Infection Control and Sanitation

At the time of writing this article, America is facing a pandemic as we have never seen before. COVID-19 has been responsible for 565,000 deaths in the United States alone. Many administrators and directors of nursing had never imagined Infection Control would be at the forefront of our daily planning. If you adhere to the following regulation provided by OHCF you will be sure to avoid potential issues with not just COVID-19, but many other infectious diseases:

22VAC40-73-100. Infection control program.

  1. The assisted living facility shall develop, in writing, and implement an infection control program addressing the surveillance, prevention, and control of disease and infection that is consistent with the federal Centers for Disease Control and Prevention (CDC) guidelines and the federal Occupational Safety and Health Administration (OSHA) bloodborne pathogens regulations.
  2. A licensed health care professional, practicing within the scope of his profession and with training in infection prevention, shall participate in the development of infection prevention policies and procedures and shall ensure compliance with applicable guidelines and regulations.
  3. The administrator shall ensure at least an annual review of infection prevention policies and procedures for any necessary updates. A licensed health care professional, practicing within the scope of his profession and with training in infection prevention, shall be included in the review to ensure compliance with applicable guidelines and regulations. Documentation of the review shall be maintained at the facility.
  4. A staff person who has been trained in basic infection prevention shall participate in the annual review and serve as point of contact for the program. This person shall be responsible for ongoing monitoring of the implementation of the infection control program.
  5. The infection control program shall be applicable to all staff and volunteers and encompass all services as well as the entire premises.
  6. The infection control program shall include:
  7. Procedures for the implementation of infection prevention measures by staff and volunteers to include:
  8. Use of standard precautions;
  9. Use of personal protective equipment; and
  10. Means to ensure hand hygiene;
  11. Procedures for other infection prevention measures related to job duties include:
  12. Determination of whether prospective or returning residents have an acute infectious disease and use of appropriate measures to prevent disease transmission;
  13. Use of safe injection practices and other procedures where the potential for exposure to blood or body fluids exists;
  14. Blood glucose monitoring practices that are consistent with CDC recommendations. When assisted blood glucose monitoring is required, fingerstick devices shall not be used for more than one person;
  15. The handling, storing, processing, and transporting of linens, supplies, and equipment in a manner that prevents the spread of infection;
  16. The sanitation of rooms, including cleaning and disinfecting procedures, agents, and schedules; f. The sanitation of equipment, including medical equipment that may be used on more than one resident (e.g., blood glucose meters and blood pressure cuffs, including cleaning and disinfecting procedures, agents, and schedules);
  17. The handling, storing, processing, and transporting of medical waste in accordance with applicable regulations; and
  18. Maintenance of an effective pest control program;
  19. Readily accessible handwashing equipment and necessary personal protective equipment for staff and volunteers (e.g., soap, alcohol-based hand rubs, disposable towels or hot air dryers, and gloves);
  20. Product-specific instructions for use of cleaning and disinfecting agents (e.g., dilution, contact time, and management of accidental exposures); and
  21. Initial training as specified in 22VAC40-73-120 C 4 and annual retraining of staff and volunteers in infection prevention methods, as applicable to job responsibilities and as required by 22VAC40-73-210 F.
  22. The facility shall have a staff health program that includes:
  23. Provision of information on recommended vaccinations, per guidelines from the CDC Advisory Committee on Immunization Practices (ACIP), to facility staff and volunteers who have any potential exposure to residents or to infectious materials, including body substances, contaminated medical supplies, and equipment, contaminated environmental surfaces, or contaminated air;
  24. Assurance that employees with communicable diseases are identified and prevented from work activities that could result in transmission to other personnel or residents;
  25. An exposure control plan for bloodborne pathogens;
  26. Documentation of screening and immunizations offered to, received by, or declined by employees in accordance with the law, regulation, or recommendations of public health authorities, including access to hepatitis B vaccine; and
  27. Compliance with requirements of the OSHA for reporting of workplace-associated injuries or exposure to infection.
  28. The facility administrator shall immediately make or cause to be made a report of an outbreak of disease as defined by the State Board of Health. Such report shall be made by rapid means to the local health director or to the Commissioner of the Virginia Department of Health and to the licensing representative of the Department of Social Services in the regional licensing office.
  29. When recommendations are made by the Virginia Department of Health to prevent or control the transmission of an infectious agent in the facility, the recommendations must be followed.

Top Takeaways:

  • Procedures for the implementation of infection prevention measures by staff and volunteers to include:
  1. Use of standard precautions;
  2. Use of personal protective equipment; and
  3. Means to ensure hand hygiene;

One of the single biggest factors in the spreading of infection is the failure to wash hands. Ensure you have the buy-in from all staff to practice effective handwashing techniques.

  • A licensed health care professional, practicing within the scope of his profession and with training in infection prevention, shall participate in the development of infection prevention policies and procedures and shall ensure compliance with applicable guidelines and regulations.
  1. The administrator shall ensure at least an annual review of infection prevention policies and procedures for any necessary updates. A licensed health care professional, practicing within the scope of his profession and with training in infection prevention, shall be included in the review to ensure compliance with applicable guidelines and regulations. Documentation of the review shall be maintained at the facility.
  2. A staff person who has been trained in basic infection prevention shall participate in the annual review and serve as point of contact for the program. This person shall be responsible for ongoing monitoring of the implementation of the infection control program.

Developing a written infection control policy is key to decreasing the spread of infection. When staff is trained on the policy and it is drilled into the daily practices you will be sure that it is an effective program.