SHEA/APIC Guideline: Infection Prevention and Control in the Long-term Care Facility

Authors

Philip W. Smith, University of Nebraska Medical CenterFollow
Gail Bennett, ICP AssociatesFollow
Suzanne Bradley, University of Michigan Medical SchoolFollow
Paul Drinka, University of Wisconsin-Madison
Ebbing Lautenbach, Hospital of the University of PennsylvaniaFollow
James Marx, Broad Street Solutions
Lona Mody, Veteran Affairs Ann Arbor Healthcare SystemFollow
Lindsay Nicolle, University of ManitobaFollow
Kurt Stevenson, Ohio State University College of MedicineFollow

Date of this Version

9-2008

Document Type

Article

Citation

American Journal of Infection Control (September 2008) 36(7): 504-535

doi: 10.1016/j.ajic.2008.06.001

Abstract

Long-term care facilities (LTCFs) may be defined as institutions that provide health care to people who are unable to manage independently in the community.¹ This care may be chronic care management or short-term rehabilitative services. The term nursing home is defined as a facility licensed with an organized professional staff and inpatient beds that provides continuous nursing and other services to patients who are not in the acute phase of an illness. There is considerable overlap between the 2 terms.

More than 1.5 million residents reside in United States (US) nursing homes. In recent years, the acuity of illness of nursing home residents has increased. LTCF residents have a risk of developing health care associated infection (HAI) that approaches that seen in acute care hospital patients. A great deal of information has been published concerning infections in the LTCF, and infection control programs are nearly universal in that setting. This position paper reviews the literature on infections and infection control programs in the LTCF.

Recommendations are developed for long-term care (LTC) infection control programs based on interpretation of currently available evidence. The recommendations cover the structure and function of the infection control program, including surveillance, isolation precautions, outbreak control, resident care, and employee health. Infection control resources are also presented.

Hospital infection control programs are well established in the US. Virtually every hospital has an infection control professional (ICP), and many larger hospitals have a consulting hospital epidemiologist. The Study on the Efficacy of Nosocomial Infection Control (SENIC) documented the effectiveness of a hospital infection control program that applies standard surveillance and control measures.²