With the uptick of COVID-19 and its variants -- especially the highly contagious Delta variant -- now is a great time for long-term care (LTC) leaders to ensure their facility-designated Infection Preventionists (IPs) are equipped for what lies ahead. 

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Although we learned very early in the pandemic there was a lack of systems in place to prevent, and/or control communicable diseases, many LTC facilities have been unable to dig themselves out of the hole dug by the pandemic to put these systems into place. The struggle to fill staffing shortages, manage the decrease in census, IP-focused surveys and widely issued IJ’s have taken priority over structuring the IP program. Now, due to the multitude of unfortunate events that occurred over the last year, a majority of long-term care facilities are still in this recovery phase and, as we say in the South, are “sittin’ ducks.”

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COVID-19 will continue to mutate and find a way to stick around. That is, unfortunately for us, what RNA viral pathogens do. And with the daily increase in cases of these variants among the vaccinated and unvaccinated, long-term care facilities must make their Infection Prevention and Control Program (IPCP) a priority. Today.

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COVID is not the only risk to your residents. I see too many facilities that rule out COVID-19 and stop there. Although it is reassuring when your resident tests negative for COVID-19, there was a reason you tested them. The symptoms the resident exhibited that alerted you to test for COVID-19 are being caused by something. It is your responsibility to determine what. 

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F880, which continues to remain the highest issued citation in LTC, states that a facility’s IPCP must include a system of surveillance designed to identify possible communicable diseases or infections before they can spread to other persons in the facility. It does not say after they can spread to other persons. It does not say the system should be designed to only identify COVID. To ensure your facility has a system of surveillance in place to protect your residents and staff from COVID-19, its variants, and the many other pathogens and multi drug resistant organisms (MDROs) that are out there, it is essential for IPCP to have a strong foundation and that starts with the IP.

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As an industry, LTC has set IPs up for failure. Regulations were set with specific requirements for facilities to have an IP, but there was a lack of guidance given for this position. IPs are tasked with structuring and implementing a vast, facility-wide program that touches every aspect and department in a nursing home concerning infection control and prevention, yet the IP often is not provided with the playbook when stepping into this position; that is because there usually isn’t one. Sure, most facilities today have a binder or computer program full of policies and procedures that is considered their “program,” but it is useless if it has not been put into action and known by all staff.

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I have conversations with new IPs weekly and the most common statement I hear is, “I don’t know where to start.” An effective IPCP should run like a fine-tuned machine, and when a new IP steps in, the program and its systems should be clear enough that the new IP can step in and ensure it continues to run properly.

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Is it possible the lack of system and program structure, as well as the lack of education, leadership, and guidance provided, has contributed to the high turn-over rate for the LTC designated IP? Probably. Is it possible to start today and give your IP the tools and support they require to implement a thorough and effective IPCP that ensures the safety of your residents and staff? Absolutely.

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Ensuring your facility’s designated IP is adequately prepared is the first step toward success.

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If you have an IP, that’s a great start. Now you need to ensure they have the support they need. They need someone they can lean on -- someone with expertise in infection prevention and control that is able to provide them with guidance and offer them continuous support, so they do not feel overwhelmed. Whether this is someone internal or a company that offers these services, make this a priority. Additionally, as a team, facility leadership should work alongside the IP to ensure the systems, policies, and procedures are not only in place, but also that they fit your facility.

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Staff education is next on the list. Ongoing education presented in a clear and concise manor should be provided to all staff continuously.  A monthly in-service training that covers the required by State topics does not guarantee your staff has a clear understanding of why they should follow the infection prevention and control best practices. Education does not have to be lengthy but should be timely and proactive.

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If you do not have an IP, or if you have one in title only (someone who’s wearing many other hats), make filling this standalone position a priority. But before putting someone in this position, make sure they step into this position with support, structure, and education available.

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AMS Infection Prevention Partners can help. We offer IP mentorship and training, and we can help you put the support into place so that your IP can succeed. Mentoring IPs is one of the most fulfilling parts of my job, and I’d love to meet you. Drop us a line today.

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