Infection Prevention in Post–Acute Care Settings Versus Acute Care Hospitals

Nimalie Stone, MD, MS, Team Lead, LTC, Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention (CDC), explores the differences in infrastructure for clinical care and infection prevention in post—acute care and long-term care settings as compared to acute care hospitals.

Interview Transcript (slightly modified for readability)

“When you think about infection prevention programs in acute care, there is a long history of infection preventionists receiving dedicated time and resources to implement their surveillance and prevention activities. Over the years we have seen a tremendous growth in the importance and recognition of the value that these infection prevention programs provide in acute care hospitals. Some of that has been tied to public reporting and the use of these healthcare-associated infection (HAI) data as a sign of quality.

In post—acute care environments—and remember there is a spectrum of post–acute care settings from long-term acute care hospitals, which look very similar to the level of acuity that you might see in a step-down intensive care unit (ICU), to skilled nursing facilities and nursing homes that may have more residential care patients in addition to rehab and skilled nursing patients—there are varying levels of infection prevention program capacity.

Some of the unique differences in nursing homes, as an example, are that the individuals who are overseeing those programs, have not received dedicated infection prevention training. They often [wear] multiple hats, [and] so they have infection prevention as a part-time role, but then they may also be in charge of staff education. Some of them may be the clinical nursing directors or administrative leaders in their facilities, so the amount of time that they actually have to focus on infection prevention is quite different from what we see with dedicated infection preventionists (IPs) in acute care settings."