![]() ![]() It is not surprising, therefore, that almost as many HAIs occur annually in LTCFs as in hospitals in the US. These elements are present in LTCFs as well as in hospitals. The major elements leading to a HAI are the infectious agent, a susceptible host, and a means of transmission. The Study on the Efficacy of Nosocomial Infection Control (SENIC) documented the effectiveness of a hospital infection control program that applies standard surveillance and control measures. Virtually every hospital has an infection control professional (ICP), and many larger hospitals have a consulting hospital epidemiologist. Hospital infection control programs are well established in the US. Infection control resources are also presented. The recommendations cover the structure and function of the infection control program, including surveillance, isolation precautions, outbreak control, resident care, and employee health. Recommendations are developed for long-term care (LTC) infection control programs based on interpretation of currently available evidence. This position paper reviews the literature on infections and infection control programs in the LTCF. A great deal of information has been published concerning infections in the LTCF, and infection control programs are nearly universal in that setting. LTCF residents have a risk of developing health care-associated infection (HAI) that approaches that seen in acute care hospital patients. In recent years, the acuity of illness of nursing home residents has increased. More than 1.5 million residents reside in United States (US) nursing homes. There is considerable overlap between the 2 terms. The term nursing home is defined as a facility licensed with an organized professional staff and inpatient beds that provides continuous nursing and other services to patients who are not in the acute phase of an illness. 1 This care may be chronic care management or short-term rehabilitative services. Long-term care facilities (LTCFs) may be defined as institutions that provide health care to people who are unable to manage independently in the community. Professor of Infectious Diseases, Colleges of Medicine and Public Health, University of Nebraska Medical Center, Omaha, Nebraska (P.W.S.) President, ICP Associates, Inc, Rome, Georgia (G.B.) Professor of Internal Medicine, Divisions of Infectious Diseases and Geriatric Medicine VA Ann Arbor Healthcare System, and the University of Michigan Medical School, Ann Arbor, Michigan (S.B.) Clinical Professor, Internal Medicine/Geriatrics, University of Wisconsin-Madison, and Medical College of Wisconsin–Milwaukee, Wisconsin (P.D.) Associate Professor of Medicine and Epidemiology, Associate Hospital Epidemiologist, Hospital of the University of Pennsylvania, and Senior Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania (E.L.) Infection Preventionist, Broad Street Solutions, San Diego, California (J.M.) Assistant professor, Divisions of Geriatric Medicine, University of Michigan Medical School, and Geriatric Research and Education Center, Veteran Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan (L.M.) Professor, Internal Medicine and Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada (L.N.) and Associate Professor of Medicine, Division of Infectious Diseases, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio (K.S.) ![]()
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