Long Term CareJune 17, 2019

Bridging the Gaps: Disinfection Efforts in Long Term Care Facilities

Long term care facilities provide medical and personal care services to patients who are unable to manage themselves independently. In the U.S., nearly four million individuals are annually admitted to or reside in nursing homes and skilled nursing facilities, while nearly one million individuals reside in assisted living facilities, according to the Centers for Disease Control and Prevention (CDC). With so many individuals living in close quarters, it’s no surprise that 1 to 3 million serious infections occur every year in these facilities, which can include but are not limited to urinary tract infections, diarrheal diseases, and antibiotic-resistant staph infections.

Although federal officials have made efforts to raise quality standards in long term care through legislation like the 1987 Nursing Home Reform Act, which provided regulated guidelines to improve nursing home care in the U.S., the spread of infectious diseases is still an issue. In fact, the CDC reports that infections are a major cause of hospitalization and death, with as many as 380,000 people dying of infections in long term care facilities every year.

With serious infections still prevalent in the long term care environments, and more individuals needing long term care than ever before, it’s necessary to identify key disinfection gaps in order to implement a more comprehensive and effective strategy against infectious pathigens.

1. Who Is at Risk?

Let’s start with who is at risk for long term care infections in the first place. Long term care residents and patients receive most of the attention when it comes to infection outbreaks, and understandably so. However, a critical gap emerges when we fail to look at long term care workers and visitors as part of the pathogen elimination equation.

Since the U.S. Congressional Budget Office anticipates one-fifth of the U.S. population will be 65 or older by 2050, the number of older adults needing long term care services is anticipated to more than double. Consequently, The Institute of Medicine anticipates the U.S. will need an additional 3.5 million long term care health care workers by 2030 to simply maintain the current ratio of workers per older U.S. resident. Of course, with this anticipated increase of residents and workers also comes an increase in visitors, who can unknowingly spread or contract germs by touching infected surfaces and individuals, or bring infections in from the outside. By considering workers and visitors two integral constituencies, professionals working in these environments can uncover new potential sources of infectious pathogen transmission.

2. What Are the Risks?

Next, let’s look at the specific infection risks. Long term care facilities can host a number of infections, such as bloodstream infections and urinary tract infections. However, some infections pose greater dangers than others, such as norovirus, influenza, and most notably, multi-drug resistant organisms (MDROs). Multidrug-resistant organisms like methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) pose serious dangers since treatment options are limited or futile due to antibiotic resistance. C. diff  is one such MDRO that is a common cause of acute diarrhea in nursing homes. According to the CDC, approximately one in 11 people over the age of 65 die of a healthcare-associated C. diff infection within one month of diagnosis.

While C. diff understandably receives more mentions than many other pathogens, another gap emerges when we fail to focus on emerging or less prevalent infections, such as Candida auris. That said, these disease’ pathogens require a solution that employs a broad-spectrum disinfectant, and that has the highest possible validated efficacy against the largest possible set of pathogens.

3. Where Are the Risks?

Third, let’s examine which areas in the long term care environment pose the greatest risk for spreading pathogens. Long term care facilities is an umbrella term that can include a number of environments, such as adult day services, home health care, hospice care, nursing home care, and residential care communities. However, the spaces that receive the most attention as potential pathogen sources are largely consistent across these facilities. Some stationary high-touch surfaces that are widely known for housing dangerous pathogens are doorknobs, counters, light switches, tables, bed rails, bedside tables, call lights, and personal care wipe packages.

But it is important to note that other sources of pathogens are mobile, and not necessarily high-touch. Mobility increases the risk of transporting germs across a facility more quickly and directly. Medical carts, wheelchairs, and facility vehicles represent other areas of the long term care environment that are mobile, and consequently, can easily transfer dangerous pathogens. Vehicles, in particular, deserve greater share of mind since they frequently bring patients to and from the medical environment, which is rife with pathogens that can be brought back to a facility’s resident population. Addressing not only high-touch surfaces, but all of the surfaces at risk for spreading pathogens, requires a flexible solution that can adapt to meet the unique requirements of each space and place in need of disinfection.

4. When Are There Risks?

Last, but certainly not least, let’s answer the critical question of timing. It is widely accepted that high-touch surfaces and equipment must be disinfected between use on each resident in order to eliminate pathogens. This is especially true for transportable surfaces that can directly transmit pathogens between patients or to other areas of the facility. Whole room disinfection cycles should also be conducted when turning rooms over in order to eliminate infectious pathogens from the previous resident before the next arrives. But that isn’t necessarily enough.

Infection risk moves about the long term care facility as patients, personnel, and visitors travel through common areas, dining rooms, restrooms, and more. That means that the question of when is far more complex than between equipment uses or during room turnovers. The real answer is that a long term care facility is continuously at risk of infection transmission, requiring rigorous and regular whole room disinfection cycles throughout a facility in order to eliminate pathogens.

Bridging the Gaps with the Right Solution

When it comes to equipment and whole room disinfection in long term care settings, our Halosil team is dedicated to providing the highest standard in disinfection. As a List K disinfectant under the EPA, our Halo Disinfection System^® kills a broad spectrum of infectious pathogens, including 99.9999% of even the most resistant C. difficile spores—all while achieving uniform coverage through its dry fogging delivery. With flexible fogging models, the system is optimized to disinfect every space and place in the long term care environment. Finally, the system offers the ability to disinfect multiple spaces in rapid succession, empowering long term care professionals to combat the ongoing risk of outbreak at all times.

Ready to eliminate infection in your long term care facility? Call Halosil today.