Nursing Homes Need Fulltime Infection Preventionists

Now this sounds familiar.

When the Association for Professionals in Infection Control and Epidemiology (APIC) this morning called on New York State to mandate that nursing homes have a fulltime infection preventionist (IP) on staff, it immediately brought to mind Infection Control Today®’s Q&As with APIC officials in which this issue was discussed. (Take a look this, this, this, and, especially, this.) APIC would like to see IPs at nursing homes not only in New York State, but in all states. Just as APIC would like to see states mandate that anybody with the title of “infection preventionist” should be certified as such. That can only enhance public trust in what IPs do.

APIC’s call results from a scathing report by New York Attorney General Letitia James—Nursing Home Response to COVID-19 Pandemic—which takes state health care officials to task for their management of nursing homes during the coronavirus disease 2’019 (COVID-19) pandemic. The report, published January 30, notes that the state’s Office of the Attorney General (OAG) received “numerous complaints that some nursing homes failed to implement proper infection controls to prevent or mitigate the transmission of COVID-19 to vulnerable residents.”

The report notes the infection prevention and control measures that were not taken. They include (according to the report):

• “Failing to properly isolate residents who tested positive for COVID-19;
• Failing to adequately screen or test employees for COVID-19;

• Demanding that sick employees continue to work and care for residents or face retaliation or termination;
• Failing to train employees in infection control protocols; and
• Failing to obtain, fit, and train caregivers with PPE [personal protective equipment].”

All of which would have been on the radar of a fulltime IP, APIC argues. APIC’s President Ann Marie Pettis, BSN, RN, CIC, FAPIC, who is also a New York State-based infection preventionist, says in today’s press release that “while APIC applauds the New York Attorney General’s investigation and the effort to protect the elderly, a critical component of staffing was omitted from the report—the need for an infection preventionist at every facility. Without qualified infection control experts, known as infection preventionists, who are trained and certified to prevent infections, nursing homes will not have the ability to prevent COVID-19 deaths, or deaths from other infectious diseases including multidrug-resistant organisms.”

Linda Spaulding RN, BC, CIC, CHEC, CHOP, has written in ICT® about the substantive approaches to solve the myriad of problems at nursing homes, many of which will not be prohibitively costly. (Spaulding is a member of ICT®’s Editorial Advisory Board.)

In its press release, APIC applauds that the OAG report calls staffing levels at nursing homes insufficient. “However, the report did not include the requirement for infection preventionists (IPs) at each facility. IPs are highly trained health care experts who specialize in reducing infection risk.”

This could represent the first step in a general expansion of IP expertise, and even IPs themselves, out of the hospital setting and into not only other health care settings but also private industry, public health care departments, and small businesses such as beauty salons and gyms.

As Pettis has told ICT®, too often the IP job in nursing homes and other long-term care facilities falls on the shoulders of someone with a host of other duties and that can lead to tragic consequences.

APIC wants New York State nursing homes to (according to the press release):

• “Require a minimum of one full-time certified infection preventionist in each nursing home as has been called for by the CDC.
• Ensure that infection prevention personnel in nursing homes are trained and certified in their field of expertise.
• Require health departments to collect and publicly report data on infection rates and the number of certified infection preventionists in nursing homes.”