APIC Study Finds Infection Control Certification Leads to Better Outcomes
A new study found that nearly half of U.S. nursing homes have inadequately trained infection prevention staff, which leads to subpar results when it comes to antibiotic stewardship. The study was published in the American Journal of Infection Control, the journal of the Association for Professionals in Infection Control and Epidemiology (APIC).
Researchers at Columbia University School of Nursing conducted a national study of more than 800 nursing homes in 2018 to evaluate the effectiveness of antibiotic stewardship programs (ASP). The study came in the wake of CMS requirements issued in 2014 mandating that nursing homes have ASPs in place to track the use of antibiotics.
The survey gauged the effectiveness of the ASPs by analyzing nursing homes’ rates of infection preventionist (IP) training and certification, participation in Quality Innovation Network-Quality Improvement Organization (QIN-QIO) activities, and facility and staff characteristics. Only 33.2% of the nursing homes surveyed had comprehensive ASPs. The nursing homes surveyed with certified infection preventionists were nearly five times more likely to have comprehensive ASPs compared to those with no specific training.
“Inappropriate use and overuse of antibiotics puts nursing home residents at an increased risk of developing infections from multidrug-resistant organisms,” said study author, Mansi Agarwal PhD, MPH, in a release. “This survey shows the importance of certified IPs in ensuring antibiotic stewardship programs are operating that reduce the risk for patients and increase their safety.”
The study found that 46% of nursing homes surveyed reported that their IPs did not have specific infection control training, with 7.6% reporting that they had an IP certified in infection control, and 35.8% said their IP had state or professional organization training.
“With the third and final implementation phase of the CMS rule approaching, it’s important that nursing homes ensure adequate training for IPs,” said APIC President Karen Hoffmann, RN, MS, CIC, FSHEA, FAPIC, in the release. “Facility-wide infection prevention programs that include antibiotic stewardship are critical and require well-trained IPs, especially in light of recent widely publicized outbreaks of Candida auris.”
Comprehensive ASPs were defined as performing six of the following seven actions:
- Collecting data on antibiotic us
- Using antibiotic prescribing guidelines or therapeutic formularies
- Restricting use of antibiotics
- Communicating antibiotic usage information when residents are transferred
- Reviewing cases to assess appropriateness of antibiotic administration
- Providing feedback to clinicians on antibiotic use and prescribing
- Providing educational resources for improving antibiotic use