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Strategy for Skilled Nursing Facilities: Expand Infection Prevention Resources

The current COVID-19 pandemic has highlighted the critical importance of infection prevention in skilled nursing facilities (SNFs), as well as the gaps in infection prevention expertise and staffing throughout the state. The Center for Health Care Quality (CHCQ) Healthcare-Associated Infections (HAI) program is proactively addressing these gaps by using a three-pronged approach:
  • Increase the number of Infection Preventionists in the state HAI program;
  • Develop infection prevention support models for local health departments (LHDs);
  • Develop infection prevention training for SNF staff, and metrics to assess the level and quality of infection prevention activity in SNFs.

A woman wearing personal protetctive equipmentAt the state level, the HAI program is working towards hiring additional Infection Preventionists, and securing long-term funding to maintain increased staffing levels. These Infection Preventionists provide expert support and consultation to LHDs statewide. Establishing funding for additional, permanent Infection Preventionist positions will enable the HAI program to provide coordinated, mission-critical infection prevention support to all of California's LHDs.

At the local level, LHDs may sometimes struggle with adequate resources to robustly conduct infection prevention activities. Earlier this year, the HAI program surveyed LHDs to assess current infection prevention staffing, training, and activities. These surveys revealed themes in relation to county size and LHD resource levels as indicated in the graph below.

The HAI program is utilizing LHD assessment findings in the development of infection prevention support models that will assist LHDs in increasing their own infection prevention capacity. This includes:

  • Developing an online repository of best practices, toolkits, and innovative approaches to staffing, and training on the HAI program web pages;
  • Adapting existing training and developing new trainings focused on practical infection prevention training needs in LHDs;
  • Marketing of HAI program services available to LHDs via the HAI program web pages and weekly e-mail updates.
The HAI program will measure the impact of infection prevention support models across LHDs to determine how counties are building better infection prevention resource capacities. These metrics include HAI team infection prevention consultations provided to LHDs, the number of new trainings and LHD participation, pre and post self-assessment of IP knowledge, and post-training survey feedback of intent to implement infection prevention strategies and best practices.

At the facility level, SNFs are required to have a staff member designated to fulfill infection prevention responsibilities; however, SNF-designated infection prevention staff are often not allocated the time needed to attend to infection prevention education, or to prioritize and conduct these activities. The HAI program is collaborating with stakeholders to develop infection prevention training for SNF staff and metrics to assess the level and quality of infection prevention activity in SNFs. Establishing appropriate infection prevention staffing standards will equip SNF-designated infection prevention staff with critical training and knowledge who are better able to address COVID-19 and other contagious infection concerns in facilities.

Contact :

COVID-19 Healthcare Asociated Infections program

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