RID – Committee to Reduce Infection Deaths

For more information, please visit hospitalinfection.org

If you’re choosing a nursing facility, this guide is for you. Often when a patient is discharged from the hospital, it isn’t possible to go directly home. The hospital staff will urge you to transfer to a skilled nursing facility, perhaps for a week or more.

Moving to the wrong nursing home can be dangerous to your health. Nursing homes have even higher infection rates than hospitals. The difference between a quality facility and a poorly operated one can determine whether you have a speedy recovery or endure terrible health setbacks, including infections.

The COVID pandemic brought public attention to the dangers of nursing facilities. RID is here to help you avoid those dangers.

Here are 10 steps to choose the safest nursing facility and avoid infection:

Pressure ulcers, also called decubitus ulcers or bed sores, are one of the biggest problems in nursing homes. If your loved one is confined to a bed, ask the staff what plan is being followed to prevent pressure ulcers. Specifically, is there a schedule for turning the patient several times a day? How often is the patient’s skin inspected for breakdown? What is being done to keep the skin clean and dry?

Also ask if the patient needs a special bed, mattress, heel protectors and foam wedges that can further reduce the risk of bed sores. A physician can order these items. However, there is no substitute for frequent turning (generally every two hours). Also ask about kinetic turning beds that allow continuous rotation.

Ask that staff clean their hands immediately before touching your loved one. This is the single most important way to reduce infection. Put a bottle of hand sanitizer on the bedside table, and a sign saying “Please use this before touching the patient.” Cleaning hands at the entrance to the room is not sufficient, because once staff members touch the bedrails, open drawers, or touch another surface in the room, their hands have picked up bacteria that could make your loved one sick.

An infection called Clostridium difficile, or C. diff for short, causes severe diarrhea, dehydration, and other life-threatening complications. To help avoid it, make sure your loved one’s hands are clean before they touch their food, and avoid putting utensils or food on any surface except the plate. Consider bringing a box of prewrapped hand wipes for the patient to use before meals.

C. diff germs invisibly contaminate many surfaces around the bed, including bedrails, call buttons, over-the-bed tables, and door knobs. When you visit, bring BLEACH wipes and wipe down these surfaces around your loved one’s bed.

Patients with indwelling urinary tract catheters have a fairly high risk of infection. Ask caregivers frequently whether
the device is still needed. The tube is hidden under the sheet, where it’s easily left in too long. Inquire whether male patients can use an external or condom catheter, which has a lower risk of infection and is often more comfortable.

Daily oral care reduces risk of pneumonia, one of the biggest killers in nursing homes. Ask specifically whether the
patient is having his tongue, mouth, and teeth cleaned daily. It’s a time consuming process, and sometimes overlooked by busy staff.

Also ask about COVID vaccines and influenza vaccines for patients and staff. RID urges all healthcare workers with direct patient contact to be fully vaccinated. And don’t forget pneumococcal vaccines for patients 65 and over.

If you’re in a nursing home for physical rehabilitation after a hip or knee replacement or other orthopedic procedure, be aware of the germs lingering on exercise equipment. Bring a canister of bleach wipes to rehab and wipe each mat, machine, or weight before using it. The once a day cleaning these items get (we hope) is not enough to prevent infection.

Don’t visit if you have a cold or other signs of illness. Don’t bring small children to visit. They are walking germ machines. And don’t put a purse or bag on the floor and then on the patient’s bed.

For more information, please visit hospitalinfection.org