4 keys to preventing infections in nursing home residents

Nursing homes can take four steps to help residents avoid contracting infections associated with multidrug-resistant organisms (MDROs) or catheter use, according to new research.

Lona Mody, MD, MSc, an associate professor of internal medicine in the University of Michigan Health System, and colleagues created a multimodal intervention and tested its efficacy on older residents with urinary catheters, feeding tubes and other “indwelling devices” in a cluster randomized trial in 12 nursing homes. Residents in six of the homes received the intervention, and residents of the other six served as controls and did not receive the intervention.

The four steps:

1. Have professional caregivers use gowns and gloves when providing intimate care, including device care.
2. Conduct active surveillance for resistance organisms and report results to each intervention facility monthly.
3. Provide interactive hand-hygiene education.
4. Deliver a structured infection-prevention educational program targeted at healthcare professionals.

To test their program, the researchers took microbial samples and related data from participants at the beginning of the study, after 15 days and then once a month until a resident was discharged or stopped using an indwelling device. The study lasted for three years, during which time 203 people in the intervention group and 215 in the control group were enrolled. Over the three years, there were 34,174 device days of follow-up and 6,557 anatomic sites sampled.

The intervention group had 23 percent fewer MDROs, Mody and colleagues found. Catheter-associated urinary tract infections (CAUTIs) also were substantially reduced by the four interventions.

“This [National Institute on Aging]-funded study should lead to wider dissemination of similar models,” Mody says. “Next, we plan to implement key aspects of this model to a nationwide sample, in an effort to reduce [CAUTIs]. We are also investigating similar models in other high-risk groups in long-term care settings.”

Mody presented results of this study at the annual meeting of the American Geriatrics Society.

Related article: Catheter-associated UTI prevention guide released