Nursing Home Infections
Nursing Home Infection Rates Are on the Rise
“Infections are a leading cause of deaths and complications for nursing home residents, and with the exception of tuberculosis we found a significant increase in infection rates across the board,” said lead study author Carolyn Herzig, MS, project director of the Prevention of Nosocomial Infections & Cost Effectiveness in Nursing Homes (PNICE-NH) study at Columbia Nursing.
“Unless we can improve infection prevention and control in nursing homes, this problem is only going to get worse as the baby boomers age and people are able to live longer with increasingly complex, chronic diseases.”
Types of Nursing Home Infections
Infections nursing home residents often are exposed to range from the common cold to the flu to pneumonia. Improper care and medical treatment can also lead to infections:
- Antibiotic Resistant Infections including Methicillin-resistant Staphylococcus Aureus (MRSA)
- Skin Infections including:
- Necrotizing Fasciitis (flesh-eating bacteria infection)
- Bacterial or Fungal Foot Infections (more common in residents with diabetes)
- Viral Infections, including Shingles (Herpes Zoster)
- Scabies Infections
- Ventilator-Associated Pneumonia
- Aspiration Pneumonia
- Sepsis and Pneumonia
- Gastrointestinal Infections— C. difficile
- Nursing Home Bedsores Causing Osteomyelitis
- Nursing Home Infections Overview
- Nursing Home–Acquired Pneumonia (NHAP)
- Respiratory Tract Infections—Pneumonia and Influenza
- Sepsis and Septic Shock
- Urinary Tract Infections
- Sexually Transmitted Diseases (STDs)
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The Risk of Infection Among Elderly Nursing Home Residents is High
As we age, our bodies naturally become more susceptible to illness, disease, and injury. Our immune systems also become weaker as we age, which is another reason the elderly are more susceptible to infections than the younger, general population.
The majority of nursing home residents are senior citizens who typically experience multiple chronic diseases and/or functional impairments, such as mobility issues that may contribute to bedsores which can become infected, or advanced diseases like diabetes which increase the risk of infections when blood sugars are not well controlled.
Medications, such as chemotherapy drugs, Disease-modifying antirheumatic drugs (DMARDs), and biologics (genetically-engineered proteins derived from human genes often used to treat bowel disorders, arthritis, skin conditions, multiple sclerosis, lupus and other serious autoimmune diseases) used to treat many conditions common to the elderly also increase the risk of contracting a serious infection in a nursing home facility.
Nursing home infections may result from:
- Natural decline in immune-system health
- Other conditions like diabetes, cancer, peripheral vascular disease, asthma, COPD
- Protein deficiency tied to malnutrition
- Thin skin and reduced mobility resulting in pressure sores and bedsores
- Antibiotic medication use which make make the elder more susceptible to getting an infection
- Decreased mobility
- Open flesh wounds and pressure sores, bed sores
- Recent urinary catheter use
- Recent feeding tube use
Nursing Homes Are Breeding Grounds for Infections
Nursing homes are busy places with people coming and going throughout the day. Visitors, staff, caregivers, medical professionals, and other residents are all potential sources of infections:
- Visitors who are actively ill, have an infection or are carriers of a disease or an infection.
- Staff members, including caretakers, medical staff, food staff, and volunteers who are actively ill, have an infection or are carriers of a disease or an infection.
- Transfer of infection from one patient or a surface to another due to a lack of proper training or failure to follow proper procedures when dealing with infections (i.e., staff must be properly trained in hygiene and nurses must be experienced in wound care in order to avoid the spread of infection.)
- New residents can introduce infections brought in from other sources (i.e., home, another nursing facility, hospital, clinic, etc.)
- Exposure to other infected residents or colonized resident.
- Outbreaks at other facilities, including hospitals and medical centers where a resident may be transported to for additional care or medical reasons.
The common occurrence and dire consequences of infectious disease outbreaks in nursing homes often go unrecognized and unappreciated. Nevertheless, these facilities provide an ideal environment for acquisition and spread of infection: susceptible residents who share sources of air, food, water, and health care in a crowded institutional setting.
Moreover, visitors, staff, and residents constantly come and go, bringing in pathogens from both the hospital and the community. Outbreaks of respiratory and gastrointestinal infection predominate in this setting, but outbreaks of skin and soft-tissue infection and infections caused by antimicrobial-resistant bacteria also occur with some frequency.
Nursing Home Responsibilities
The risk of infection is high for nursing home residents, therefore, nursing homes have a duty to residents to minimize the risk of infection, and to keep infections that do occur, from spreading.
Nursing homes must ensure that nurses and all staff that provide care to residents are qualified and properly trained in all aspects of their jobs. Wound care, dosing of medications, and disease management are all part of nursing home care. If a nursing home is negligent in the care of any of their residents they may be held liable for harm caused to a resident, including contracting an infection.
Nursing homes must devise and implement effective infection control programs. Delays in diagnosing and treating infections can also contribute to the spread of infections among nursing home residents.
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