A Pro-Active Approach to IPC for COVID-19 and Beyond – Strategies to Achieve Early Detection and Minimize Outbreaks of Infectious Disease
The emergence of COVID-19 has shed a bright light on Infection Prevention & Control (IPC) in nursing facilities. With clinical teams stretched beyond their limits, successful facilities are leaning on technology to help drive their IPC efforts.
We recently sat down with Registered Nurse and certified Infection Preventionist, Cheryl Scalzo, Clinical Account Specialist for Real Time Medical Systems, to discuss technology’s role in detecting infectious disease early and minimizing outbreaks. She explains the value of leveraging live EHR data and documentation to highlight subtle changes in resident condition in real-time, which identifies early warning signs and symptoms of potential infection.
From facility-wide centralized surveillance to assuring families you are doing everything possible to prevent infection and keep their loved ones safe, learn how your facility can take a proactive approach to infection surveillance.
Real Time: What role does technology play in the infection prevention and control program?
Cheryl Scalzo: Technology’s role in the IPC program is quite significant, especially as it pertains to surveillance aspects of the program. When I think back to my role as an Infection Preventionist, we didn’t have the technology to access live data within the EHR. Instead, we manually sifted through each resident chart, deciphering illegible handwritten narratives, and then tried to conduct a thorough tracking and trending analysis on the infections that were occurring within the facility.
The capabilities of what technology offers nursing homes today is incredible. The ability to instantly pull live data from the patient EHR and identify early warning signs of potential infections and automate tracking and trending analysis saves time and allows us to be better caregivers to our residents.
Real Time: What specifically should clinicians be doing to minimize infectious diseases within their facilities and avoid potential outbreaks?
Cheryl: There are a few key focuses here, I think the most vital are identifying early warning signs and symptoms of potential infections among residents, mapping the infections within the facility to conduct trend analysis, and communicating IPC protocols with your nursing staff.
We are all too familiar with the CDC’s early warning signs and symptoms of COVID-19 and influenza – so I won’t reiterate those, but there are many other infectious diseases that nursing facilities deal with on a daily basis, from urinary tract infections, to pneumonia and C. difficile. The key is being able to easily identify early warning signs associated with these infections, such as increased temperature or sudden change in bowel movements. These subtle changes in condition may seem minor and may be hard to detect among a 200+ resident population, but they are key to early identification.
Once infections have been identified, it is a requirement within the IPC program to know where within your facility these occurrences are happening. By mapping the infections within your facility, you are able to easily conduct trend analysis to see if the infection may have spread and to isolate that specific unit early before an outbreak occurs across the entire facility. The trending analysis can also help the facility’s designated Infection Preventionist determine if the nursing staff is properly documenting early warning signs of potential infections. This is why it is extremely important to ensure your facility’s nursing staff are informed of what early signs to look for and the protocols to take when they are identified.
Real Time: Is most of this data found within the EHR?
Cheryl: It is, but here again we have some caveats. It is imperative to work closely with your facility’s nursing staff and communicate what early signs and symptoms to look for, but most importantly to document them. As they say, “If we didn’t document it, it didn’t happen.”
However, even with proper documentation, the sheer magnitude of looking through every resident’s medical record can be extremely time consuming. If we have learned anything from COVID-19, it is that time is of the essence to intervene in care and isolate immediately to avoid a facility-wide outbreak. This is where the role of technology becomes essential – having an effective interventional analytics solution that can analyze live data and documentation within the EHR and immediately notify you of potential infections not only saves time but can help save lives.
Real Time: How does establishing a centralized surveillance system across a multi-facility network improve the tracking and trending components for the IPC Program?
Cheryl: Surveillance has to be one of those key pieces in our IPC program. We can’t have anything happen in a facility or across a chain of facilities that relates to infectious processes and not know about it.
The key to establishing a successful surveillance program across multiple facilities is having access to live data from the EHRs as it is being documented. But, can you imagine what that would entail if you are having to establish surveillance and conduct tracking and trending analysis across five or even ten or more facilities? Reading each resident record and sourcing through countless nursing notes, not to mention reviewing all of the assessments and reports for every resident at every facility? This could take days and possibly even weeks to extract the needed data just to begin the analysis.
This is why implementing the right analytics solution is going to help centralize the data, allowing the Infection Preventionist to easily identify early warning signs and automate tracking and trending across multiple facilities. This time saved will allow the Infection Preventionist to focus on the outcomes of the trend analysis and determine how to better improve IPC management.
Real Time: How can facilities use the data, particularly the data analytics you mentioned, to reassure families that their loved ones are in a facility that is proactively taking steps to avoid potential outbreaks?
Cheryl: This is a great question, especially with how nursing homes were negatively perceived during the height of the COVID-19 pandemic.
First and foremost, it is essential that every facility have a designated Infection Preventionist on staff. This is a mandatory requirement issued by CMS, but most importantly, it shows the families of your residents that you have a dedicated individual who is monitoring early warning signs and symptoms of infection and proactively working toward the reduction of infectious diseases throughout the facility.
As an added layer of protection, families can be reassured you are doing everything possible to prevent infections in the facility with the help of technology that monitors all residents for the early warning signs of any type of infection 24/7. You will also have the metrics to back up your IPC efforts, should a family member or potential new resident wish to view the history of infection within the facility.
From my previous experience as both an Infection Preventionist and Director of Nursing, the last thing you want to tell a resident’s family is “We do a great job at preventing infections in our facility,” without being able to prove it. Now, you’ll have the data to show them how your facility is managing infections and keeping infection rates down.
Most importantly, incorporating a data analytics solution into your IPC program will help improve timely communications to the family. Because your facility is using live data analysis to identify early warning signs, you are now able to inform family members early, educate them on when and where (mapping) their loved one first showed early symptoms, and reassure them on the proactive steps your facility is taking to treat the infection before an adverse situation occurs.
