Healthcare-associated infections (HAIs) can lead to significant illnesses and even death among nursing facility residents. HAIs are responsible for nearly half of all transfers from nursing facilities to hospitals, leading to between 150,000 to 200,000 hospital admissions each year. When a person living in a nursing facility (NF) is hospitalized with a primary diagnosis of infection, the mortality rate can be as high as 40%, with pneumonia being the leading cause of death.
Older adults may have diminished immune responses, increasing their risk for developing infections. Other risk factors include:
- Living in a congregate setting, such as a NF or assisted living facility;
- Reduced responsiveness to vaccinations;
- Chronic diseases such as diabetes mellitus, chronic obstructive pulmonary disease, etc.;
- Degenerative diseases that require the use of prosthetic devices (e.g., joint prostheses, implantable cardiac devices); and
- Use of invasive medical devices, such as central venous lines, urinary catheters or enteral feeding tubes
People with cognitive impairment may not be compliant with sanitary practices such as handwashing and basic personal hygiene, leading to an increased risk of infection.
Resources Created by HHSC
- Evidence-Based Best Practices: Infection Control (PDF) is a guide for developing a facility-wide system for infection prevention and control.
- Quality Monitoring Program Immunizations includes information for developing a system for immunizations, as well as the current CDC guidelines for common vaccine-preventable diseases.
Resources from Other Organizations
Center for Disease Control and Prevention (CDC)
- Infection Control and Response Tool for General Infection Prevention and Control Across Settings (ICAR) can be used by nursing facilities to evaluate their Infection Prevention and Control programs and practices.
- Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19 Pandemic) provides strategies for preventing the spread of COVID-19, as well as the latest testing and treatment recommendations.
- Nursing Homes and Assisted Living (Long-term Care Facilities) is a website for clinical professionals, residents and their families. Resources include a number of fact sheets, guidelines and toolkits that address infection control and prevention.
- Core Elements of Antibiotic Stewardship for Nursing Homes provides nursing facilities with resources for developing an effective antibiotic stewardship program.
- Influenza (Flu) is a comprehensive resource for influenza-related information.
- Hand Hygiene in Healthcare Settings provides healthcare workers and their patients with helpful information, including hand hygiene guidelines, self-assessment tools and other educational resources.
- Carbapenem-Resistant Enterobacteriaceae (CRE) Control and Prevention Toolkit will help facilities develop interventions to prevent infections caused by CRE.
- Considerations for Use of Enhanced Barrier Precautions in Skilled Nursing Facilities provides guidance for and resources for reducing the transmission of multidrug-resistant organisms in skilled nursing facilities.
Association for Professionals in Infection Control and Epidemiology (APIC)
- Infection Preventionist’s Guide to Long-Term Care is available for purchase from the Association for Professionals in Infection Control and Epidemiology (APIC). This guide provides a comprehensive approach to developing a facility-wide infection prevention and control program.
- Recommended Practices for Surveillance (PDF) outlines the seven recommended practices for monitoring, measuring, and reporting important outcomes and processes to assist surveillance program development.
Society for Healthcare Epidemiology of America (SHEA)
- Surveillance Definitions of Infections in Long-Term Care Facilities-Revisiting the McGeer Criteria outlines the updated surveillance definitions for infections in long-term care settings.
- Reliability of Nonlocalizing Signs and Symptoms as Indicators of the Presence of Infection in Residents of Nursing Homes (PDF) provides a framework for determining when to evaluate people for infection when they have non-specific signs/symptoms, such as fever, low blood pressure, elevated blood sugar, delirium, or falls.
Texas Department of State Health Services (DSHS)
- Influenza provides Texas-specific information regarding the distribution of flu cases across the state, as well as updates on locations for receiving immunizations.
- Notifiable Conditions is a current list of infectious diseases and other conditions that must be reported to state and/or local health authorities. Information on reporting procedures in included as well.
- Antibiotic Resistant/Multi-Drug Organisms provides information on drug-resistant organisms, including MRSA, C. diff and CRE.
- Infection Prevention and Control Overview is a brief video developed by the DSHS Healthcare Safety Training Unit. The video highlights the importance of infection control, what germs need to spread, and the types of precautions used in healthcare settings.
Statewide Program for Infection Control and Epidemiology (SPICE)
- Competency for Proficient Infection Preventionists (PDF) can be used to document the ongoing competency of the facility’s Infection Prevention and Control coordinator/Infection Preventionist.
- Hand Hygiene Audit Tool (PDF) can be used by the Infection Preventionist to monitor compliance with the facility’s hand hygiene policies and procedures.
- Hand Hygiene Competency Validation Tool (PDF) can be used by the Infection Preventionist to document individual employee’s competency with hand hygiene protocols.
U.S. Department of Health and Human Services
- Partnering to Heal: Teaming Up Against Health Care-Associated Infections is an interactive video-simulation training program on infection control practices.
World Health Organization
- WHO Guidelines on Hand Hygiene in Health Care 2009 provides health care workers with evidence-based recommendations for hand hygiene in healthcare settings.
- Five Moments for Hand Hygiene (PDF) is a graphic representation of the WHO Guidelines for Hand Hygiene in Health Care.