Infection prevention and control: Building a healthier community

Throughout history, infection control and prevention have shaped society, the economy, and the population. In short, it has had a major impact of nearly every aspect of life, as illustrated by the COVID-19 pandemic.

“Christian Health has extensive and thorough infection control and prevention policies and procedures. We exceeded not only our own standards, but guidelines and recommendations of the Centers for Disease Control and Prevention, and the New Jersey Department of Health to battle COVID-19 because we care for the most vulnerable and fragile members of our community,” says Constance Hobson Falls, RN, MSHA, MSJ, CJCP, who spearheads infection control and prevention at Christian Health.

On any given day, Christian Health cares for 987 long-term care residents and independent seniors, and 449 of short-term rehab and mental-health inpatients and outpatients. A large majority of these individuals are 65 and older – a population at greater risk to infection for a number of reasons. Antibody production and immunological function declines. Underlying diseases, such as diabetes and cellulitis, thinning skin and mucous membranes, poor nutritional status, decreased activity, swallowing difficulties, impaired mental status, incontinence, and certain medications can all affect resistance to infection.

The most common infections among seniors are urinary-tract infections, influenza, pneumonia, skin and soft-tissue infections, gastroenteritis, and conjunctivitis. Because of seniors’ impaired immunity, infections that tend to be mild in other populations may be more severe.

“Detecting infection among the elderly can be a challenge because they often have atypical symptoms,” Ms. Hobson Falls says. “Rather than having classic signs, such as a fever, chills, or pain, an older person may be confused, restless, or incontinent when an infection develops. Our nursing staff plays a major role in detecting and investigating these signs. ”

Infections spread through a source, means, and host. The source is a person, object, or animal which serves as the carrier of an infectious agent. Means is transmission via one of four routes: direct contact, indirect contact, airborne, and vehicle. Direct contact is person to person. Indirect is person to object to person. Airborne is droplets or particles in the air, and vehicle is through food and/or water. The host is the person that enables an infectious agent to thrive.

“At Christian Health, we concentrate our efforts on means – the mode of transmission. Since the major route of transmission is direct contact, we are diligent about teaching and enforcing proper hand hygiene,” Ms. Hobson Falls says.

Infection prevention and control education is provided to all new employees during general orientation. New clinical staff receive a more intensive orientation. Annual education is required for all employees thereafter.

To protect all residents, patients, clients, and consumers, Christian Health practices Standard Precautions. These include routine hand washing/sanitizing; appropriate use of gloves, masks, gowns, eye protection, and face shields, when required; and routine cleaning and disinfecting.

“In a hospital, a patient with an infectious disease can be put in isolation. Infection prevention and control in an elder-care setting, however, is unique because it is a home for residents. The respect, dignity, safety, and comfort of our residents is of utmost importance. Infection prevention and control must be balanced with resident needs and rights,” Ms. Hobson Falls says. “When necessary and appropriate, we cohort – place two residents of the same sex with the same diagnosis or infection in the same room until the infection is gone. This was standard practice for COVID-19.”

Cohorting was one of countless standard practices at Christian Health for COVID-19. Visitation was restricted, communal dining and activities were suspended, employees were screened daily upon arrival, and outpatient mental-health services converted to a telehealth virtual counseling platform.

“In addition to state and federal guidelines and regulations, Christian Health went above and beyond,” Ms. Hobson Falls says. “For instance, we sanitized all flooring – carpet, tile, and wood – every day using an EPA-registered and hospital-grade disinfectant. We even disinfected campus roads and parking lots with a cleaning solvent. We are, and always have been, committed to maintaining strong and proactive measures to keep everyone on our campuses and the community safe and protected.”

To learn more about infection prevention and control at Christian Health contact (201) 848-5200. To support CHCC’s Annual Fund during this time of COVID-19, contact Sue Kelly at (201) 848-5799 or skelly@christianhealthnj.org, or visit ChristianHealthCare.org/Annual Fund.