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. 2015 Jul;36(7):759-66.
doi: 10.1017/ice.2015.59. Epub 2015 Mar 23.

Healthcare-associated pathogens and nursing home policies and practices: results from a national survey

Zhiqiu Ye  1 , Dana B Mukamel  2 , Susan S Huang  3 , Yue Li  1 , Helena Temkin-Greener  1
Affiliations

Healthcare-associated pathogens and nursing home policies and practices: results from a national survey

Zhiqiu Ye et al. Infect Control Hosp Epidemiol. 2015 Jul.

Abstract

OBJECTIVE To examine the prevalence of healthcare-associated pathogens and the infection control policies and practices in a national sample of nursing homes (NHs). METHODS In 2012, we conducted a national survey about the extent to which NHs follow suggested infection control practices with regard to 3 common healthcare-associated pathogens: methicillin-resistant Staphylococcus aureus, Clostridium difficile, and extended-spectrum β-lactamase producers, and their prevalence in NHs. We adapted a previously used and validated NH infection control survey, including questions on prevalence, admission and screening policies, contact precautions, decolonization, and cleaning practices. RESULTS A total of 1,002 surveys were returned. Of the responding NHs, 14.2% were less likely to accept residents with methicillin-resistant Staphylococcus aureus, with the principal reason being lack of single or cohort rooms. NHs do not routinely perform admission screening (96.4%) because it is not required by regulation (56.2%) and would not change care provision (30.7%). Isolation strategies vary substantially, with gloves being most commonly used. Most NHs (75.1%) do not decolonize carriers of methicillin-resistant Staphylococcus aureus, but some (10.6%) decolonize more than 90% of residents. Despite no guidance on how resident rooms on contact precautions should be cleaned, 59.3% of NHs report enhanced cleaning for such rooms. CONCLUSION Overall, NHs tend to follow voluntary infection control guidelines only if doing so does not require substantial financial investment in new or dedicated staff or infrastructure.

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Figures

Figure 1
Figure 1
Overall prevalence rate of healthcare-associated pathogens in nursing homes for MRSA; C.diff; ESBL. Error bars indicate 95% confidence intervals. (n=total number of residents).
Figure 2
Figure 2
Admission denial policies and cleaning practices for residents harboring healthcare-associated pathogens: MRSA; C.diff, and ESBL.
Figure 3
Figure 3
Isolation precaution and activity restriction policies for residents harboring MRSA.
See this image and copyright information in PMC

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