Infection Control


Nursing homes are required to establish and maintain an infection prevention and control program. This program must be designed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections.


Infection control practices in a long-term care facility, or hospital, apply equally to all personnel, consultants, contractors, residents, visitors, volunteer workers, and the public, regardless of race, color creed, national origin, religion, age sex, handicap, marital or veteran status, or payor source.


Objections of an infection control policy and practice should include:

  • Prevent, detect, investigate and control infections

  • Maintain a safe, sanitary, and comfortable environment

  • Establish guidelines for implementing Isolation Precautions

  • Establish guidelines for the availability and accessibility of supplies and equipment necessary for standard and transmission-based precautions.

  • Maintain records of incidents and corrective actions related to infections and

  • Provide guidelines for the safe cleaning and reprocessing of reusable resident-care equipment


                                                                                             Prevention and Control

Infectious organisms may be transmitted by direct contact or indirect contact. Since healthcare staff and resident care equipment often move from person to person, they can serve as a vehicle for transferring infectious organisms.


Personal protective equipment (PPE): protective items or garments worn to protect the body or clothing from hazards that can cause injury and to protect the residents from cross-transmission. PPE items include but are not limited to:

  • Gloves

  • Gowns

  • Facemasks

  • Protective eyewear

  • hairnet


Direct Contact

  • Also known as person to person

  • Occurs when microorganisms are transferred from an infected or colonized person to another person

  • May occur in common areas of the facility, such as dining room


Indirect Contact

  • Involves transfer of an infectious agent through a contaminated inanimate object or person

  • Examples of opportunities for indirect contact:

    • Clothing

    • High touch environmental surfaces, such as hand rails, bedside table, sinks, etc.

  • Some pathogens can contaminate an object and live for an extended period of time:

    • C. difficile spores can live on a surface for up to 5 months

    • Hepatitis B virus can last up to a week on a surface

    • Influenza virus can survive up to 8 hours



Different levels of safety precautions have been designed to help reduce the transmission of infectious organisms.


Standard Precautions: Applies to all resident care, regardless of suspected or confirmed infection status of the resident. This is based on the principle that all blood, body fluids, secretions, excretions except sweat and mucous membranes may contain transmissible infectious agents. Standard precautions include but are not limited to:

  • Hand hygiene

  • Use of gloves, gown, mask or eye protection

  • Safe infection practices

  • Respiratory hygiene/cough etiquette


Contact Precautions: Measures intended to prevent transmission of infectious agents which are spread by direct or indirect contact with the resident or the resident’s environment. Requires the use of appropriate personal protective equipment:

  • Gown and gloves upon entering the room/before making contact with the resident or resident’s environment

  • PPE is removed, and hand hygiene performed before leaving the resident’s room


Droplet Precautions: Designed to reduce/prevent the transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions.

  • Area of defined risk is approximately 3-10 feet

  • Facemasks required upon entry if coming within 3 feet of resident

  • Gloves and gown should be worn if coming into contact with resident or contaminated surface

  • Private room preferred if available


Airborne Precautions: Intended to prevent or minimize the transmission of infectious agents that remain infectious over long distances when suspended in the air. Rare in long-term care.

  • Requires fit-tested N95 or higher-level respirator that is donned prior to room entry

  • CDC requires special air handling and ventilation systems



Handwashing is the single most effective way to break the cycle of infection.


Staff must perform hand hygiene, even if gloves are used:

  • Before and after contact with the resident

  • Before performing an aseptic task

  • After contact with blood, body fluids, visibly contaminated surfaces or after contact with objects in the resident’s room

  • After removing personal protective equipment (gloves, gown, facemask)

  • After using the restroom

  • Before meals


How to wash your hands:

  • Wet your hands with clean running water and apply soap

  • Lather your hands by rubbing them together with the soap

  • Scrub all surfaces, including palms, backs, fingers, between fingers and under your nails

  • Keep scrubbing for 20 seconds, or hum the “happy birthday” song twice

  • Rinse your hands under clean running water

  • Dry your hands using a clean towel or air dry them


The use of alcohol-based hand rub is acceptable; however, you still need to wash your hands if they are visibly soiled and after using the restroom.

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