Hacking Infection Control in Nursing Homes

COVID-19 revealed large lapses in our healthcare system’s infection control.  The global pandemic killed nearly 136,000 nursing home residents and more than 2,000 workers.  Infection control isn’t a new problem though; nursing home residents make up less than 1% of the U.S. population, yet they accounted for 20% of COVID-19-related deaths in the United States.  On top of this, low-income seniors were hospitalized for COVID-19 at more than four times the rate of other Medicare beneficiaries. 

Nursing homes are infamously known for their lack of poor infection control practices.  Before the pandemic, almost 400,000 nursing home residents died due to infection annually.  Common infections include urinary tract infections, respiratory infections, skin and soft tissue infections, gastroenteritis, and influenza.  Infection control was the most commonly cited deficiency on state surveys for nursing homes; 40% of nursing homes were cited for poor infection control practices.  Another example of a lack of proper infection control practices is the fact that between one and three million serious infections occur every year in skilled nursing facilities.

During the pandemic, more than 300 nursing homes closed, and post-pandemic, more than 400 certified United States nursing homes are on the brink of shutting down — double the pre-pandemic rate.  These closings are occurring because most facilities are losing money; on average, nursing homes are operating at a margin of -4.8% per year.  It isn’t just homes that are experiencing shortages.  Since January 2020, roughly 236,000 caregivers have left; that’s 15% of the total nursing home workforce.  Almost 90% of healthcare organizations are experiencing a staffing shortage.  Nurses are key to infection control, but two years into the pandemic, nurses report feeling stressed, frustrated, overwhelmed, and undervalued.  Higher stress levels and increased workloads often lead health workers to skip simple practices like washing their hands. 

How can nursing homes hack these issues?  Simple changes in infection control prevention can make a significant difference.  Distributing new practices and guidelines in print online is not as effective as in-person support.  Nursing homes need to provide a more personalized and hands-on approach.  One day of in-person training is more valuable than months of searching and studying online material.  In-person training allows a worker to see what’s working and what isn’t, starting with the basics and working towards higher-level practices.  Proper infection control helps nursing home facilities hack infection control issues and learn more about the problems and solutions facing the system.