Study Finds Infection Control Violations at 15 Percent of U.S. Nursing Homes

Washington, DC, 3 May, 2011 – Fifteen percent of U.S. nursing homes receive deficiency citations for infection control per year, according to a new study published in the May issue of the American Journal of Infection Control, the official publication of APIC - the Association for Professionals in Infection Control and Epidemiology.

Conducted by a team of researchers at the University of Pittsburgh’s Graduate School of Public Health, the study analyzed deficiency citation data collected for the purpose of Medicare/Medicaid certification between 2000 and 2007, representing approximately 16,000 nursing homes per year and a panel of roughly 100,000 observations. The records analyzed represent 96 percent of all U.S. nursing home facilities. The team discovered a strong correlation between low staffing levels and the receipt of an infection control deficiency citation.

Infections are the leading cause of morbidity and mortality in nursing homes, responsible for nearly 400,000 deaths per year. Although this has been the focus of mainstream media attention, very little empirical research has been conducted on the subject.

The Centers for Medicare and Medicaid Services (CMS) requires that nursing homes be certified before receiving reimbursement for Medicare and/or Medicaid residents. As part of this certification process, facilities that do not meet certain standards are issued deficiency citations. This study examined the deficiency citation for infection control requirements known as the F-Tag 441.

“Our analysis may provide some clues as to the reason for the persistent infection control problems in nursing homes,” state the authors. “Most significantly, the issue of staffing is very prominent in our findings; that is, for all three caregivers examined (i.e., nurse aides, LPNs and RNs) low staffing levels are associated with F-Tag 441 citations. With low staffing levels, these caregivers are likely hurried and may skimp on infection control measures, such as hand hygiene.”

The authors conclude, “The high number of deficiency citations for infection control problems identified in this study suggests the need for increased emphasis on these programs in nursing homes to protect vulnerable elders.”

A number of states have enacted legislation that applies to infection prevention practices in long-term care facilities. Illinois is poised to pass legislation requiring an infection preventionist in each skilled nursing facility.

(AJIC 2011; 39 [5])

Full text of the article is available to journalists upon request; contact Liz Garman, APIC, +1 202-454-2604, egarman@apic.org to obtain copies.

# # #


About Ajic: American Journal of Infection Control
AJIC: American Journal of Infection Control ( www.ajicjournal.org) covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC - the Association for Professionals in Infection Control and Epidemiology - AJIC is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. AJIC also publishes infection control guidelines from APIC and the CDC. Published by Elsevier , AJIC is included in MEDLINE and CINAHL.

About APIC
APIC’s mission is to improve health and patient safety by reducing risks of infection and other adverse outcomes. The association’s more than 14,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities around the globe. APIC advances its mission through education, research, collaboration, practice guidance, public policy and credentialing. Visit APIC online at  www.apic.org . For consumer-related information, visit  www.preventinfection.org. Follow us on Twitter:  http://twitter.com/apic.

Notes for Editors

“Nursing Home Deficiency Citations for Infection Control,” appears in the American Journal of Infection Control, Volume 39, Issue 5 (May 2011), published by Elsevier.

Authors:

Corresponding Author: 

Nicholas G. Castle, PhD, Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA

Laura M. Wagner, PhD, RN, New York University College of Nursing, New York, NY

Jamie C. Ferguson-Rome, MHA, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA

Aiju Men, MS, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA

Steven M. Handler, MD, MS, CMD, University of Pittsburgh School of Medicine, Department of Biomedical Informatics, Pittsburgh, PA

About Elsevier
Elsevier is a global information analytics company that helps institutions and professionals progress science, advance healthcare and improve performance for the benefit of humanity. Elsevier provides digital solutions and tools in the areas of strategic research management, R&D performance, clinical decision support, and professional education; including ScienceDirect, Scopus, ClinicalKey and Sherpath. Elsevier publishes over 2,500 digitized journals, including The Lancet and Cell, more than 35,000 e-book titles and many iconic reference works, including Gray's Anatomy. Elsevier is part of RELX Group, a global provider of information and analytics for professionals and business customers across industries. www.elsevier.com

Media Contact
Liz Garman
+1 202-454-2604
egarman@apic.org