Monday, November 27, 2023

Infection Control Manual For Assisted Living Facilities

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Safe Disposal Of Waste

Preparing Nursing Homes and Assisted Living Facilities for COVID-19

Different types of waste will be produced within care homes.

Some waste may be disposed of through the domestic waste route but other types of waste needs special handling and disposal for example sharps and waste from people who have or may have an infection.

Waste bags in care settings may be colour coded to denote the various categories of waste.

Local procedures and policies on waste disposal must be followed.

How To Use This Guide

This guide is divided into four sections, some of which have multiple subsections. Each section and subsection is arranged into four categories:

Key Messages are high-level takeaways for each topic.

Basic Background provides general information about each topic. It is designed to give simple “what” and “why” know-how.

Practice Tips are actions to take to reduce the risk of infections in long-term care facilities.

Communication Tips offer ways to talk with residents, families, coworkers, and others about infection prevention.

Handling Resident Care Equipment

All reusable equipment and supplies, electronics, personal belongings, etc., should be dedicated to the use of the resident who is considered exposed to, or suspected or confirmed to have COVID-19. If reuse with other residents is necessary, the equipment and supplies should first be cleaned and disinfected with a hospital-grade disinfectant for the recommended contact time. Items that have been cleaned and disinfected should be clearly identified as such and stored separately from any non-clean and non-disinfected items.

Single-use disposable equipment should be discarded into a no-touch waste receptacle immediately after use.

Upon resident discharge, items that cannot be appropriately cleaned and disinfected should be discarded. Resident-owned items with hard surfaces should be cleaned and disinfected, and all items placed in a bag for family or a representative to take. Resident items and laundry should be handled with gloves and then cleaned and disinfected or laundered with regular laundry soap and hot water followed by handwashing and prior to subsequent use. Unwanted items should be discarded.

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Outbreaks And Universal Testing

Outbreaks of COVID-19 in congregate care facilities are defined as five cases or more within a fourteen day period. This may include both residents as well as staff.

When a congregate living setting has a single case of confirmed COVID-19 among staff or residents, Maine CDC recommends universal testing for all other staff and residents in the unit or building. Universal testing in this context refers to testing done by unit or building, not at a facility level, unless staff are shared or rotate among various units or buildings.

Applications Designs Survey Assistance

Virginias Assisted Living Rules and Regulations

Application Evaluation and Assistance – We can provide your organization with a detailed review ofyour application materials for an Assisted Living Residence license or, we can complete theapplication paperwork and assemble the required attachments for you. Our application evaluation toolwill ensure that all regulatory requirements are considered and that your application is fullycomplete for state review.

Building Plans Consultation – We can review your proposed floor plans to ensure the design meet boththe state regulatory requirements but also meets the care needs of your residents.

Mock Surveys – To help your organization better prepare for an upcoming state licensing survey ourteam can conduct an onsite survey that will be more thorough that what you will experience duringthe licensing inspection. We will conduct a thorough exit conference and provide technicalassistance to correct any regulatory deficiencies.

Plan of Correction Assistance – we can assist your organization in completing a Plan of Correctionfor your state surveyor.


Direct Care Worker Training – We can provide training content on the following topics to yourtraining manager. These training resources are designed for new direct care workers.


We will provide the appropriate assisted living-related forms for your state. Where appropriate, wecan complete, provide, or spend time with you reviewing the material and/or processes covered by theform. The forms provided may include the following:

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What Needs To Be Reported

The recipient will report on the use of NHIC payments associated with the following infection control expenses as outlined in the Terms and Conditions:

  • Costs associated with administering COVID-19 testing
  • Reporting COVID-19 test results to local, state, or federal governments
  • Hiring staff, whether employees or independent contractors, to provide patient care or administrative support
  • Providing additional services to residents, such as technology that permits residents to connect with their families if the families are not able to visit in person
  • Other expenses incurred to improve infection control, including activities such as implementing infection control mentorship programs with subject matter experts or changes made to physical facilities
  • PRF recipients that received only NHIC payments will not report on lost revenues. Per the Terms and Conditions of payment, NHIC payments may not be used to reimburse lost revenues.
  • The interest earned on Nursing Home Infection Control Distribution payments must be reported separately from interest earned on other PRF payments

Recipients may use NHIC payments for eligible expenses to prevent, prepare for, and respond to coronavirus. The recipient must not use NHIC funds to reimburse expenses that have been reimbursed from other sources or that other sources are obligated to reimburse. The reporting entity will report expenses by calendar year quarter. Calendar year quarters are defined as follows:

  • Healthcare Related Expenses
  • Safe Management Of Sharps In Your Care Home

    sharps handling must be assessed, kept to a minimum and eliminated if possible with the use of approved safety devices

    always dispose of needles and syringes as a single unit immediately at the point of use

    sharps containers need to be assembled and labelled correctly

    use the temporary closure mechanisms in between use

    if a safety device is being used safety mechanisms must be deployed before disposal

    follow manufacturers instructions for safe use and disposal

    do not re-sheath used needles or lancets

    do not store sharps containers on the floor

    ensure sharps containers are not accessible to residents or the public

    sharps containers must not be more than three-quarters full.

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    Standards Manual For Assisted Living Accreditation Program Available Electronically


    On July 1, 2021, The Joint Commission will begin accepting applications for a new Assisted Living Communities accreditation program. Well be sharing more information about specific standards for ALCs in the coming weeks but I wanted to make you aware of a new opportunity to review them. Organizations can now view the program accreditation standards by requesting a free 90-day trial of E-dition®, the electronic standards manual. Standards Development ProcessThe ALC standards were developed with consideration to scientific evidence and best practices, as well as state regulations and Life Safety Codes. Experts were actively engaged in a collaborative effort to design standards that align with quality care delivery and safe practices in all aspects of an assisted living community including, but not limited to, the following:

    • infection control

    The ultimate goal of the program is to address the rights of the resident to maintain independence and to receive the care and services needed to promote a high quality of life in a safe environment. This program is built upon the premise that ALCs are homes first and locations of health care delivery second.

    In addition to an extensive internal review of the standards by subject matter experts, The Joint Commission elicited feedback and expert guidance from the following:

    Debbie Holzer RN, is Project Director, Clinical, Department of Standards and Survey Methods at The Joint Commission.

    Infection Control Assessment & Response Program

    Infection Control

    APIC Consulting has conducted ICAR assessments in many states, on behalf of their state health departments. During the COVID-19 global pandemic, APIC Consulting, has provided up to 16 interim infection preventionists for a state health department on part-time and full-time basis from May 2020 to the present. These consultants address COVID-19 outbreaks, perform onsite and tele-ICAR assessments, review infection control policies and procedures, and deliver IPC training to multiple shifts throughout healthcare facilities.

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    Ltch Staff Safety And Training

    LTCHs should evaluate the potential risks posed to staff, and ensure that practices are in place to mitigate and manage them.

    • Facility management should work with IPC experts to identify and mitigate the risks of facility staff exposure to COVID-19 by conducting an organizational risk assessment
    • Plans for managing occupational exposures should be in place
    • Staff should receive ongoing education, training, practice and monitoring for compliance with IPC practices including hand hygiene and selecting, putting on, wearing and removing PPE to minimize contamination of themselves and the immediate environment
    • Staff IPC training and compliance monitoring should be in place, tracked, recorded, and kept up-to-date
    • The application of Routine Practices and Additional Precautions is based on a PCRA. Staff have a responsibility to perform a PCRA prior to any interaction with a resident and/or the residents environment, and to ensure that appropriate control measures are taken to prevent transmission of microorganisms
    • Staff should be fit-tested for an N95 or equivalent respirator, and monitored for proper wearing, seal checking and removal of their assigned size and type
    • Facilities should have specific policies and procedures for cleaning and disinfection of any reusable PPE

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    Choose The Correct Product

    Liquid soap and water must be used:

    if your hands look dirty

    If you are caring for a resident who is being sick or having diarrhoea or has diarrhoeal illness such as norovirus or Clostridioides difficile then you must use soap and water for hand hygiene.

    Do not use ABHR as it will not work in these cases.

    Make sure you wet your hands before applying liquid soap.

    Use paper towels to turn off taps if the taps are not elbow operated mixer taps.

    Elbow operated mixer taps are considered to provide the best temperature and flow for optimum hand hygiene and should be considered for any new build, refurbishment or if they need repaired/changed.

    When you have washed your hands dry them thoroughly using paper towel and dispose of the paper towel in a foot operated waste bin.

    To make sure you clean your hands properly with soap and water you must follow the steps in the poster How to hand wash step by step images. This poster can be printed off and displayed throughout the care home to ensure that all staff and visitors are aware of and practice this hand hygiene method when required in the care home.

    Select image for full size version

    Alcohol based hand rub

    Alcohol based hand rub is a gel, foam or liquid containing one or more types of alcohol that is rubbed into the hands to stop or slow down the growth of microorganisms .

    If your hands look clean then you can use ABHR for routine care

    Select image for full size version

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    Infection Prevention And Control

    Infection Prevention and Control refers to evidence-based practices and procedures that, when applied consistently in health care settings, can prevent or reduce the risk of transmission of microorganisms to health care providers, clients, patients, residents and visitors.

    We provide public health professionals with expertise, support and resources for infection prevention and control. For information and resources related to specific topics or services, see the list below.

    Different Transmission Routes Need Different Tbps

    Assisted Living Facility: Fall Prevention Tips # ...

    The three routes or ways an infection is transmitted or spread are called contact, droplet and airborne. You need to use different transmission based precautions for each route.

    Contact precautions are used to prevent infections that spread through direct contact with the resident or indirectly from the residents immediate care environment and care equipment.

    Droplet precautions are used to prevent and control infections spread over short distances via small droplets from the respiratory tract of one individual directly onto the mucosal surface of another persons mouth or nose or eyes. Droplets penetrate the respiratory system to above the alveolar level.

    Airborne precautions are used to prevent and control infections spread without necessarily having close contact via from the respiratory tract of one individual directly onto the surface of another persons mouth or nose or eyes. Aerosols penetrate the respiratory system to deep into the lung.

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    Blood And Body Fluid Spillages Must Be Decontaminated:

    immediately by staff trained to undertake this safely

    using body fluid spill kits/equipment available.

    Responsibilities for the decontamination of blood and body fluid spillages should be clear within each area/care setting.

    Read the management of blood and body fluid spillages literature review to find out more about why we do things this way for blood and body fluid spillages.

    Use the poster management of blood and body fluids to help you when you clean up blood and body fluid spillages.

    Select the image for full size

    Reporting Period 3 Is Now Open

    Providers who are required to report during Reporting Period 3:

    • The PRF Reporting Portal opened for Reporting Period 3 on July 1, 2022 and will remain open through September 30, 2022 at 11:59 p.m. ET.
    • Providers who received one or more General and/or Targeted PRF payment exceeding $10,000, in the aggregate, from January 1, 2021 to June 30, 2021 must report on their use of funds in Reporting Period 3.
    • The deadline to use funds for Payment Received Period 3 was June 30, 2022.

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    Conditions Of Purchase For Antimicrobial Stewardship Toolkit For Long

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    If you agree to the non-returnable and non-refundable conditions of this product and to any applicable copyright, and wish to continue with your purchase, please confirm by selecting the I Agree button below.

    Important Words And What They Mean

    Infection control complaints at Texas nursing homes surge 22 times higher

    Mandatory means that you must do it.

    In order to support care homes successfully adopt and implement the NIPCM, this context specific Care Home Infection Prevention and Control Manual has been co-produced with national and local stakeholders. The content of the CH IPCM is completely aligned to the evidence based NIPCM and is intended to be used by all those involved in residential care provision.

    The CH IPCM contains chapters on:

  • Standard Infection Control Precautions
  • Transmission Based Precautions
  • There are web links in some sections taking you directly to information contained in the NIPCM.

    The CH IPCM is a practice guide for use in care homes, which when used, can help reduce the risk of infections and ensure the safety of those being cared for, staff and visitors in the care home environment.

    It aims to:

    • make it easy for care home staff to apply effective infection prevention and control precautions
    • help reduce the risk of infection
    • reduce variation and optimise IPC practices throughout care home settings
    • help align practice, monitoring, quality improvement and scrutiny.

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    What Were The Performance Periods Of Qip Program

    The performance periods were as follows:

    Table 1. Length of Each Performance Period

    Performance Period

    While the performance periods were mostly limited to four-week blocks, the alignment of NHSN reporting weeks results in October containing five weeks of data. For reference, the performance period referred to the four-week period during which infection rates and death counts were totaled up. However, in order to accurately measure mortality rates, we looked at the count of infections in an infection exposure window that covered the performance period and the six preceding weeks.

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    Responsibilities For The Ch Ipcm

    ARHAI Scotland to:

    • ensure that the content of the CH IPCM remains evidence based.

    Care Home providers to:

    • ensure that the CH IPCM is adopted and implemented in their care homes in accordance with local governance processes
    • ensure that systems and resources are in place to facilitate implementation and compliance monitoring of IPC as specified in the manual in all care areas – compliance monitoring includes all staff
    • ensure there is a system in place which promotes incident reporting or potential hazards and focuses on improvement that ensures safe working practices, through regular monitoring and review
    • ensure there is a nominated lead with responsibility for IPC.

    Care Home Managers to:

    • ensure that all staff are aware of, have access to and know where to locate the CH IPCM
    • ensure that all staff have completed appropriate IPC training relevant to their roles and that this is centrally recorded. Training could include resources developed by your organisation, your local NHS Board or Health and Social Care Partnership, NHS Education for Scotland or the Scottish Social Services Council
    • ensure that all staff have adequate support and resources available to enable them to implement, monitor and take corrective action to ensure compliance with this manual
    • ensure that all staff include IPC as an objective in their Personal Development Plans and are encouraged to discuss any issues around this with their line manager.

    Care Home staff to:

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