BACKGROUND: Control of infection within the long-term care facility is a daunting problem. Elderly patients are at high risk for contracting infection because of reduced innate immunity, malnutrition, and the presence of chronic medical conditions. This small study tested the effect of developing and implementing a comprehensive preventive infection control program in the long-term care setting and examined the resultant incidence of infections. METHODS:Eight private, freestanding, long-term care facilities in urban and suburban settings were selected for the study. The 4 test sites had a total of 443 beds; there were 447 beds in 4 matched control sites. Data on infection rates were accrued in both preintervention and intervention years. The control homes maintained their existing infection control policies and procedures. The test homes were provided with an infection control educational program and replaced all currently used germicidal products with single-branded products for a 12-month period. A criteria-based standardized infection control surveillance system was used to monitor and report infections in all facilities. RESULTS: In the preintervention year, the test sites experienced 743 infections (incidence density rate, 6.33) and the control homes experienced 614 infections (incidence density rate, 3.39). In the intervention year, the test homes reported 621 infections, a decrease of 122 infections (incidence density rate, 4.15); in the control homes, the number of infections increased slightly, to 626 (incidence density rate, 3.15). The greatest reduction in infections in the test homes was in upper respiratory infections (P =.06). CONCLUSIONS: This study provides additional evidence that a comprehensive infection control program that includes handwashing and environmental cleaning and disinfecting may help reduce infections among the elderly residing in long-term care settings.
RCT Entities:
BACKGROUND: Control of infection within the long-term care facility is a daunting problem. Elderly patients are at high risk for contracting infection because of reduced innate immunity, malnutrition, and the presence of chronic medical conditions. This small study tested the effect of developing and implementing a comprehensive preventive infection control program in the long-term care setting and examined the resultant incidence of infections. METHODS: Eight private, freestanding, long-term care facilities in urban and suburban settings were selected for the study. The 4 test sites had a total of 443 beds; there were 447 beds in 4 matched control sites. Data on infection rates were accrued in both preintervention and intervention years. The control homes maintained their existing infection control policies and procedures. The test homes were provided with an infection control educational program and replaced all currently used germicidal products with single-branded products for a 12-month period. A criteria-based standardized infection control surveillance system was used to monitor and report infections in all facilities. RESULTS: In the preintervention year, the test sites experienced 743 infections (incidence density rate, 6.33) and the control homes experienced 614 infections (incidence density rate, 3.39). In the intervention year, the test homes reported 621 infections, a decrease of 122 infections (incidence density rate, 4.15); in the control homes, the number of infections increased slightly, to 626 (incidence density rate, 3.15). The greatest reduction in infections in the test homes was in upper respiratory infections (P =.06). CONCLUSIONS: This study provides additional evidence that a comprehensive infection control program that includes handwashing and environmental cleaning and disinfecting may help reduce infections among the elderly residing in long-term care settings.
Authors: Tom Jefferson; Chris B Del Mar; Liz Dooley; Eliana Ferroni; Lubna A Al-Ansary; Ghada A Bawazeer; Mieke L van Driel; Sreekumaran Nair; Mark A Jones; Sarah Thorning; John M Conly Journal: Cochrane Database Syst Rev Date: 2011-07-06
Authors: Tom Jefferson; Ruth Foxlee; Chris Del Mar; Liz Dooley; Eliana Ferroni; Bill Hewak; Adi Prabhala; Sreekumaran Nair; Alessandro Rivetti Journal: Evid Based Child Health Date: 2008-12-10
Authors: Diana S Fleischman; Gregory D Webster; Gaby Judah; Mícheál de Barra; Robert Aunger; Valerie A Curtis Journal: BMJ Open Date: 2011-11-24 Impact factor: 2.692
Authors: Tom Jefferson; Chris Del Mar; Liz Dooley; Eliana Ferroni; Lubna A Al-Ansary; Ghada A Bawazeer; Mieke L van Driel; Ruth Foxlee; Alessandro Rivetti Journal: BMJ Date: 2009-09-21
Authors: Elisabeth König; Mara Medwed; Christian Pux; Michael Uhlmann; Walter Schippinger; Robert Krause; Ines Zollner-Schwetz Journal: Antibiotics (Basel) Date: 2021-05-07
Authors: Isabella Annesi-Maesano; Dan Norback; Jan Zielinski; Alfred Bernard; Cristina Gratziou; Torben Sigsgaard; Piersante Sestini; Giovanni Viegi Journal: Multidiscip Respir Med Date: 2013-11-21