Long-Term Care Settings:

Long-term care facilities (LTCFs) may be defined as institutions, such as nursing homes and skilled nursing facilities that provide healthcare to people who are unable to manage independently in the community. This care may represent custodial or chronic care management or short-term rehabilitative services. Approximately 3.2 million Americans lived in U.S. nursing homes and skilled nursing facilities participating in the Medicare and Medicaid programs at some point during 2008. In addition, nearly one million persons reside in Assisted Living Facilities. The growing complexity of care being delivered in LTCFs has led to increased recognition for improved infection control and prevention of healthcare-associated infections in LTCFs over the last 2 decades.

Healthcare-associated Infections (HAIs):

Healthcare-associated infections (HAIs) are infections caused by a wide variety of common and unusual bacteria, fungi, and viruses during the course of receiving medical care.

Medical advances have brought lifesaving care to patients in need, yet many of those advances come with a risk of HAI. These infections related to medical care can be devastating and even deadly. As our ability to prevent HAIs grows, these infections are increasingly unacceptable.

Recent successes in HAI elimination have been very encouraging. Examples include sustained reduction in central line-associated bloodstream infections (CLABSIs) by 70%, simply by ensuring adherence to available guidelines. Reductions have been demonstrated for other HAIs as well, but, much more remains to be done.

Wherever patient care is provided, adherence to infection prevention guidelines is needed to ensure that all care is safe care. This includes traditional hospital settings as well as outpatient surgery centers, long-term care facilities, rehabilitation centers, and community clinics. The information on this website is intended to inform patients and healthcare personnel and help move healthcare systems toward elimination of HAIs.

Guidelines and Recommendations From CDC:

Healthcare Infection Control Practices Advisory Committee (HICPAC) Guideline for Prevention of Catheter-associated Urinary Tract Infections, 2009 Rutala WA, Weber DJ, the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 Siegel JD, Rhinehart E, Jackson M, et al. the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, 2007 Siegel JD, Rhinehart E, Jackson M, et al. The Healthcare Infection Control Practices Advisory Committee (HICPAC). Management of Multidrug-Resistant Organisms In Healthcare Settings, 2006 CDC. Influenza Vaccination of Healthcare Personnel CDC. Sehulster L, Chinn RYW, the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for Environmental Infection Control in Healthcare Facilities MMWR 2003;52 (RR10):1–42. CDC. Boyce JM, Pittet D. the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Hand Hygiene in Healthcare Settings  [PDF - 496 KB] MMWR 2002;51 CDC. the Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for Infection Control in Healthcare Personnel, 1998  [PDF - 1.04 MB]Immunization of Healthcare Workers: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee

Additional Guidelines to Clinical Practice Consensus Guidelines:

CMS 2009 Nursing Home Compendium  [PDF - 14.41 MB]CMS 2009 Nursing Homes - Issuance of Revisions to Interpretive Guidance at F Tag 441, as Part of Appendix PP, State Operations Manual (SOM), and Training Materials  [PDF - 1.1 MB]Smith PW, Bennett G, Bradley S, Drinka P, Lautenbach E, Marx J, Mody L, Nicolle L, Stevenson K; SHEA/APIC Guideline: Infection Prevention and Control in the Long-Term Care Facility. Infect Control Hosp Epidemiol 2008;29:785–814Kevin P. High, Suzanne F. Bradley, Stefan Gravenstein, David R. Mehr, Vincent J. Quagliarello, Chesley Richards, and Thomas T. Yoshikawa Clinical Practice Guideline for the Evaluation of Fever and Infection in Older Adult Residents of Long-Term Care Facilities. Clinical Infectious Diseases. 2009;48:149–171 Loeb M, Bentley DW, Bradley S, Crossley K, Garibaldi R, Gantz N, McGeer A, Muder RR, Mylotte J, Nicolle LE, Nurse B, Paton S, Simor AE, Smith P, Strausbaugh L. Development of Minimum Criteria for the Initiation of Antibiotics in Residents of Long-Term–Care Facilities: Results of a Consensus Conference, Infect Control Hosp Epidemiol 2001;22:120–124Lindsay E. Nicolle, MD; David W. Bentley, MD; Richard Garibaldi, MD; Ellen G. Neuhaus, MD; Philip W. Smith, MD; the SHEA Long‐Term–Care Committee Antimicrobial Use in Long-Term–Care Facilities. Infect Control Hosp Epidemiol 2000;21:537–545McGeer A, Campbell B, Emori TG, Hierholzer WJ, Jackson MM, Nicolle LE, Peppler C, Rivera A, Schollenberger DG, Simor AE, et al. Definitions of Infections for Surveillance in Long-Term Care Facilities, AJIC 1991  [PDF - 116 KB] Am J Infect Control. 1991 Feb;19(1):1-7