IPC Practices Demonstrate Higher Hand Hygiene Rates in Skilled Nursing Facility


The encouraging method used in the facility to raise the percentages was the answer to creating a positive response from the team.

When California’s All Facilities Letter was issued in November 2020, the state’s more than 1,200 skilled nursing facilities were required to have a full-time, dedicated infection preventionist (IP) on staff, annual infection prevention and control training for all staff, and a plan for infection prevention and control for the facility.

At the O’Connor Hospital in San Jose (SNF), part of the County of Santa Clara Health System, the result of hiring a full-time, dedicated infection preventionist profoundly demonstrated higher hand hygiene rates and compliance within the facility. The team’s study results were presented in a poster presentation titled, “Implementing Infection Prevention and Control (IPC) Practices Including COVID-19 Mitigation Strategies in a Skilled Nursing Facility” at the Association for Professionals in Infection Control and Epidemiology (APIC) 2022 Annual Conference, held June 13-15, 2022, in Indianapolis, Indiana.

Priya Pandya-Orozco MSN, RN, CIC, infection control and prevention nurse manager at O’Connor Hospital, who co-authored and presented the poster with Jeffrey Mantes, BSN, RN, infection preventionist at O’Connor Hospital, joined Infection Control Today (ICT®)to share their results of the study.

“We implemented some basic infection prevention strategies because we wanted to make sure that the staff had the fundamental knowledge of what infection prevention is because when we have the elements of infection prevention, we already start with the knowledge base that's strong,” Pandya-Orozco told ICT®. “So that's the first step that Jeffrey did in his work in the skilled nursing facility. But we did focus particularly on hand hygiene and the use of personal protective equipment. And we wanted to focus on [those elements] because most of these patients did have Foley catheters. So we wanted to also focus on catheter-associated urinary tract infection bundle elements.”

As a result of the team’s focus, hand hygiene and PPE compliance at O’Connor increased from 66% in December 2020 to 99% in November 2021. Additionally, compliance with best practices to prevent catheter-associated urinary tract infections rose from 81% to 98%.

Mantes said that it was more than having the infection preventionist on the floor; it was also encouraging the team and teaching them what they needed to know without fear of punishment. “Because there's a go-to person, if they have any questions about infection prevention, because during the pandemic, they all have fear of COVID-19. There is someone to talk to or advise them what to do and the specific cause [of the guideline]. Everybody's anxious, [asking] if this is proper? Is this a proper isolation? Is this a proper PPE that I'm using? Educating them during the pandemic really helped them conquer their fear of taking care of patients.”

Pandya-Orozco agreed. “To bring a little bit perspective too, I think kindness wins. And I say that a lot. What I teach is kindness wins over people’s fear and their anxiety. Come in with compassion and kindness, and share why we do what we call the kind of term, ‘the why behind the do’ [answering] why do we do it, and when they understand that, they then can incorporate it into their practices because they understand why.”

In March, APIC issued a pandemic Call to Action report, urging federal policy makers to require that every nursing home have at least one full-time dedicated IP located onsite.

Now that they have achieved and sustained success in these areas, the O'Connor IP team will continue this positive momentum to focus on environmental cleaning practices.

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