Transitions from hospitals to long-term care facilities are associated with safety hazards. This prospective cohort study identified adverse events in the 45 days following acute hospitalization among 555 nursing home residents, which included 762 discharges during the study period. Investigators found that adverse events occurred after approximately half of discharges. Common adverse events included falls, pressure ulcers, health care–associated infections, and adverse drug events. Most adverse events were deemed preventable or ameliorable. The authors conclude that improved communication and coordination between discharging hospitals and receiving long term-care facilities are urgently needed to address this patient safety gap. A previous WebM&M commentary discussed challenges of nursing home care that may contribute to adverse events.

The CDC has launched the new Strategies for Preventing HAIs training, the latest of 11 new infection control training courses.  These training courses were developed by national infection prevention experts led by the Health Research & Educational Trust (HRET) for the Centers for Disease Control and Prevention (CDC).

All courses are free and offer continuing education (CE).

Access the new courses at the STRIVE training page. 

The STRIVE curriculum will include over forty individual training modules grouped into 11 courses that focus on Foundational and Targeted infection prevention strategies. 

Foundational Infection Prevention Strategies

· Competency-Based Training (available now)

· Hand Hygiene (available now)

· Strategies for Preventing HAIs (available now)

· Environmental Cleaning

· Personal Protective Equipment

· Patient and Family Engagement

· Business Case

Targeted Infection Prevention Strategies

· Catheter-Associated Urinary Tract Infection (CAUTI)

· Methicillin-Resistant Staphylococcus aureus (MRSA) Bacteremia

· Clostridioides difficile Infection (CDI)

·  Central Line-Associated Bloodstream Infection (CLABSI)

Princeton Place Did Not Always Comply With Care Plans for Residents Who Were Diagnosed With Urinary Tract Infections (A-06-17-02002)

Princeton Place did not always provide services to Medicaid-eligible residents diagnosed with UTIs in accordance with their care plans, as required by Federal regulations. Specifically, Princeton Place staff did not always document that they monitored the residents' urine appearance at the frequencies specified in their care plans. Princeton Place did not have policies and procedures to ensure that its staff provided services in accordance with its residents' care plans. As a result of Princeton Place not following residents' care plans, the residents were at increased risk for contracting UTIs and for incurring complications from UTIs, including requiring hospitalization.

EVS personnel play a critical role in preventing the spread of germs and healthcare-associated infections

“EVS and the Battle Against Infection” is an interactive graphic novel illustrating the important role of EVS personnel in the prevention of healthcare-associated infections. The online version of the training tool features real-world infection prevention and control scenarios and allows participants to choose options that affect the outcome of the story. 

Healthcare professionals are the first line of defense against healthcare-associated infections (HAIs) and the spread of germs in healthcare settings. CDC now offers a new online interactive infection control training, “Let’s Talk Patient Safety: Reducing HAI Transmission Risk,” to help healthcare professionals identify infection risks and prevent the spread of HAIs. The training provides free continuing education for healthcare professionals, including nurses, physician assistants, medical assistants, health educators, and other clinicians. (0.1 CEU and 0.6 CNE).

The free online training can be completed anywhere. It has two modules and takes approximately 30 minutes to complete the entire training.

Module 1: “What’s the Risk?” 

This interactive module transports healthcare professionals into a scenario where they must identify infection risks and take action to protect patients, colleagues, and visitors. 

Module 2: “Chain of Infection” 

This story-based interactive module challenges professionals to break the chain of infection in a busy healthcare environment and educates them on the consequences of not following infection prevention and control recommendations.

Please join Christine LaRocca, MD and the National Nursing Home Quality Improvement Campaign to learn more about sepsis, who is at risk and the signs and symptoms for early detection. In addition, we will:

·        Review examples of sepsis screening tools commonly used in hospital settings;

·        Learn what tools to use while recognizing the limitations of sepsis screening tools in the nursing home population; and

·        Understand the elements of evidence-based treatment for optimal outcomes.

The CDC has begun using Clostridioides difficile instead of Clostridium difficile to refer to the bacterium that commonly causes infectious diarrhea.

The change followed a decision early last year by the Clinical and Laboratory Standards Institute (CLSI).

Given that laboratories and medical publications may be transitioning to the new name, the National Nursing Home Quality Improvement Campaign is making the transition when using the full name. However, the abbreviated form C. Diff is still applicable.

Strysko J, Fialkowski V, Marsh Z, et al. Notes from the Field: Outbreak of Multidrug-Resistant Shigella sonnei Infections in a Retirement Community — Vermont, October–November 2018. MMWR Morb Mortal Wkly Rep 2019;68:405–406. 

On October 22, 2018, the Vermont Department of Health (VDH) notified CDC’s Waterborne Disease Prevention Branch of an outbreak of diarrhea caused by Shigella sonnei among residents, visitors, and staff members of a retirement community in Chittenden County, the state’s most populous county. High-quality single nucleotide polymorphism (SNP) analysis predicted initial isolates were multidrug resistant (MDR), and were closely related to a concurrent multistate cluster (differing by 0–11 SNPs). In the United States, rates of MDR shigellosis are increasing (1); outbreaks of MDR shigellosis are more common among men who have sex with men and are rare in retirement community settings (2). CDC collaborated with VDH to identify additional cases, determine transmission routes, and recommend prevention and control measures.

Specialized Infection Prevention and Control Training for Nursing Home Staff in the Long-Term Care Setting is Now Available

The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) collaborated on the development of a free on-line training course in infection prevention and control for nursing home staff in the long-term care setting.

The training provides approximately 19 hours of continuing education credits as well as a certificate of completion (i.e., free CME, CNE or CEUs).

The course introduces and describes how to use IPC program implementation resources including policy and procedure templates, audit tools, and outbreak investigation tools.

The course is made up of 23 modules and sub-modules that can be completed in any order and over multiple sessions.

The course covers:

• Core activities of effective IPC programs
• Recommended IPC practices to reduce
• Pathogen transmission
• Healthcare-associated infections
• Antibiotic resistance

All Cause Harm Prevention in Nursing Homes Applying Strategies from the New CMS Change Package

Thursday, January 24, 2019, 3:00pm ET (1 hour) Recording Available.

One-third of SNF residents experience an adverse or temporary harm event, and the majority of those are preventable. As part of CMS’s focus on raising awareness of nursing home safety and to support safer nursing home care across the nation, CMS and the Quality Innovation Network National Coordinating Center released a new resource: a Change Package to prevent all cause harm in nursing homes. The Change Package is a compendium of successful practices of high-performing nursing homes, illustrating how they prevent harm while honoring each resident’s rights and preferences.