Causes Of Infections In Long-Term Care Facilities

Introduction:

Long-term care is a broad category of facilities or services that provide care to patients or clients for over a few months. Long-term care can be either temporary or permanent, and it can even include hospice care. In addition, the care can be medical or rehabilitation in nature. A residential setting with different levels of assistance can also be referred to as long-term care. The size of long-term care facilities varies depending on their purpose, clientele, and location.

Living in a long-term care facility comes with some risks, the most serious of which is an increased risk of infection, which may lead to sepsis. Sepsis, also known as blood poisoning, is the body's life-threatening response to infection. Sepsis is a medical emergency that requires prompt diagnosis and treatment. Sepsis has killed and disabled millions of people and requires early detection and treatment for survival.

What Increases the Risk of Infections in a Long-Term Care Facility?

Many factors can add to the cause of an infection in a long-term facility, it includes:

• Catheter or ventilator use.

• Injections.

• Frequent visitors.

• Facilities or equipment that has not been cleaned properly.

• Surgery.

• Spread of infections among patients and from a healthcare worker to a patient.

What Causes Infection in Long-Term Care Facilities?

Living in a long-term care facility allows you to interact with many people, from other residents and visitors to facility employees. However, the more people come and go, the more likely certain illnesses will be brought into and spread throughout the facility. Healthcare-acquired infections, or HAIs, are infections acquired in a hospital or long-term care facility.

Some of the causative agents of infections in long-term facilities include:

• Gram-negative bacteria are capable of causing infections such as pneumonia, bloodstream infections, and meningitis. This also includes Acinobactere infections, which are uncommon outside a healthcare facility.

• Clostridioides difficile (C. difficile) is a germ that causes colon inflammation and a highly contagious form of diarrhea.

• MRSA (methicillin-resistant Staphylococcus aureus) is an infection resistant to common antibiotics such as Penicillin, Amoxicillin, and Methicillin. MRSA is typically found as a skin infection outside of healthcare facilities. MRSA infections can be fatal and can be contracted inside healthcare facilities. Other antibiotics, such as Carbapenem and Vancomycin, are effective against other infections.

• Hepatitis is a group of viral infections that affect the liver and are easily spread in hospitals.

If someone in a long-term care facility becomes too ill for the facility to handle, they may need to be transported or admitted to a hospital. The following are the five most common infections that require a hospital transfer and admission:

• Pneumonia: The leading cause of death among long-term care facility residents is pneumonia and related lower respiratory tract infections. Nursing home pneumonia occurs at 0.3 to 2.3 episodes per 1,000 resident care days. Residents who used feeding tubes were at the greatest risk of contracting pneumonia.

• Urinary Tract Infections: Urinary tract infection (UTI) is the most common infection in nursing homes and other long-term care facilities. It is also the most over-diagnosed infection among the residents. The presence of an indwelling catheter increases the risk of urinary tract infections and bacterial sepsis. Each day the catheter remains in place, approximately 3 to 7 percent of residents will develop a urinary tract infection. By the 30th day, nearly all residents will have bacteria in their urine. Symptomatic urinary tract infections will affect half of all long-term care facility residents. Those who have indwelling catheters have a higher mortality rate than those who do not have a catheter.

• Wound Infections: Chronic wound infections, such as infected pressure ulcers, vascular ulcers, and diabetic wound infections, are more common. Intertrigo, tenia versicolor, herpes zoster, scabies, and herpes simplex are all skin infections.

• Meningitis.

• Endocarditis.

Due to their treatments, people in long-term care facilities may be more vulnerable to infections. For example, they could use a long-term or indwelling urinary catheter, leading to a urinary tract infection. Other chronic invasive devices that can cause infection include a ventilator tube, a port, or an intravenous site. These devices create openings in the body through which germs can enter and cause an infection.

Residents with frail skin are more likely to develop scratches, skin tears, other wounds, and pressure ulcers (bed sores), all of which can become infected. One of the common sources of infection among long-term care facility residents is wound infection, particularly pressure ulcers. In addition, people with difficulty swallowing may aspirate (inhale) food or drink, leading to aspiration pneumonia.

How Are Infections in a Long-Term Care Facility Treated?

Infections in long-term care facilities can cause illnesses ranging from minor to severe and potentially fatal. The treatment is determined by the infection. Some people respond to antibiotic treatments that are carefully chosen, while some can be extremely difficult to treat due to antibiotic resistance. As a result, the best treatment for infections in long-term care facilities is prevention.

How Can Infections in a Long-Term Care Facility Be Prevented?

People who volunteer or work in long-term care facilities must be aware of infection prevention practices. These include:

• Washing hands in between moving from each patient or resident to another for providing care.

• Using safety protocols (gloves, gowns, or masks) wherever necessary.

• Cleaning rooms and objects following the facility's protocol.

• Isolating patients or residents who exhibit symptoms of illness.

However, visitors to these facilities also play a role in infection prevention. This includes the following:

• Avoid visiting if one is sick, even if it is "just a cold.”

• Wash the hands properly using soap or an alcohol sanitizer when entering the facility and returning to the patient or resident.

• Any signs of open wounds, infection, or illness displayed by the patient or resident must be reported to the staff.

• Be up to date on all vaccinations.

Conclusion

Infections in a long-term care facility are common but avoidable situations. There are several ways for an infection to occur, so it is critical to be vigilant in preventing and treating it as soon as it occurs.