A multifaceted hand-washing and surface cleaning intervention may reduce the risk of infection among nursing home residents, according to a new study led by Dr. Kevin McConeghy, Dr. Rosa Baier, and Dr. Vincent Mor in the department of health services, policy and practice.

[Photo: Dr. Rosa Baier]

Healthcare-associated infections are one of the leading sources of morbidity and mortality among the 1.4 million people who reside in, or are transitioning through, the 15,600 nursing homes in the United States on any given day. A unique aspect of nursing homes is that they are residential; residents live and socialize in close proximity to one another and can be exposed to contaminated environmental surfaces during daily activities. Consequently, recommendations for the prevention of infections in nursing homes include hand hygiene and surface cleaning to reduce exposure to pathogens and person-to-person transmission. However, opportunities remain to improve compliance with hand hygiene and surface cleaning in the nursing home setting.

The purpose of this study was to demonstrate the feasibility of implementing a hand-washing and surface cleaning intervention to reduce hospital-associated infections in nursing homes. The intervention was conducted as a randomized, pair-matched pilot in 10 Colorado nursing homes over an 8-month period. The intervention comprised of staff education, provision of cleaning products, and periodic feedback on compliance. Compared to the control nursing homes, intervention nursing homes reported an increased frequency of hand-washing occurrences and lower surface bacteria counts. Though nonsignificant, there was also a small reduction in the infection rates in intervention nursing homes. Intervention participants were highly compliant to the intervention, and reported high levels of satisfaction.

The results of this study, published in JAMDA, provide encouraging process data and preliminary results that support the evaluation of a larger, randomized controlled trial.