September 2017 LTCF Newsletter

Inside This Issue

September 2017 Newsletter – Print version [PDF – 2 MB]

Save The Date!

The National Healthcare Safety Network’s (NHSN) 2018 Long-term Care Facility Annual Training is scheduled to take place April 18 – 20, 2018 in Atlanta at the CDC. All three days will be dedicated to Infection Prevention and Surveillance in the Long-term Care Facility setting. Speakers will discuss a variety of topics including antibiotic stewardship, prevention and surveillance for UTI, C. difficile, multi-drug resistant organisms, antibiotic stewardship, and more. Users will also have the opportunity to participate in hands-on NHSN navigation and analysis training. Stay tuned for more information later this year.

Thank you.

NHSN Long-Term Care Team

Centers For Medicare & Medicaid (CMS) Final Rule Revision For Long-Term Care Facilities

The Centers for Medicare and Medicaid Services (CMS) revisions to the final rule for Long-Term Care Facilities (LTCF) became effective November 28, 2016. The rule now requires LTCFs to develop a system for preventing, identifying, reporting, investigating, and controlling infections and communicable diseases. This includes the implementation of a data collection tool and the use of nationally recognized surveillance criteria. Although use of NHSN is not required for these purposes, we encourage you to consider NHSN as a surveillance strategy for your facility. NHSN allows facilities to identify problem areas, measure progress of prevention efforts, and ultimately eliminate healthcare-associated infections.

View all of the posted CMS materials.

To learn more about how NHSN can help your facility fulfill CMS requirements, please visit our training webpages and plan to attend the 2018 NHSN Annual Training for Long-term Care Facilities. More info to come!

CDC’s Assessment Of Infections And Use Of Antibiotics: Project Update

In spring 2017, CDC initiated a new project to learn about infections and the use of antibiotics in nursing homes and skilled nursing facilities. The project is being conducted in partnership with the CDC’s Emerging Infections Program (EIP), teams of experts trained in infectious diseases and data collection, located in 10 states (CA, CO, CT, GA, MD, MN, NM, NY, TN & OR).

To date, 145 facilities have agreed to participate and data collection is under way at most facilities. If your facility has agreed to participate, we sincerely thank you! We expect the project data from your facility will help inform your own infection prevention and antibiotic stewardship activities.

CDC will use the information gained from this important project to:

Improve infection tracking efforts, like the NHSN, for long-term care facilities
Develop interventions to better prevent infections in residents
Identify ways to best support antibiotic stewardship efforts in nursing homes and skilled nursing facilities.
For additional information about this project go to: HAI and Antibiotic Use Prevalence Survey.

Map of nursing home facilities in the United States with pins placed on California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New York, Tennessee, and Oregon.

Frequently Asked Questions

Question: Is there a repeat infection time frame for identifying if a resident meets NHSN criteria for a new urinary tract infection (UTI)?

Answer: Long-term Care Facilities should use protocols from the LTCF Component. These protocols are different from the protocols used for acute care hospitals, inpatient rehabilitation facilities, and long-term acute care hospitals. Specifically, the protocol for identifying urinary tract infections among residents in LTCFs does not incorporate considerations for a repeat

infection time-frame (RIT) or infection window period rules. Therefore, in a resident with a previous UTI, the combination of clinical judgment and documentation must be used to make the determination for NHSN reporting.

Some questions to consider may include:

Are the UTI symptoms new or acutely worse (e.g., change from the baseline)?
Have the signs and/or symptoms from the initial UTI resolved prior to the onset of the new signs and/or symptoms?
Did the resident complete antimicrobial therapy for the initial UTI?

View the NHSN UTI protocol

We are happy to review individual cases and provide you with our feedback and suggestions! If you’d like to submit a case for our review, please submit the specific details (e.g., urine culture results, signs/symptoms, dates, etc.) without resident personal identifier information to nhsn@cdc.gov with the subject line “LTCF case review”. As a reminder, the NHSN UTI definitions are for the purpose of performing surveillance and are not intended for clinical diagnosis.

Coming Soon! An Update To The NHSN Agreement To Participate And Consent

Attention ALL NHSN users! An updated NHSN Agreement to Participate and Consent will be available for review and electronic signature with the December NHSN release. Primary Contacts must accept this updated consent form by February 24, 2018, or risk losing access to NHSN.

Once the consent form is available with the new release, an alert will appear on all NHSN component home pages, and primary contacts and facility administrators will receive an email notification. Additional information, including Frequently Asked Questions, will be available online later this year. If you have any questions, please send an email to NHSN@cdc.gov with the subject line “NHSN Re-consent.”