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Infection Control in Long Term Care Settings. Moderator: Carol Goldman, RN, BScN, CIC Infection Control Consultant IFIC Board member, CHICA-Canada Expert Guest: Allison McGeer, MD, FRCP Director, Infection Prevention and Control Dept.

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infection control in long term care settings
Infection Control in Long Term Care Settings

Moderator: Carol Goldman, RN, BScN, CIC

Infection Control Consultant

IFIC Board member, CHICA-Canada

Expert Guest: Allison McGeer, MD, FRCP

Director, Infection Prevention and Control Dept.

Mount Sinai, Hospital Toronto, Canada

infection control in long term care settings3
Infection Control in Long Term Care Settings

Format for today’s workshop:

  • Define and review long term care (LTC) settings
  • Discuss common infections and outbreaks associated in LTC
  • Review surveillance in LTC
  • Work collaboratively in groups to review and present the elements of an IPC programme in LTC
infection control in long term care settings4
Infection Control in Long Term Care Settings
  • A facility that provides rehabilitative, restorative, and/or ongoing skilled care for those of all ages in need of assistance with activities of daily living
    • nursing homes
    • rehabilitation facilities,
    • Extended care situations – behaviour health, psychiatric, physical and mental challenges
    • long-term chronic care
infection control in long term care settings5
Infection Control in Long Term Care Settings

The differences of Infection Control in a LTC vs. Acute Care

  • fewer resources
  • less expertise/increased turnover
  • multiple duties
  • diagnostic facilities
  • residence
  • medical record
  • limited research
infection control in long term care settings6
Infection Control in Long Term Care Settings
  • urinary infections
  • respiratory infections
  • skin and soft tissue infections
  • Outbreaks also occur frequently, and some facilities have a high prevalence of colonization of residents with antimicrobial-resistant organisms.
infection control in long term care settings7
Infection Control in Long Term Care Settings
  • Prevalence of infection documented between 5.4 and 32.7 per 100 residents per month
  • Infection incidence rates have been documented between 1.5 and 9.4 per 1,000 resident days
  • An estimated 1.5 million infections occur annually in LTC facilities in the United States
  • Facility-acquired infections account for 30% of all hospital admissions from nursing homes
  • Are the most common immediate cause of death in nursing home residents
  • NURSING HOMES,  May, 2006  by Linda L. Spaulding
infection control in long term care settings8
Infection Control in Long Term Care Settings
  • 3 yr study looking at respiratory infections in Toronto
  • 0.42 infections per 1000 resident-days
  • Outbreaks occurred year round, with no seasonal pattern
  • Pneumonia developed in 72 (15%)
  • 58 (12%) required transfer to hospital
  • The case-fatality rate was 8% (37/480)

CMAJ,  April 2000, McGeer et al

infection control in long term care settings questions you need to ask
Infection Control in Long Term Care Settingsquestions you need to ask

Who are your patients and what kind of infections are they most at risk of?

- slide on NH distribution

- but it depends on populations

Are these infections sporadic, or do they occur as outbreaks?

What opportunities are there to prevent disease?