Nosocomial infections occur at the average estimated rate of 1 infection per resident per year in long term care facilities (LTCFs). Under HCFA's Health Care Quality Improvement Program, 8 LTCFs agreed to share standardized performance data on lower respiratory, urinary tract, and C. Difficile infections for 12-15 months. The project coordinator (an RN) provided individual onsite consultation and coaching on quality improvement methods. The process improvements instituted by most facilities focused on respiratory or urinary infections; but only 1 facility demonstrated significant improvement - namely, fewer respiratory infections during the subsequent winter. Four of the LTCFs adopted new systems to promote hand cleaning among staff and residents. The next most common intervention was new immunization strategies for residents and/or staff. Lack of change in most targeted outcomes is likely due to the limited options for simple evidence-based strategies to reduce these 2 clinical conditions (with the exception of vaccinations). Increased coordination between state certification agencies, PROs, researchers, and LTC associations should accelerate improvement. Thorough cost-effectiveness analyses of infection control programs may be necessary for LTCFs to devote more resources to this problem. This study was done during a time of tremendous resource challenges for LTCFs; under these circumstances, maintaining a steady nosocomial infection rate may be a victory.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1. List five key barriers to LTC quality improvement in nosocomial infection rates. 2. Identify three lessons learned from working with long term care facilities in quality improvement. 3. Describe the process by which a PRO, infectious disease consultant, HCFA nurse epidemiologist, and outpatient laboratory collaborated with long term care facilities for quality improvement
Keywords: Long-Term Care, Quality Improvement
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.