III
INFECTION PREVENTIONIST’S GUIDE TO LONG-TERM CAREAcknowledgements ...v
Declarations of Conflicts of Interest ... vi
Foreword ... vii
Chapter 1: Understanding Infection Prevention in Long-Term Care ...1
Deborah Patterson Burdsall, MSN, RN-BC, CIC Chapter 2: Regulatory Surveys and CMS F tag 441 Compliance ...13
Deborah Patterson Burdsall, MSN, RN-BC, CIC Chapter 3: Infection Prevention and Control Programs ...23
Marilyn Hanchett, RN, MA, CPHQ, CIC; Patricia Rosenbaum, RN, CIC Chapter 4: Surveillance, Epidemiology, and Reporting ...39
Deborah Patterson Burdsall, MSN, RN-BC, CIC Chapter 5: Isolation Precautions ...71
Dolly Greene, RN, CIC Chapter 6: Nursing Care to Prevent Infections ...93
Marilyn Hanchett, RN, MA, CPHQ, CIC Chapter 7: Residents with Advanced Medical Needs ...11 1 Steven J. Schweon, RN, MPH, MSN, CIC, HEM Chapter 8: Seasonal Influenza ...127
James F. Marx, PhD, RN, CIC Chapter 9: Occupational Health ... 137
James F. Marx, PhD, RN, CIC Chapter 10: Environment and Equipment ... 153
Dolly Greene, RN, CIC; Steven J. Schweon RN, MPH, MSN, CIC, HEM Chapter 11: Infection Prevention for Interdisciplinary Services ... 173
Patricia Rosenbaum, RN, CIC; Marilyn Hanchett, RN, MA, CPHQ, CIC Chapter 12: Life Enrichment and Support Services ...195
Deborah Patterson Burdsall, MSN, RN-BC, CIC Chapter 13: Education and Training ... 207
Irena Kenneley, PhD, APRN-BC, CIC Chapter 14: Transitions in Care ... 217
Irena Kenneley, PhD, APRN-BC, CIC; Marilyn Hanchett, RN, MA, CPHQ, CIC Chapter 15: Emergency and Disaster Preparedness ... 231
Dolly Greene, RN, CIC; Steven W. Hilley, RN Glossary ... 251
Index ... 259
Table of Contents
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INFECTION PREVENTIONIST’S GUIDE TO LONG-TERM CARE The Association for Professionals in Infection Control and Epidemiology acknowledges the valuable contributions from each of the following individuals:Acknowledgements
Authors
Lead Author:
Steven J. Schweon, RN, MPH, MSN, CIC, HEM
Infection Prevention Consultant Saylorsburg, PA
Contributing Authors:
Deborah Patterson Burdsall, MSN, RN-BC, CIC
Infection Preventionist Lutheran Home/Lutheran Life Communities
Arlington Heights, IL
Dolly Greene, RN, CIC
Director of Clinical Services and Education Diagnostic Laboratories & Radiology/ Mobilex USA
Burbank, CA
Marilyn Hanchett, RN, MA, CPHQ, CIC
Sr. Director, Professional Practice Association for Professionals in Infection Control and Epidemiology Washington, DC
Steven W. Hilley, RN
Infection Prevention Coordinator Yampa Valley Medical Center Steamboat Springs, CO
Irena Kenneley, PhD, APRN-BC, CIC
Assistant Professor/Faculty Development Officer
Case Western Reserve University Cleveland, OH
James F. Marx, PhD, RN, CIC
Infection Preventionist Consultant Broad Street Solutions
San Diego, CA
Patricia Rosenbaum, RN, CIC
Infection Prevention Consultant PAR Consulting, LLC Silver Spring, MD
Reviewers
Amy Cotton, MSN, GNP, FNP, FNGNA, FAAN
Past President, The National Gerontological Nursing Association
Eastern Maine Healthcare Systems Brewer, ME
Sherrie Dornberger, RN, GDCN, CDP, CDONA, FACDONA
Executive Director
National Association Directors of Nursing Administration in Long Term Care Mullica Hill, NJ
Paul Drinka, MD, AGSF, FSHEA*
Clinical Professor of Internal Medicine/ Geriatrics
University of Wisconsin and Medical College of Wisconsin
Madison, WI
Darlene Fawcett, RN**
Infection Control Practitioner Ontario Shores Centre for Mental Health Sciences
Whitby, ON, Canada
Jill E. Holdsworth, MS, CIC, EMT-B
Infection Control Practitioner Inova Mount Vernon Hospital Alexandria, VA
Kathy Horn, RN, CIC
Consultant in Infection Prevention Upper Black Eddy, PA
Jolynn Zeller, RN, BSN, CIC
Coordinator, Infection Prevention Avera St. Luke's
Aberdeen, SD
Production Team
Executive Editor:
Marilyn Hanchett, RN, MA, CPHQ, CIC
Sr. Director, Professional Practice Association for Professionals in Infection Control and Epidemiology
Washington, DC Managing Editor:
Anna Conger
Sr. Manager, Practice Resources
Association for Professionals in Infection Control and Epidemiology
Washington, DC Copyeditors:
Jim Angelo
Director, Practice Resources
Association for Professionals in Infection Control and Epidemiology
Washington, DC
Thomas Weaver, DMD
Director, Professional Practice
Association for Professionals in Infection Control and Epidemiology
Washington, DC Cover Design:
Sarah Vickers
Art Director
Association for Professionals in Infection Control and Epidemiology
Washington, DC
Book Design and Layout:
Project Design Company
Washington, DC Printing:
Linemark
Upper Marlboro, MD
* Paul Drinka, MD, AGSF, FSHEA reviewed on behalf of AMDA - Dedicated to Long Term Care Medicine. ** Darlene Fawcett, RN reviewed on behalf of Infection Prevention and Control Canada.
VI
INFECTION PREVENTIONIST’S GUIDE TO LONG-TERM CAREDeborah Patterson Burdsall, MSN, RN-BC, CIC has nothing to declare.
Amy Cotton, MSN, GNP, FNP, FNGNA, FAAN is President and Board of Directors Chair for National Gerontological Nursing Association (volunteer).
Sherrie Dornberger, RN, GDCN, CDP, CDONA, FACDONA serves on the South Jersey Red Cross Board of Directors (volunteer).
Paul Drinka, MD, AGSF, FSHEA has nothing to declare. Darlene Fawcett, RN has nothing to declare.
Dolly Greene, RN, CIC has nothing to declare.
Marilyn Hanchett, RN, MA, CPHQ, CIC has nothing to declare.
Steven W. Hilley, RN is a member of the State Emergency Medical and Trauma Services Advisory Council, Statewide Trauma System Committee, and Hospital Preparedness Advisory Group and is Vice Chair of the Routt County Emergency Response Coalition and Northwest Colorado Hospital Emergency Coordination System.
Jill E. Holdsworth, MS, CIC, EMT-B has nothing to declare. Kathy Horn, RN, CIC has nothing to declare.
Irena Kenneley, PhD, APRN-BC, CIC has nothing to declare.
James F. Marx, PhD, RN, CIC is a member of the GOJO Industries consortium and speaker’s bureau.
Patricia Rosenbaum, RN, CIC has nothing to declare.
Steven J. Schweon, RN, MPH, MSN, CIC, HEM has done consulting work for GOJO Industries and Crothall Healthcare and is a member of the Society for Healthcare Epidemiology of America Education Committee.
Jolynn Zeller, RN, BSN, CIC has nothing to declare.
VII
INFECTION PREVENTIONIST’S GUIDE TO LONG-TERM CARE On behalf of APIC, I am delighted to introduce to you the Infection Preventionist’s Guide to Long-term Care.This is the most comprehensive book that APIC has published on infection prevention and control in this unique practice setting.
With more than 15,000 long-term care facilities (LTCF) in the United States and a national priority to prevent healthcare-associated infections (HAIs), APIC has leveraged member expertise and experience specific to infection prevention and control in long-term care to produce this book.
APIC is committed to increasing its educational resources for long-term care to advance knowledge and
competencies of healthcare personnel working in this setting and for the benefit of the residents under their care. This book presents the historical context and background on LTCF as an emerging national priority for preventing HAIs. In addition, it provides detailed explanations of the requirements and the challenges in this practice setting along with recommended actions, procedures, and checklists that can be implemented to improve infection prevention programs.
When it comes to the “how-to-implement” infection prevention and control strategies and practices in this country, APIC is unparalleled. APIC is committed to patient and resident safety across the healthcare continuum. To support this commitment, APIC continues to bring forward practice resources and professional development for those working in long-term care settings.
Together, we can improve quality and prevent infections.
Katrina Crist, MBA
Chief Executive Officer
Association for Professionals in Infection Control and Epidemiology
