Infectious Disease: Partnering for Control and Prevention

Infectious disease can be deadly, especially for seniors. From the flu to bacterial pneumonia, these diseases account for 40 percent of deaths in older adults. They are caused by microorganisms, such as viruses, bacteria, fungi, or parasites, and can rapidly spread from person to person. Some infections, such as MRSA – the so-called “superbug” – are resistant to many antibiotics, further complicating control and prevention.

An infection often makes an underlying chronic condition worse and can lead to hospitalization and additional costs. To win the war on infectious disease outbreaks, many senior living communities are escalating their infection control and prevention initiatives and partnering with hospital-based infection prevention programs to share best practices.

Pinpointing the challenges

One organization taking a proactive stance against infectious disease is StoneGate Senior Living, a leading provider of senior living services in Texas, Oklahoma, and Colorado. “Skilled nursing and rehabilitation facilities encounter many challenges in effectively implementing and maintaining infection prevention programs,” says Rhonda Abercrombie, StoneGate’s corporate director of quality and infection control.

“Unlike patients in hospital rooms, residents in senior living communities typically frequent common spaces, from dining rooms to rehabilitation areas – and spend a lot of time breathing the same air. This can increase the risk of transmitting pathogens. We have stringent disinfection procedures because the many shared areas where our residents congregate can be breeding grounds for disease.

“If a resident tests positive for an infection, we proactively treat other residents who have similar symptoms, even if they haven’t yet been diagnosed. We want to nip any infections in the bud because they can spread so fast from person to person.”

Preparing for government mandates

Post-acute care facilities have traditionally lacked the specialized infection control training of hospitals, a challenge the Centers for Medicare & Medicaid Services (CMS) is addressing through new rules on infection control for long-term care facilities. “StoneGate communities, along with our industry colleagues nationwide, are working to comply with recent mandates from the federal government,” says Dianne Sullivan-Slazyk, StoneGate’s chief clinical officer. “These directives are designed to lower overall healthcare-associated infection rates, prevent harm to residents and healthcare providers, and reduce overall cost burdens to care delivery.”

To participate in the Medicare and Medicaid programs, CMS has mandated that long-term care facilities have a trained, certified, dedicated infection preventionist on staff by November 2019. Infection preventionists are experts in preventing and controlling the spread of infectious diseases among patients, staff, and visitors. They are responsible for developing, enforcing, and evaluating the effectiveness of infection control policies and procedures; investigating disease outbreaks; and training staff members in prevention.

An earlier CMS requirement mandated that facilities have a formal program in place for “antimicrobial stewardship” – a coordinated plan designed to optimize treatment of infections and promote appropriate use of antibiotics. StoneGate’s program was launched in 2017.

“A major concern with antibiotics is that they may not be effective in treating the specific infection a resident is fighting,” Abercrombie explains. “Or, the antibiotics given may be unnecessary. This can lead to increased risk of contracting Clostridium difficile, or ‘C. diff.,’ a bacterial infection that can spread rapidly. Antimicrobial stewardship helps ensure the right antibiotic is used at the right time – and only when it’s truly needed.”

Paving the way for a safety-first future

“An integrated healthcare delivery system is a prime opportunity for acute and post-acute care to collaborate in reducing infectious disease,” Abercrombie says. “We’re seeing many positive results from this combined effort nationwide.”

A notable success is the Veterans Health Administration (VHA), the nation’s largest integrated healthcare delivery system. The VHA implemented a systemwide MRSA prevention initiative within its hospitals, spinal-cord injury units, and nursing facilities that has significantly reduced MRSA rates across care settings.

Collaboration is particularly critical in preventing sepsis, a serious bloodstream infection that can quickly become life threatening. “Many post-acute care facilities are joining forces with acute care partners to promote early sepsis detection,” Sullivan-Slazyk explains. “For example, StoneGate has partnered with Methodist Charlton Medical Center in Dallas, TX, and Southwestern Medical Center in Lawton, OK, to educate healthcare teams through a “Suspect Sepsis, Save Lives” campaign. The goal is to increase staff awareness of sepsis signs and symptoms for immediate intervention.

“Heightened collaboration across the delivery system – coupled with the government’s focus on improving infection control in all healthcare settings – bodes well for the future of patient care. Together, we’re creating a continuing care network that delivers quality care, contains the spread of disease, and puts patient safety first.”