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February 23, 2024

“There are some dangerous infectious agents residents may harbor. As they get more frequent—and the CDC says the numbers are up significantly, we will have to contend with them, for example, CPCRE, Candida Auris,” says Swati Gaur, MD, MBA, CMD, moderator of an upcoming AMDA webinar, TBP, EBP, and Outbreaks: Case-Based Unlocking of Infection Control Conundrum, set for February 28.

While COVID-19 has been a key focus in post-acute and long-term care in recent years, other infections have continued to plague facilities. Dr. Gaur says, “While we feel we understand and have developed competencies during this phase, infection control continues to be one of the top deficiencies facilities get.”

This program will offer a unique interdisciplinary panel of experts discussing the types and principles of transmission-based precautions (TBP) and the use of enhanced barrier precautions (EBP) in nursing homes. The former is commonly called ‘isolation’ in nursing homes, while the latter is a somewhat new concept that nursing homes generally find challenging to implement. The experts also will address implementation challenges and successes in this setting. Additionally, the panel will review approaches to conduct risk assessments and develop policies and procedures related to EBP.

The panelists will lead a discussion around a key challenge facing facilities—multi-drug-resistant organism (MDRO) infections. “We know from a CDC report that during the pandemic, there was a significant increase in antibiotic prescribing and more deaths from MDROs in hospitals,” says Dr. Gaur. “We think that our focus on COVID could have created an environment for increased incidence of MDROs. We have to be better prepared moving forward.”

“We need to be able to manage patients with these resistant organisms and these dangerous infectious colonizations when they come into nursing homes,” suggests Dr. Gaur. “We will discuss real cases that have sometimes stumped us; the nitty gritty, where the rubber meets the road by discussing actual cases and situations. We will try to put some understanding around those issues to inform guidance with the knowledge facilities need to keep their environments safe for residents and staff alike.”

Dr. Gaur says, “I am excited about this program because we will be addressing the kinds of questions we get daily.” The conversation will be particularly stimulating with an “incredible and truly interdisciplinary panel” featuring Muhammad Salman Ashraf, MBBS, medical director at the Nebraska Department of Health and Human Services Healthcare-Associated Infections and Antimicrobial Resistance Program; Kara Jacobs Sifka, MD, MPH, an infectious diseases physician and medical epidemiologist at the CDC; and Amy Ward, MS, BSN, RN, an infection preventionist, with the patient safety team at a CMS Quality Improvement Organization. “We will be tackling things from a broad perspective and highlighting the need for a truly interdisciplinary approach to these challenges,” says Dr. Gaur.

Preventing and managing the spread of infections has never been more important, but Dr. Gaur stressed that it’s not just a safety issue, although this is the top concern. “If you look at facility operations, we have value-based purchasing measures, and we are in the midst of a performance period where we are being assessed for the number of health-care facility-acquired infections,” she notes. Everyone in the facilities, beyond just clinicians, should be paying attention to these issues.

Anyone who is getting questions about infection control—from what kinds and lengths of isolation are necessary for different infections, what MDROs need to be prioritized, and how to balance resident autonomy and safety—needs to participate in this webinar, Dr. Gaur noted. She urges people to submit their questions or their own cases in advance by sending them to Linda Lang. “We want to hear from everyone, and we expect this to be a truly interactive and stimulating conversation,” says Dr. Gaur. “We are super excited to present this robust discussion as a curtain raiser to the annual conference. Not just that, we have an incredible opportunity to continue the conversation after the webinar at the In-the-Trenches Roundtable Discussion during PALTC24 on Sunday, March 10, from 6:45 to 7:45 AM, where the panel will be available.” You can register for PALTC24 here.

If you have cases you want to discuss during the February 28 program, send them to Ms. Lang. This webinar is free for AMDA members and PALTC24 registrants. Register now