320. Nursing Homes with Trained Infection Control Professionals are More Likely to Implement Infection Control Policies and Programs
Session: Poster Abstract Session: HAI: Long Term Care
Thursday, October 8, 2015
Room: Poster Hall
  • IDWeek2015_Herzig_IP Training and Policies.pdf (30.6 kB)
  • Background: Nursing homes (NH) are required to have infection control (IC) programs. Two key program aspects include an infection preventionist (IP) specifically trained in IC and written IC policies. Annual inspections are conducted for Centers for Medicare & Medicaid Services certification and poor performance can result in a deficiency citation. The objectives of this study were to evaluate associations between (1) NH IC program characteristics and receiving an IC deficiency citation and (2) IP training and the presence of IC policies.

    Methods: A cross-sectional survey of 2,550 randomly sampled US NH was conducted for one year, starting in December 2013, to assess: IP training, frequency of IC committee meetings, and the presence of policies or programs (7 for antibiotic use; 10 for outbreak control; 5 for contaminated materials/environment; 9 for urinary tract infection (UTI) prevention). Responses were linked to 2013 Certification and Survey Provider Enhanced Reporting data, which contains information about NH providers and citations. Descriptive statistics were computed and multivariable regression analyses conducted to account for NH characteristics (number of beds, percent occupancy, ownership status, urban setting, and US census region).

    Results: Surveys were received from 990 NH (39% response); 941 had complete deficiency citation and IP training data. About 35% of NH received an IC citation. Weekly/monthly and quarterly IC committee meetings were held in 61% and 27% of NH, respectively. NH that received IC citations were more likely to have committees that met weekly/monthly versus quarterly (p<0.01). IPs in 39% of facilities had received specific IC training. NH with trained IPs were more likely to have 5 of the antibiotic use policies (prevalence ratios (PRs) = 1.14 - 3.33; p<0.05), 7 of the outbreak control policies (PRs = 1.11 – 1.68; p<0.01), 1 contaminated material policy (PR = 1.21; p=0.03), and 3 UTI prevention policies (PRs = 1.31 – 1.93; p<0.05). The presence of those policies was not associated with fewer IC citations.

    Conclusion: Although IP training in IC was associated with policy implementation, such training was lacking. The presence of those policies was not associated with fewer IC deficiency citations and it is unclear whether policy implementation was related to practice; this should be addressed in future studies.

    Carolyn Herzig, MS, Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY; Center for Health Policy, Columbia University School of Nursing, New York, NY, Nicholas Castle, MHA, PhD, University of Pittsburgh, Pittsburgh, PA, Monika Pogorzelska-Maziarz, PhD, MPH, Thomas Jefferson University, College of Nursing, Philadelphia, PA, John Engberg, PhD, RAND Corporation, Pittsburgh, PA, Andrew Dick, PhD, RAND Corporation, Boston, MA, Elaine Larson, RN, PhD, FAAN, CIC, FIDSA, FSHEA, School of Nursing, Columbia University Medical Center, New York, NY and Patricia Stone, PhD, MPH, RN, FAAN, Columbia University School of Nursing, New York, NY


    C. Herzig, None

    N. Castle, None

    M. Pogorzelska-Maziarz, None

    J. Engberg, None

    A. Dick, None

    E. Larson, None

    P. Stone, None

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