What Should Nursing Homes Do to Prevent Infections?
Infections are a pressing concern for nursing homes, exacerbated by resident vulnerabilities such as chronic health conditions, weakened immune systems, and frequent interaction with both staff and visitors. The Covid-19 pandemic only served to highlight the lack of infection control and prevention strategies in many facilities.
Effective prevention requires a comprehensive strategy encompassing strict hygiene protocols, staff training, early detection, and timely medical intervention. Failure to meet these requirements may constitute elder abuse. Let’s look at some of the key measures nursing homes should take to prevent and control outbreaks — and which residents are most at risk.
Hygiene and Sanitation. Hygiene is the first line of defense against infections in nursing homes. Staff should follow rigorous hand-washing procedures, especially after providing personal care or handling medical equipment. Proper use of personal protective equipment (PPE) — such as gloves and masks — is critical. Facilities must maintain excellent cleanliness standards by regularly disinfecting surfaces, communal areas, and shared equipment.
Infection Control. Nursing homes must have thorough infection control programs, including monitoring, early detection, and rapid response. Comprehensive programs should include:
- Routine audits
- Maintenance of sufficient PPE supplies
- Appropriate isolation of infected residents
- Staff training to recognize early symptoms (e.g. cough, fever, skin changes) and act quickly to contain the spread
Vaccinations. Vaccines play a key role in preventing illnesses like flu, pneumonia, and Covid-19. Programs should include both residents and staff, ensuring vaccines are current and readily available.
Catheter and Device Management. Residents with invasive devices (e.g. catheters, IV lines, feeding tubes) face higher infection risks. These devices must be cleaned regularly, replaced on schedule, and monitored for signs of infection. Nursing homes should only use catheters when medically necessary, and ensure removal as soon as possible to lower the risk of UTIs.
Dietary Modifications and Swallowing Assessments. Residents with swallowing difficulties (dysphagia) are at greater risk for aspiration pneumonia. Speech-language pathologists should conduct regular swallowing assessments. Dietary changes, such as pureed foods or thickened liquids, help prevent aspiration. Proper meal positioning and trained supervision during eating are also essential.
Regular Health Assessments and Screening. Ongoing health checks — monitoring vital signs, respiratory function, and skin condition — can catch infections early. Screenings for MRSA or C. diff should be performed when residents exhibit symptoms or arrive from another healthcare setting.
Oral Care. Good oral hygiene reduces respiratory infection risks, particularly aspiration pneumonia. Neglect can allow bacteria to accumulate and enter the lungs. Residents should also receive daily brushing, flossing, and regular dental checkups — with close attention paid to those who cannot perform these tasks independently.
Isolation and Quarantine Measures. When a contagious infection (e.g., MRSA, C. diff) is diagnosed, facilities should promptly isolate the resident. This includes proper signage, dedicated staff, and restricted communal access. Dignity and quality care must persist during any isolation measures.
Staff Training and Education. Regular training reinforces infection control procedures, proper PPE use, safe equipment handling, and symptom recognition. Ongoing education helps staff stay prepared to prevent and manage infections.
Who is Most At Risk of Infection?
Elderly nursing home residents are especially prone to infections due to the natural decline of the immune system with age. As immunity weakens, the body becomes less capable of defending against pathogens. In communal settings such as long-term care facilities, these infections can spread rapidly.
The most at-risk groups among nursing home residents are:
Bedbound or Immobile Residents. Residents who are unable to move independently face higher risks of infection, particularly from pressure injuries and pneumonia.
Cognitively Impaired Residents. Residents with dementia, Alzheimer’s disease, or other cognitive impairments may not recognize or communicate symptoms of infection. They may also struggle to follow preventive practices like hand-washing or reporting discomfort. As a result, infections often go unnoticed until they become severe.
Immunocompromised Residents. Individuals with weakened immune systems are at very high risk. Even minor infections can escalate into life-threatening illnesses such as sepsis or pneumonia. These vulnerable residents require strict infection control measures to safeguard their health.
Incontinent Residents. Residents experiencing bladder or bowel incontinence are more susceptible to skin infections, UTIs, and complications from prolonged exposure to moisture. The risk of UTIs is particularly grave, as bacteria such as E. coli can migrate from the skin or soiled clothing into the urinary tract.
Residents with Invasive Devices. Those who require catheters, feeding tubes, or intravenous (IV) lines are at heightened risk due to the direct pathways devices provide for bacteria to enter the body.
Residents with Chronic Conditions. Chronic illnesses such as diabetes, heart disease, COPD, and kidney disease weaken the body’s ability to fight infections and delay recovery. (For example, diabetes impairs circulation and slows wound healing, thereby increasing susceptibility to infections such as staph and MRSA.)
If your loved one has suffered an infection in a long-term care facility, we can help you determine whether or not elder abuse has occurred. For a free consultation with a San Francisco/Bay Area or Los Angeles elder abuse attorney, contact Dudensing Law here.
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