“Despite years of government reports sounding the alarm about infection control lapses in nursing homes, and despite evidence showing that focused attention from the federal government can improve infection rates in hospitals, there remains an astonishing lack of attention to infection prevention and control (IPC) in nursing homes,” APIC charged.1
The letter from APIC CEO Devin Jopp, EdD, MS, called on Congress to require a full-time, dedicated infection preventionist (IP) in nursing homes in light of the of the devastation of the pandemic and the ongoing threat of healthcare-associated infections (HAIs).
“Even when pandemics are not making headlines, HAIs are a constant threat to the patient population,” APIC states. “According to the Centers for Disease Control and Prevention [CDC], there are approximately 687,000 HAIs in U.S. acute care hospitals each year, with about 72,000 hospital patients dying during their hospitalizations.”2
Moreover, there could be as many as 3 million HAIs in nursing homes annually, according to CDC estimates.3
“For too long, IPC has been underresourced and put on the back burner,” APIC states. “Although nursing staff is essential to patient care, they must rely on the specialized training and expertise of IPs to oversee facility-wide infection prevention.”
The CDC’s National Healthcare Safety Network (NHSN) HAI tracking system for hospitals should be expanded into long-term care, APIC emphasizes.
“For the last decade, hospitals have been required to report HAI data into NHSN to help drive HAI reduction and provide transparency around infection rates,” the letter states. “However, nursing home reporting through this platform was voluntary until the pandemic, when CMS [Centers for Medicare and Medicaid Services] required facilities to report COVID-19 data. It is crucial to build on current reporting requirements in nursing homes to include surveillance of HAIs and drug-resistant pathogens like we have in hospitals.”
APIC also called for adequate funding of nursing home surveys, saying CMS should require standardized training in infection prevention so that surveyors have the basic knowledge to hold facilities accountable to evidence-based practices.
“Federal efforts to train staff in nursing homes have at times been limited due to failure to understand that the practice of IPC requires specialized knowledge,” APIC further noted.
The letter underscored that the minimum competency requirements for individuals providing training in IPC should be a Long-Term Care Certification in Infection Prevention (LTC-CIP) or a Certification in Infection Prevention and Control (CIC) credential.
“As Congress considers improvements in nursing home safety, APIC hopes you will take steps to address this very well-documented area of risk to nursing home residents: IPC deficiencies,” the letter concluded.
REFERENCES
- Jopp D. APIC letter to Congress. June 16, 2023. https://apic.org/wp-content/uploads/2023/06/APIC-Support-of-IPC-in-LTC.pdf
- Centers for Disease Control and Prevention. National Healthcare Safety Network (NHSN) Patient Safety Component. Healthcare Associated Infections (HAIs). Data Portal. Data retrieved March 28, 2023. https://www.cdc.gov/hai/data/portal/index.html
- Centers for Disease Control and Prevention. Nursing Homes and Assisted Living (Long-term Care Facilities [LTCFs]). Data retrieved March 28, 2023. https://www.cdc.gov/longtermcare/index.html
In a strongly worded letter to Congress, the Association for Professionals in Infection Control and Epidemiology said action must be taken to protect frail residents of nursing homes.
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