Effect of a comprehensive infection control program on the incidence of infections in long-term care facilities

Background: Control of infection within the long-term care facility is a da unting problem. Elderly patients are at high risk for contracting infection because of reduced innate immunity, malnutrition, and the presence of chro nic medical conditions. This small study tested the effect of developing an d implementing a comprehensive preventive infection control program in the long-term care setting and examined the resultant incidence of infections. Methods: Eight private, freestanding, long-term care facilities in urban an d suburban settings were selected for the study. The 4 test sites had a tot al of 443 beds: there were 447 beds in 4 marched control sites. Data on inf ection rates were accrued in both preintervention and intervention years. T he control homes maintained their existing infection control policies and p rocedures. The test homes were provided with an infection control education al program and replaced all currently used germicidal products with single- branded products for a 12-month period. A criteria-based standardized infec tion control surveillance system was used to monitor and report infections in all facilities. Results: In the preintervention year, the test sires experienced 743 infect ions (incidence density rate, 6.33) and the control homes experienced 614 i nfections (incidence density rate, 3.39). In the intervention year, the tes t homes reported 621 infections, a decrease of 122 infections (incidence de nsity rate, 4.15); in the control homes, the number of infections increased slightly, to 626 (incidence density rate, 3.15). The greatest reduction in infections in the test homes was in upper respiratory infections (P = .06) . Conclusions: This study provides additional evidence that a comprehensive i nfection control program that includes handwashing and environmental cleani ng and disinfecting may help reduce infections among the elderly residing i n long-term care settings.