Today we are talking with Laurie Laxton of ABILITY Network, an infection prevention expert, to discuss the best processes for infection prevention, control, and surveillance and help you formalize and upgrade your Infection Prevention & Control programs.
Infection Prevention and Control Programs
Infection Prevention and Control (IPC) is the practice of preventing or stopping the spread of infections in a healthcare setting. It is a long-term care facility’s regulatory solution to avoiding infections in their residents’ and health workers’ communities.
It’s always been important, but especially during the COVID-19 pandemic, IPC is one of the most relevant care programs at every single healthcare facility especially those serving vulnerable or senior communities often found in long-term care.
Nursing homes often demonstrate a consistent lack of enforced IPC programs and Infection Control standardized policies that protect their residents.
However, the government owns part of the blame. For years, the CMS has missed the opportunity to push care providers to develop Infection Prevention basic policies and specialized training.
The consequences of this have been tragic in nursing homes and SNFs, being the cause of millions of cases of disease in infection outbreaks across the country.
The presence of an empowered Infection Preventionist and adequate EHR solution to continually monitor all the community’s contamination signs and prevention procedures are crucial to providing safe and efficient long-term care.
Since the COVID-19 pandemic startled the long-term care industry, this has become more urgent than ever.
IPC programs have overlapped nursing home management priorities, but the government is also waking up and getting more involved in monitoring the effectiveness and processes of these programs, both through punishments and rewards.
HHS Funding Goes to Those With Top Infection Control Performance
On October 28, the Department of Health and Human Services (HHS) announced allocating about $333 million in payments among 10,000 nursing homes that managed to improve their COVID-19 infection and death rates over the last two months.
The initiative is motivated by the industry’s need for robust Infection Prevention and Control programs.
By providing these performance-based incentives and making new Infection Control training resources available, the CMS aims to consolidate effective Infection Control policies and roles that generate substantial progress in long-term care’s fight against COVID-19.
More specifically, HHS will evaluate nursing homes based on two criteria:
- Infection Criteria
- Mortality Criteria
Back in August, HHS already distributed $5 billion to nursing homes. While half of it promoted COVID-19 testing, facilities staffing, and personal protective equipment needs, the other half’s allocation was also based on performance.
Infection Control as CMS’s Central Priority
The CMS is closely tracking nursing homes’ performance based on their weekly National Healthcare Safety Network (NHSN) data to ensure that facilities introduce robust surveillance programs and Infection Control programs that meet all of the high-quality IPC program elements.
Nursing homes must gather, report, and utilize accurate and verifiable surveillance data using standard Infection Control definitions to comply with the NHSN requirements for a legitimate IPC.
You can refer to the NHSN’s database for a detailed breakdown of the CMS Nursing Home COVID-19 Public File. There you’ll find links to resources as well as useful graphs and maps such as the density of nursing homes across the country.
Reporting Requirements and Staff Testing
Knowing what the current requirements are for infection reporting and testing is an important part of maintaining regulatory compliance. But how do you know when to test staff and residents?
CMS Updates COVID-19 Testing Methodology for Nursing Homes is a great resource to bookmark to make sure you’re up-to-date on regulations.
In addition, CMS has produced this in-depth document detailing Measures for Skilled Nursing Facility (SNF) Healthcare-Associated Infections (HAIs) Requiring Hospitalizations
As part of their strict involvement, the administration is not only compensating care providers but also flagging them or locking them down when necessary based on NHSN’s reporting data on:
- Smart and consistent testing of staff and patient or residents
- Utilization of a standardized definition of infection prevention and control criteria
- Infection Preventionists and surveyors feedback
- F-Tags from Healthcare-Acquired Infections (HAI)
Survey F-Tags Associated with Infection Control
Infection Control Focused surveys during the initial pandemic and beyond have several key areas that have neem reported to be emphasized. These include
- Documentation of staff education on Policies and Procedures, infection control practices.
- Areas where improper infection control practices have been cited (i.e. not properly donning PPE, breaks in aseptic technique, etc.)
The most common F-tags related to infection control include:
- F-884 New during PHE pertaining to NHSN reporting
- F-885 New during PHE pertaining to family notification of COVID-19 cases
- F-886 New pertaining to testing requirements
- Other F-tags are not always considered but also tied to infection prevention and control programs
F880 to Regulate Healthcare-Acquired Infections
Nursing homes have always been compelled to develop a thorough understanding of critical F-Tags and adopt emergency preparedness requirements to ensure they avoid steep fines following Infection Control-focused surveys.
Yet, since the pandemic became the industry’s most threatening and time-sensitive matter, the CMS is exclusively prioritizing HAI’s monitoring.
As Infection Control rises in the regulatory spotlight, the government centers its new survey process on the new F880 Tags, based on the attribution of Healthcare-Acquired Infections.
Of course, CMS regulations change frequently. Here is the newly proposed SNF QRP Measure surrounding HAIs in Skilled Nursing Facilities
What Do Surveyors Focus on for The F880 Tag?
- Hand hygiene
- Appropriate Personal Protective Equipment (PPE)
- Transmission Based Precautions
- Overall IPC program quality compliance
This F-Tag’s uprising and HHS’s incentive programs help the government enforce effective infection prevention in nursing homes through increasingly stringent IPC program establishment and maintenance requirements.
Measures center on providing a safe, sanitary, and comfortable environment and preventing the development and transmission of the COVID-19.
What Exactly is an Infection Preventionist?
Infection Preventionists ensure healthcare providers and residents follow Infection Prevention best practices and meet surveillance quality requirements.
In 2016, the CMS announced IPC programs’ mandatory nature within nursing home regulations. Since November 2019, this requirement has focused on compelling facilities to nominate an on-site Infection Preventionist.
Due to limited resources and in some cases because of in-house expertise, this role is often taken on as an additional duty by nurses, epidemiologists, public health professionals, microbiologists, doctors, or other health professionals from the facility.
What to Look for in an Infection Preventionist
Infection Preventionists aren’t required to be certified or nurses, but the government demands at least essential epidemiology background and proper training on Infection Prevention and Control.
To hire or select the right Infection Preventionist from your team, some professional and attitude requirements should be met to ensure your facility’s IPC program efficiency.
- Strong communication and leadership skills. The right Infection Control surveyor has to work hand-in-hand and collaborate with doctors, administrators, and other authorities.
- Attention to detail. He or she will need to be able to identify potential breaks in Infection Control, sterile techniques, and on-site policies and procedures.
- Organized and thorough problem solver. An efficient Infection Preventionist would ideally be confident and interested in designing and writing policies and procedures for all potential infections.
- Not be afraid to speak up. This is likely the most important trait of an effective Infection Preventionist. Your organization and community’s safety is in their hands, and they have to be committed to reporting issues when they arise.
What Does an Infection Preventionist Do?
- Tracks infection patterns within the facility
- Survey practices
- Educates teams
- Provides advice and recommendations
- Compiles Infection Control data for the NHSN
- Designs complying policies and procedures
- Coordinates with local and national public health agencies
What Must Their IPC Program Achieve?
- Hand Hygiene
- Regulated Immunizations
- Proper Medication Management
- Catheter Devices Correct Application
- Safe Infection Control Practices
- Right PPE Usage
- Correct Room and Equipment Cleanness
What Training is Available for an Infection Preventionist?
Once you’ve selected the right person for the job, you’ll need to ensure that they have the resources and knowledge to be effective in their role. Fortunately, there are plenty of free online resources you can utilize.
CDC’s Infection Control Training and Education Webinars
To consolidate the implementation of coordinated IPC programs in nursing homes across the country, the CMS and CDC teamed up to promote the release of a series of More than 20 specific training topics with free learning modules and other training resources.
There you will find the tools and resources needed to educate healthcare providers on best practices to improve patient safety, such as free Webinars with continuing education.
These training materials aim to teach Infection Control best practices and empower Infection Preventionists’ role as the facility’s arm on surveillance programs.
QSEP CMS-CDC Training for Nursing Homes
This COVID-19 targeted certificate includes both trainings for front-line staff and administrators and it’s scenario-based.
QIO Series and Certificates on COVID-19 Prevention Fundamentals
The Quality Improvement Organizations (QIO) provides a Comprehensive National Nursing Home Training Series in partnership with the CDC and CMS to deliver coronavirus prevention-centric training materials and live Q&A sessions with on-completion Participation Certificates in the following areas.
- Establishing an IPCP in a Nursing Home
- Is Your Nursing Home Ready to Handle COVID-19?
- COVID-19 Surveillance: NHSN Mandatory Data Collection
- COVID-19 Testing
- Cohorting Strategies
- Cleaning Environmental Surfaces and Shared Equipment
- Creating a COVID-19 Recovery Center
- PPE Strategies for COVID-19 Care
- Accepting New Patients During an Active Pandemic
- Telehealth in Nursing Homes
- Transparency: Resident and Family Notification
- Clinical Care: Managing COVID-Positive Residents
- Managing Staffing Challenges
CDC’s Project Firstline
CDC’s new infection control training collaborative provides innovative content designed to engage, innovate, and effectively train millions of frontline U.S. healthcare workers in Infection Control.
- COVID-19 Infection Prevention and Control
- Keep COVID-19 Out!
- COVID-19 Monitoring Residents
- COVID-19 PPE
- COVID-19 Environmental Cleaning
- COVID-19 Hand Hygiene
On October 9, 2020, the HHS released information on a new national action plan for combating antibiotic-resistant bacteria in 2020-2025
The CDC offers an interactive web-based program designed to help clinicians optimize antibiotic use to combat antibiotic resistance and improve healthcare quality and patient safety.
Electronic Solutions for Infection Control
Depending on manual methods to identify potential Healthcare-Acquired Infections within nursing homes can be extremely challenging and unreliable. Your staff is busy and no one can be perfect all the time.
Charting reviews, entering data, and looking for correlations is impossible to manually coordinate in mid-sized long-term care organizations and is highly susceptible to human error.
I’ve literally seen exit maps of the building photocopied in highlighter pens to highlight where the various infections are in the rooms.
Let’s say that a nurse forgot to highlight a room of somebody who had an MDR, which is a MultiDrug-Resistant organism. If they forgot to highlight it in a color, when you’re doing it manually, you have the risk of human error. “I forgot to color that room yellow.” Well, that patient discharges and the next one comes in, and he ends up with the same infection.
Electronic solutions streamline your health records management and Infection Control monitoring.
A computerized system’s speed and efficiency overlap human capabilities to sort through the interoperability and real-time data filtering nursing homes require to comply with CMS’s regulations and your IPC program demands.
An EHR solution provides a more proactive Infection Prevention and Control approach compared with traditional techniques when collecting and coordinating resident data to stop or prevent infection outbreaks.
EHR-Supported Surveillance Challenges
Introducing an electronic solution into your healthcare processes, data operability, and continuum of care management can be challenging and get a little pushback for its implementation affecting processes in the short-term.
But there’s no doubt about it, in 2020 healthcare teams need to learn new software, and many operational systems must change and upgrade to automate data management and standardize quality control practices.
You just can’t operate effectively and stay competitive without it.
And nursing homes can’t ensure Infection Control coordination without automatic data management systems, especially during unexpected events, like our current pandemic.
No IPC program can entirely prevent HAIs during a pandemic without properly standardizing Quality Assurance practices and tracking infection patterns facility-wide.
EHR computerized reminders to providers at the point of care lead to a 6.1% to 28.4% increase in preventive health programs.
NetSolutions QA reporting and documenting modules improve and update your facility’s Quality Measures and enable your Infection Preventionist to overcome the challenge of meeting CMS requirements to qualify for performance-based incentives.
The investment of your time in NetSolutions EHR upfront yields time-saving solutions on the back-end. Cloud-based solutions make your data and operating systems available and accessible for your teams, eliminating handwriting, filing, and pulling charts.
You have access to modules to standardize report content while ensuring proper actions are taken and crucial data is captured to prevent and control infection breaks at the point of care.
Our interactive and user-centric training material and customer support assist your staff to tailor the system to your facility’s demands to begin streamlining your Infection Control program as soon as possible.
Learn how our Quality Assurance Module provides better Infection Control documentation and reporting.
How Can an EHR Enhance Your IPC Program?
Automate Your Data Surveillance
NetSolutions EHR analyzes your data by identifying abnormal distributions of variables from large interrelated databases.
Our EHR requires one-third to one-sixth the amount of time required by standard surveillance methods to screen potential outbreaks and find and report endemic HAIs.
With the current emphasis on mandatory reporting of HAI and CMS requirements to perform facility-wide surveillance, NetSolutions’ customer-driven EHR provides a unique opportunity to support the shift to automated surveillance strategies, allowing Infection preventionists to minimize time spent finding HAIs and to maximize time spent preventing them.
Enhance Your IPC with Real-Time Data
To support your IPC program, you can customize your EHR to incorporate patient-specific clinical data such as laboratory or microbiology information along with diagnostic, demographic, and clinical guidelines.
The software allows several decision support modes, including alerts for critical laboratory values and recommendations for best antibiotic practices.
NetSolutions’ communication and notification features enable better care plan coordination and timely notification of critical patient data to keep all your teams updated in Infection Control matters.
You can even customize automated alerts that specify the need for isolation and a negative-air room for a patient that is suspected to be infected.
NetSolutions’ Partnership with Infection Watch
NetSolutions integrates with ABILITY Network’s Infection Watch system to provide nursing homes with access to relevant, actionable data to rapidly identify infection outbreaks and establish the most efficient and regulatory prevention measures in your operations.
The integration connects directly with your residents’ EMRs to coordinate demographic information when pulling MDS assessments enabling Infection Watch to pull all NetSolutions’ demographic and medical records anytime an infection is entered.
Infection Watch ensures your Infection Prevention and Control program has the tools to improve infection surveillance and meet CMS requirements while improving residents’ outcomes.
- Streamline Infection Surveillance: Save time and resources identifying infection-related sentinel events and detecting outbreaks. Focus your IPC on prevention, intervention, and performance improvement efforts.
- Easily Meet Regulatory Compliance: The application helps your facility fulfill reporting requirements and avoid survey deficiencies and monetary penalties.
- Track and Trend Infections: Data interoperability allows you to identify problem areas and initiate corrective Infection Control measures quickly.
- Set Alerts and Notifications: Get the data you need automatically delivered so you can stay on top of infection surveillance.
Let’s Streamline Your IPC Together
Who is Laurie Laxton?
Laurie Laxton, RN,BSN,CCFA,RAC-CT,IP-BC
UCLA nursing graduate, specializing in Operating Room. Then as Nurse Coordinator of the UCLA Hand Center, and later, the Hip and Pelvic Reconstructive Division of the Good Samaritan Hospital, Los Angeles, Laurie was involved in cutting-edge technology and care.
In the late 1990s, Laurie started a consulting business advising school districts and day camps on CPR, First Aid, medication administration, care planning, and incident reporting.
In 2009, she became a Nurse Auditor, contracting with three national firms to conduct hospital and skilled nursing facility audits in several states and later obtained certification as a clinical financial auditor.
In 2017, she pursued board certification in Infection Prevention.
Currently, she is Clinical Education Program Lead at the ABILITY Network, an industry-leading software company that offers products to assist with Infection Prevention and Control, Quality improvement, risk reduction, and correct billing practices for the long-term care, acute care, and home health industries.
- CMS Coronavirus Waivers: Everything You Need to Know for 2021 - January 5, 2021
- How to Solve Safety Issues in Long-Term Care - January 4, 2021
- How To Get Your Infection Prevention and Control Program on Track - November 5, 2020