Infection Control in Long Term Care Settings

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Infection Control in Long Term Care Settings

• Moderator Carol Goldman, RN, BScN, CIC
• Infection Control Consultant
• IFIC Board member, CHICA-Canada
• Expert Guest Allison McGeer, MD, FRCP
• Director, Infection Prevention and
  Control Dept.
• Mount Sinai, Hospital Toronto, Canada

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Infection Control in Long Term Care
SettingsThank you for sponsoring this workshop
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Infection Control in Long Term Care Settings

• Format for todays workshop
• Define and review long term care (LTC) settings
• Discuss common infections and outbreaks
  associated in LTC
• Review surveillance in LTC
• Work collaboratively in groups to review and
  present the elements of an IPC programme in LTC

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Infection Control in Long Term Care Settings

• A facility that provides rehabilitative,
  restorative, and/or ongoing skilled care for
  those of all ages in need of assistance with
  activities of daily living
• nursing homes
• rehabilitation facilities,
• Extended care situations behaviour health,
  psychiatric, physical and mental challenges
• long-term chronic care

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Infection Control in Long Term Care Settings

• The differences of Infection Control in a LTC vs.
  Acute Care
• fewer resources
• less expertise/increased turnover
• multiple duties
• diagnostic facilities
• residence
• medical record
• limited research

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Infection Control in Long Term Care Settings

• urinary infections
• respiratory infections
• skin and soft tissue infections
• Outbreaks also occur frequently, and some
  facilities have a high prevalence of colonization
  of residents with antimicrobial-resistant
  organisms.

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Infection Control in Long Term Care Settings

• Prevalence of infection documented between 5.4
  and 32.7 per 100 residents per month
• Infection incidence rates have been documented
  between 1.5 and 9.4 per 1,000 resident days
• An estimated 1.5 million infections occur
  annually in LTC facilities in the United States
• Facility-acquired infections account for 30 of
  all hospital admissions from nursing homes
• Are the most common immediate cause of death in
  nursing home residents
• NURSING HOMES,  May, 2006  by Linda L. Spaulding

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Infection Control in Long Term Care Settings

• 3 yr study looking at respiratory infections in
  Toronto
• 0.42 infections per 1000 resident-days
• Outbreaks occurred year round, with no seasonal
  pattern
• Pneumonia developed in 72 (15)
• 58 (12) required transfer to hospital
• The case-fatality rate was 8 (37/480)
• CMAJ,  April 2000, McGeer et al

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Infections in residential long term care for the
elderly in Canada, 1994-6
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Prevalence of infections in Italian long term
care facilities
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Infection Control in Long Term Care
Settingsquestions you need to ask

• Who are your patients and what kind of infections
  are they most at risk of?
• - slide on NH distribution
• - but it depends on populations
• Are these infections sporadic, or do they occur
  as outbreaks?
• What opportunities are there to prevent disease?