The August 2019 issue of the ICCS Infection Prevention & Control Newsletter has published.
The issue includes stories on hepatitis A, duodenoscopes, a new long-term care law, total knees, antibiotic use, immunization schedules and C. diff.
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The results of a nationally representative survey of nursing homes reveal noteworthy improvements in the development of antibiotic stewardship programs.
The 2018 survey of more than 860 nursing homes analyzed antibiotic stewardship program "comprehensiveness" as well as issues such as infection preventionist training and participation in Quality Innovation Network-Quality Improvement Organization (QIN-QIO) initiatives. Survey results were published in the American Journal of Infection Control.
Comprehensiveness was evaluated based upon a nursing home's number of reported antibiotic stewardship program policies based on the Centers for Disease Control and Prevention's (CDC) core stewardship elements, reports the Center for Infectious Disease Research and Policy (CIDRAP).
Of the nursing homes participating in the survey, about a third had what was defined as "comprehensive" antibiotic stewardship program policies (six or more policies based on CDC core stewardship elements), about 41% had "moderately comprehensive" antibiotic stewardship program policies (4-5 policies) and about a quarter had "not comprehensive" antibiotic stewardship program policies (three or fewer policies).
The survey also revealed that more than 91% of nursing homes reported collecting data on antibiotic use, but just 19% reported restricting the use of specific antibiotics. Also, while the number of nursing home infection preventionists trained in infection control had increased, gaps remain.
CIDRAP noted that a 2013-2014 national survey found that only about half of nursing homes certified by the Centers for Medicare & Medicaid Surveys (CMS) collected antibiotic use data, and less than half had written antibiotic initiation guidelines. In October 2016, CMS finalized a rule requiring nursing homes to have an antibiotic stewardship program, which likely contributed to the increase in the development of more comprehensive programs.
New Jersey has passed a new law requiring some long-term care (LTC) facilities to submit outbreak response plans to the state's department of health (DOH).
The legislation was prompted in response to a 2018 adenovirus outbreak at an LTC facility for severely ill children in Haskell, N.J., that killed 11 patients.
As a press release from N.J. Governor Phil Murphy notes, the law — A5527 — requires certain LTC facilities to develop and submit an outbreak response plan to the N.J. DOH within 180 days after the bill's effective date. These plans should include protocols for isolating infected and at-risk patients in the case of an outbreak, policies for notification of family and staff and additional requirements for containing outbreaks.
The legislation also requires facilities like the one in Haskell that provide care for particularly vulnerable, ventilator-dependent residents to submit a more detailed response plan for review.
"Breaches in infection control practices are a major contributing factor in the spread of disease in healthcare facilities," said Acting Health Commissioner Judith Persichilli, in the release. "Outbreak response plans help facilities remain aware of the need to contact and work with public health to implement practices to minimize further spread of disease."