BACKGROUND: The medical needs of the approximately 1 million persons residing in assisted living facilities (ALFs) continually become more demanding. Moreover, the number of ALF residents is expected to double by 2030. ALFs are not subject to federal oversight; state regulations that govern ALF infection control are variable. In 2005, two outbreaks of acute hepatitis B virus (HBV) infection in ALFs in Virginia were associated with sharing fingerstick devices used in blood glucose monitoring. OBJECTIVE: To characterize infection control practices, determine compliance with guidelines, and identify educational and policy needs in ALFs in Virginia. METHODS: Following the outbreaks of HBV infection, educational packets were sent to ALFs in Virginia to inform them of infection control guidelines and recommendations regarding glucose monitoring. A follow-up survey consisting of on-site interviews was conducted in a random sample of ALFs. Differences among infection control practices, according to the size and ownership of the ALFs, were assessed. RESULTS: Fifty of 155 ALFs in central Virginia were surveyed. Of the 45 ALFs that had used fingerstick devices, 7 (16%) had shared these devices (without cleaning) between residents. Sharing practices for glucose monitoring equipment did not differ by facility size or ownership. Of all 50 ALFs, 17 (34%) did not offer employees HBV vaccine. HBV vaccine was less frequently offered at ALFs that had fewer than 50 residents, compared with ALFs with at least 50 residents (P<.01), and HBV vaccine was less frequently offered at ALFs that were individually owned, compared with those that were not individually owned (P=.02). CONCLUSIONS: Despite outreach and long-standing recommendations, approximately 1 in 6 facilities shared fingerstick devices, and more than one-third of ALFs surveyed were considered noncompliant with federal guidelines (Occupational Safety and Health Administration Bloodborne Pathogens Standard). Public health and licensing agencies should work with ALFs to implement infection control measures and prevent disease transmission.
BACKGROUND: The medical needs of the approximately 1 million persons residing in assisted living facilities (ALFs) continually become more demanding. Moreover, the number of ALF residents is expected to double by 2030. ALFs are not subject to federal oversight; state regulations that govern ALF infection control are variable. In 2005, two outbreaks of acute hepatitis B virus (HBV) infection in ALFs in Virginia were associated with sharing fingerstick devices used in blood glucose monitoring. OBJECTIVE: To characterize infection control practices, determine compliance with guidelines, and identify educational and policy needs in ALFs in Virginia. METHODS: Following the outbreaks of HBV infection, educational packets were sent to ALFs in Virginia to inform them of infection control guidelines and recommendations regarding glucose monitoring. A follow-up survey consisting of on-site interviews was conducted in a random sample of ALFs. Differences among infection control practices, according to the size and ownership of the ALFs, were assessed. RESULTS: Fifty of 155 ALFs in central Virginia were surveyed. Of the 45 ALFs that had used fingerstick devices, 7 (16%) had shared these devices (without cleaning) between residents. Sharing practices for glucose monitoring equipment did not differ by facility size or ownership. Of all 50 ALFs, 17 (34%) did not offer employees HBV vaccine. HBV vaccine was less frequently offered at ALFs that had fewer than 50 residents, compared with ALFs with at least 50 residents (P<.01), and HBV vaccine was less frequently offered at ALFs that were individually owned, compared with those that were not individually owned (P=.02). CONCLUSIONS: Despite outreach and long-standing recommendations, approximately 1 in 6 facilities shared fingerstick devices, and more than one-third of ALFs surveyed were considered noncompliant with federal guidelines (Occupational Safety and Health Administration Bloodborne Pathogens Standard). Public health and licensing agencies should work with ALFs to implement infection control measures and prevent disease transmission.
Authors: Rania A Tohme; Debo Awosika-Olumo; Carrie Nielsen; Salma Khuwaja; Jennifer Scott; Jian Xing; Jan Drobeniuc; Dale J Hu; Cynthia Turner; Toni Wafeeg; Umid Sharapov; Philip R Spradling Journal: Vaccine Date: 2011-10-18 Impact factor: 3.641
Authors: Rachel A Kossover; Carolyn J Chi; Matthew E Wise; Alvin H Tran; Neha D Chande; Joseph F Perz Journal: J Am Med Dir Assoc Date: 2013-11-13 Impact factor: 4.669
Authors: Arlene C Seña; Anne Moorman; Levi Njord; Roxanne E Williams; James Colborn; Yury Khudyakov; Jan Drobenuic; Guo-Liang Xia; Hattie Wood; Zack Moore Journal: Infect Control Hosp Epidemiol Date: 2013-05-16 Impact factor: 3.254
Authors: Thomas John Bender; Matthew E Wise; Okey Utah; Anne C Moorman; Umid Sharapov; Jan Drobeniuc; Yury Khudyakov; Marielle Fricchione; Mary Beth White-Comstock; Nicola D Thompson; Priti R Patel Journal: PLoS One Date: 2012-12-26 Impact factor: 3.240