Achieving balance between implementing effective infection prevention and control practices and maintaining a home-like setting in U.S. Department of Veterans Affairs nursing homes

Am J Infect Control. 2018 Nov;46(11):1307-1310. doi: 10.1016/j.ajic.2018.04.221. Epub 2018 May 24.

Abstract

Nursing homes present a unique challenge for implementing infection prevention and control practices while striving to maintain a home-like environment. Medical devices such as urinary catheters and central venous catheters have become a part of nursing home care but can predispose residents to associated infections. Because evidence-based prevention bundles were implemented, catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs) were monitored in all U.S. Department of Veterans Affairs (VA) nursing homes, and outcomes were evaluated. Bundle components for CLABSIs focused on insertion technique, site selection, and routine assessment of central line necessity, while the CAUTI bundle focused on insertion technique, appropriate indication, and routine assessment of urinary catheter necessity. From October 2010 through September 2016, VA nursing homes reported nationwide reductions of CAUTIs (51.2%; P < .0001) and CLABSIs (25.0%; P = .0009).

Keywords: Catheter-associated urinary tract infections; Central line-associated bloodstream infections; Nursing homes; Veterans; Veterans Affairs.

MeSH terms

  • Catheter-Related Infections / prevention & control
  • Central Venous Catheters / adverse effects
  • Cross Infection / prevention & control*
  • Humans
  • Infection Control / standards*
  • Nursing Homes / standards*
  • Patient Care Bundles
  • United States
  • United States Department of Veterans Affairs*
  • Urinary Catheterization / adverse effects
  • Urinary Catheters / adverse effects
  • Urinary Tract Infections / prevention & control