Implementing Infection Prevention and Control (IPC) Practices Including COVID-19 Mitigation Strategies in a Skilled Nursing Facility

BACKGROUND: The All Facilities Letter (AFL) issued by the California Department of Public Health (CDPH) on November 9, 2020, informed all skilled nursing facilities (SNFs) of the passage of AB 2644 (Chapter 287, Statutes of 2020). This AFL requires SNFs to have a full-time, dedicated infection preventionist (IP), a plan for infection prevention, quality control, and annual infection prevention and control training for all healthcare personnel (HCP). Healthcare facilities are ideal settings for transmitting infections to residents, healthcare workers, their families, and communities. Therefore, the objective was to assess compliance with infection prevention and control and standardized practices in Hand Hygiene, Personal Protective Equipment (PPE) donning and doffing, and Catheter-Associated Urinary Tract Infection (CAUTI) prevention bundle. METHODS: Hand Hygiene, PPE, and CAUTI competencies were developed to increase awareness and compliance with standardized practices. Hand Hygiene and CAUTI champions representing every shift in the unit were created to lead SNF staff in observing IPC practices. A direct observation tool was utilized to gather data, and just in time, feedback was provided to staff when opportunities in non-compliance were identified. RESULTS: The compliance rate in Hand Hygiene, PPE, and CAUTI prevention in 11 months increased from 69 % to 99 %. CONCLUSIONS: Infection Prevention and Control practices are the most critical element in reducing healthcare-associated infection among residents and staff. Implementing IPC practices increased compliance in Hand Hygiene, PPE, and CAUTI prevention bundle. Comprehension of fundamental IPC practices is critical to health care systems, especially during a pandemic.