing Wisely initiative

Help protect the health of your community by addressing antimicrobial resistance (Monthly Briefing, July 2017)
Community coalitions are in a terrific position to reduce this threat from the increasing numbers of drug-resistant bacteria, parasites, viruses, and fungi.
 

Condition-Specific Resources

C. difficile

CDI Prevention and Control Policy: Sample
Minnesota Department of Health

Clostridium difficile: Should we be testing for cure? (NHQCC Update, October 2017

Clinical practice guidelines for Clostridium difficile infection in adults
SHEA and IDSA

Guidance for providers: testing for C. difficile infection
Vanderbilt University Medical Center

Resources for prevention of C.difficile in healthcare facilities
Centers for Disease Control and Prevention

Guide to Preventing Clostridium difficile Infections
APIC

Sepsis

ID and WA Claims Data, by Community
See the 30-day rehospitalization rates for Medicare beneficiaries admitted with a primary diagnosis of septicemia.

 

SNF-Specific

Sepsis Toolkit for Post-Acute Care Settings
Developed by the New Jersey Sepsis Learning Action Coalition

Sepsis Management Across the Care Continuum
A webinar hosted by Qualis Health's Communities for Safer Transitions of Care team, originally recorded 11/17/16

 

Sepsis Fact Sheets
Jointly developed by the Sepsis Alliance, CDC, and Rory Staunton Foundation

Septicemia: Clinical and Patient Education Resources
Sepsis Alliance

Sepsis, antimicrobial stewardship & immunizations: Is there alignment among your programs? (Monthly Briefing, October 2017)
Don't develop tunnel vision when focusing on QI: sometimes, seemingly disparate concepts are intertwined.

Urinary tract infections (Listed on a separate webpage)

All other infections

Clinical Practice Guidelines for the Diagnosis and Management of Acute Bacterial Lower Respiratory Tract Infection in Nursing Home Residents
Rochester Nursing Home Collaborative

Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update
Infectious Diseases Society of America

Norovirus Prevention and Management in Skilled Nursing Facilities & Critical Access Hospitals
Qualis Health
In this recorded webinar, get information about norovirus prevention and outbreak management.

Guide to the Elimination of Methicillin-Resistant Staphylococcus aureus (MRSA) in the Long-Term Care Facility
APIC

Developing a Water Management Program to Reduce Legionella Growth and Spread in Buildings
Centers for Disease Control and Prevention
All healthcare settings are now required to evaluate water systems in an effort to prevent legionnaires’ disease.

Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE)
Oregon Health Authority

Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE)—November 2015 Update CRE Toolkit
Centers for Disease Control and Prevention

Handwashing

Handwashing is the number one thing all can do to protect yourself, as well as your residents and their families, from infection. A recent Wall Street Journal article called out the benefits for using the World Health Organization’s technique to train healthcare personnel.

Use Qualis Health's "hand hygiene huddle" to engage residents and their families in infection prevention. has also done recent projects to encourage participation by hospital patients and families in handwashing.
 

Immunizations

All Immunizations

View the CDC's immunization schedule for adults

Improve immunization rates for residents by implementing standing orders, standardizing any of your facility's current best practices, and consulting the Idaho or Washington immunization information system for a record of past vaccinations.

Medicare coverage, billing, and other immunization-related guidance from CMS.

Pneumonia

This video introduces guidance and tools from AMDA's Infection Advisory Committee on pneumococcal vaccination for PA/LTC facilities.

View the CDC's resources related to the pneumococcal vaccine.

Influenza

It is important to vaccinate both patients and healthcare workers against the flu.
 

Resource Libraries

Resources from the Rochester Nursing Home Collaborative, including policy examples, staff education, and tracking recommendations.

Resources from the CDC related to infection prevention in long-term care facilities, from clinical resources to resident and family education.

Infection Prevention (IP) Tools

Statewide Program for Infection Control and Epidemiology (SPICE)
 

Long-Term Care Resources; links compiled by the Association of Health Facility Survey Agencies
 

Potential Local Partners

Your local health departments can be valuable partners regarding infection prevention. Find contacts for Idaho and Washington.

Training

Nursing home regulations require the facility infection control officer have relevant training. Places to start include:

University of North Carolina
Includes a brief, excellent series of training videos; 2 hours of nursing CE

Society for Healthcare Epidemiology Association (SHEA)

Association for Professionals in Infection Control and Epidemiology (APIC)

• Intermountain APIC (Idaho, Eastern Oregon, Northern Nevada)
• Inland Northwest APIC (North Idaho, Eastern Washington) Email contact
• Oregon and South Washington APIC
• Puget Sound APIC