Healthcare-associated infections (HAIs), generally defined as bacterial, viral, or fungal infections contracted by patients while receiving medical treatment, are a potentially major hazard for residents of nursing homes and other long-term care facilities (LTCFs). As many as 2.8 million LTCF patients may contract HAIs, some of them fatal, every year. A group of epidemiologists recently revised the definitions used in the surveillance of HAIs, providing new tools to document and track infections. The Centers for Disease Control and Prevention (CDC) has also issued new guidelines to help LTCF’s monitor HAIs. These new tools will hopefully help reduce the development and spread of infections among nursing home residents.
HAI Surveillance Definitions
In the October 2012 issue of the Society for Healthcare Epidemiology of America’s (SHEA) journal, Infection Control and Hospital Epidemiology, a panel of experts present a new set of definitions for use in monitoring LTCF infections. The existing set of definitions, known as the McGeer criteria, date back to 1991.
A group of experts led by Allison McGeer published a set of definitions in the February 1991 issue of the American Journal of Infection Control. The purpose of the McGeer criteria was to establish a uniform set of guidelines to monitor infections in nursing homes, such as standards for identifying newly-contracted or worsened acute infections that require monitoring.
According to the paper containing the revised definitions, the McGeer criteria work well in nursing homes providing non-acute care to older residents, but they do not necessarily address concerns faced in LCTFs providing acute care and care to younger patients. New types of nonhospital treatment facilities have appeared since 1991, so newer criteria for identifying and tracking HAIs is necessary.
Conditions are changing for older patients as well. A commentary on the paper appearing in the same journal issue notes that, as the elderly population of the country grows, the range of medical conditions requiring long-term, specialized care increases as well. More LCTF patients require sophisticated treatments and invasive procedures. Infections that resist most antimicrobial treatments are also on the rise among elderly patients. In addition to providing new tools for diagnosing HAIs among acute and younger patients, a broader set of definitions can also help identify and isolate problems in more traditional nursing home environments.
CDC Surveillance Tools
The CDC operates the National Healthcare Safety Network (NHSN), a system that collects data from healthcare facilities via secure internet servers, allowing monitoring and tracking of HAIs across a broad area. Health officials at all levels of government may also access the system, which allows them to track prevention programs.
This system may be especially useful for nursing home administrators and staffers, who have a duty to their residents to provide a safe environment with diligent medical care. They must therefore remain constantly on guard against infections that can devastate elderly, often frail patients. These systems may give them the ability to access information from other healthcare facilities nearby about HAI concerns, as well as information from other parts of the country that may have faced a similar problem.
At Lebowitz and Mzhen, we defend the rights of Maryland seniors who have suffered injury because of nursing home abuse or neglect. To schedule a free and confidential consultation, contact us today online or at (800) 654-1949.
Web Resources:
Allison McGeer, et al, “Definitions of Infection for Surveillance in Long-Term Care Facilities” (PDF file), American Journal of Infection Control, February 1991, pp. 1-7
Nimalie D. Stone, MD, et al, “Surveillance Definitions of Infections in Long-Term Care Facilities: Revisiting the McGeer Criteria,” Infection Control and Hospital Epidemiology, Vol. 33, No. 10, October 2012, pp. 965-77
Maria Luisa Moro, MD, “Commentary: A Significant Step Forward: New Definitions for Surveillance of Infections in Long-Term Care,” Infection Control and Hospital Epidemiology, Vol. 33, No. 10, October 2012, pp. 978-80.
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