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Top 10 Infection Prevention Questions to Ask a Nursing Home - Healthcare Quality Improvement Campaign
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What infections commonly occur
among residents in this facility?

Why is this question important? Nursing home
residents can have a higher chance of getting an
infection due to frailty from getting older, needing
more help from caregivers who may not have clean
hands, and open wounds or medical devices like
IV tubes going into their body that break the skin
providing a path for germs to enter the body. A
nursing home should be tracking the common
infections in its residents so they can be
sure that actions are taken (i.e., infection
prevention practices) to reduce the spread
of germs to residents.

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When was the last outbreak (i.e.,
infection spreading among residents)
in this facility?

What was the cause (e.g., flu,
norovirus, other)?
u Did the facility request assistance from
local public health authorities or any
other partners?
Why are these questions important? Shared
living spaces and lots of visitors can make it easier
for a contagious germ (like flu or diarrhea from
norovirus) to spread quickly through a nursing
home. While many facilities experience outbreaks,
early detection and quickly alerting
public health authorities can help limit
the spread of the infection to more
residents, staff and visitors.

How does the facility communicate
with residents, family and visitors
when an outbreak occurs?

Why is this question important? Outbreaks
of infections do occur in nursing homes. It is
important the facility staff have a process for
notifying residents, family members and visitors
so everyone can take steps to decrease the chance
of spreading the infection or getting ill. Sometimes
a facility might have to restrict visitation or stop
new admissions temporarily in order to stop an
outbreak. In those situations, it’s very
important that everyone is informed
about what is happening.

Is the flu vaccine mandatory for all
staff working in this nursing home?

What percentage of your staff received
the flu vaccine this year (or last year)?
Why are these questions important? A growing
number of healthcare facilities are making flu shots
a requirement for staff as a measure to protect
patients and staff from flu. In nursing homes, giving
a flu vaccine to staff can help reduce the spread of
flu in residents. Even if a flu vaccine isn’t mandatory
for staff, all staff should be offered the vaccine and
a nursing home should know how many of their
staff received the vaccine during the last
flu season. The nursing home should
also know what percentage of residents
received the flu vaccine during the last
flu season.

If a staff member is sick or has covid, is he/she
allowed to stay at home (or go home
from work) without losing pay or time off?

Why is this question important? Coming to work sick
is never a good idea, but it can be really dangerous if
a person is working with frail or older people who are
at increased risk for getting severe infections. Nursing
homes should have sick leave policies that
support staff to make the right decision to
stay home when they are sick.

How are facility staff trained to
respond to questions about hand hygiene
from residents and family?

Why is this question important? Cleaning hands
before and after care for a resident is an important
way to prevent the spread of infections. Residents and
family members should feel comfortable and
encouraged to provide helpful reminders to
busy staff about cleaning their hands

Are residents with new diarrhea given
separate toilet facilities until the cause
of their diarrhea is determined and/or
the diarrhea is resolved?

Why is this question important? When a person has
new diarrhea it’s important to rule out contagious germs
like C. difficile, as the cause. Diarrhea can contain large
numbers of the germs causing it. Some of these germs,
like C. difficile, are very tough and difficult to clean from
the environment. One way to prevent the spread
of infectious diarrhea is to have a separate toilet
for an ill resident until the diarrhea goes away.

How is shared equipment (e.g., objects
in the therapy area or common room)
managed to prevent the spread of germs?

Why is this question important? People can carry
germs on their skin or other parts of the body for long
periods of time without being sick. Having a process to
clean and disinfect shared equipment before
the next resident uses it is a way to ensure
these germs are not spread to others.

Does the facility have private rooms for
residents who develop signs or symptoms
of a potentially contagious infection like
new cough and fever or new vomiting and
abdominal pain?

If the facility does not have private rooms,
what precautions are taken?
Why are these questions important? When a resident
develops signs and symptoms which could be due to a
contagious germ, like flu or norovirus, one way to protect
the resident and others in the facility is to provide the
ill resident with a private room until the cause of their
symptoms is known. If a private room is not available,
the facility should have a process to prevent spread of a
contagious germ in a shared room. Other residents can get
sick from germs picked up from contaminated surfaces
or spread by unclean hands. Containing a
contagious germ quickly can prevent spread
to other residents, staff and visitors.

Does the facility provide educational
materials for residents and families on the
following topics?

Hand hygiene
u Use of gowns/gloves and other equipment
to prevent the spread of germs
u Antibiotic use policies/practices in this facility
u C. difficile
Why is this question important? Residents and families
are important partners in preventing the spread of
infections and reducing misuse of antibiotics. Nursing
homes should have materials to educate their residents,
families and visitors on the facility’s infection
prevention and antibiotic stewardship
policies, and steps they can take to support
a safe environment

What High Level Disinfection System do you use to prevent COVID outbreaks?

The facility should have a protocol in place to minimize all outbreaks including c-diff and COVID with disinfection services or equipment like the Pure Defense A4 unitl that eliminates covide in under 55 min per cycle..

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Top 10 Infection Prevention Questions to Ask a Nursing Home

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