Outcomes of Infection Prevention and Process Measures in Nursing Homes

In order to ensure safe nursing home resident environments, infection prevention and control (IPC) programs that use evidence-based policies, audits, staff education and data-sharing are of significant importance.

Investigators from the University of Michigan recently conducted a study which identified outcome and process measure data in nursing homes to prevent both non-catheter and catheter-associated urinary tract infections (UTIs and CAUTIs).

The data was presented at the 2021 Association for Professionals in Infection Control and Epidemiology conference virtual sessions.

For the study, the team of investigators supplied 58 nursing homes with a 36-question survey on IPC characteristics at the start of each year between 2018 and 2020. The surveys were taken by infection preventionists and the directors or administrators of the nursing homes.

All of the surveys were completed prior to the beginning of the COVID-19 pandemic in March of 2020.

Findings from the study showed that most of the participants who completed the surveys were aware of their UTI and CAUTI rates (93% and 87%). Staff training on prevention practices were common but inconsistent, with some nursing homes providing education at hire (55%), annually (70%), “when needed” (60%) or never (4%).

All participants reported sharing data with nursing home leadership, 70% reported sharing data with bedside nursing staff and 26% reported sharing data with residents and families.

Additionally, prevention strategies employed included hydration practices (77%), nurse-initiated indwelling urinary catheter (IUC) discontinuation (59%), stop orders (45%), indwelling device rounds (28%), and electronic alerts (25%). Despite weak efficacy data, 57% used cranberry juice or tablets to prevent UTI/CAUT.

“While awareness of UTI and CAUTI rates is high, process measures like hand hygiene rates and gown/glove use are not evaluated consistently. Hand hygiene and use of personal protective equipment have heightened priority during the current COVID pandemic,” the authors wrote. “NHs have made significant progress operationalizing many evidence-based infection prevention practices but gaps exist.”