As nursing home professionals, you play a crucial role in caring for vulnerable residents and maintaining a safe and healthy environment. One of the most pressing challenges faced by healthcare facilities is the emergence and spread of multidrug-resistant organisms (MDROs). In this article, we will explore the essentials of infection prevention in nursing homes, focusing on the identification, prevention, and management of MDROs.

Understanding Multidrug-Resistant Organisms (MDROs)

Multidrug-resistant organisms are bacteria, viruses, or fungi that have developed resistance to multiple antimicrobial agents, making them challenging to treat effectively. The overuse and misuse of antibiotics have accelerated the emergence of these dangerous pathogens, leading to serious healthcare-associated infections. In nursing homes, where residents often have weakened immune systems and underlying health conditions, the threat posed by MDROs is especially concerning.

Identification and Surveillance

      • Comprehensive Screening: Implement a robust surveillance system to identify residents colonized or infected with MDROs. Regularly screen residents upon admission, transfer, and during outbreaks to detect carriers and prevent further transmission.
      • Laboratory Support: Collaborate with the laboratory to ensure timely and accurate reporting of MDRO testing results. Prompt communication of positive findings is essential to initiate appropriate precautions and treatments promptly.

Preventing MDRO Transmission

      • Hand Hygiene: Emphasize the importance of proper hand hygiene among staff, residents, and visitors. Frequent handwashing with soap and water or the use of alcohol-based hand sanitizers can significantly reduce the transmission of MDROs.
      • Contact Precautions: Implement contact precautions for residents with known or suspected MDROs. This may involve using gowns and gloves when providing care and adhering to specific protocols to prevent cross-contamination.
      • Environmental Cleaning: Regularly clean and disinfect frequently-touched surfaces and resident care equipment. Pay close attention to shared areas and high-touch objects, as they can serve as reservoirs for MDROs.
      • Cohorting: Consider cohorting residents with MDRO infections or colonization to limit the spread of organisms within the facility. This practice involves grouping residents with the same MDRO together, reducing the risk of transmission to other vulnerable individuals.

Management and Treatment

      • Antibiotic Stewardship: Engage in antibiotic stewardship efforts to ensure appropriate and judicious use of antimicrobial agents. Avoid the unnecessary prescription of antibiotics, as this can contribute to the development of resistance.
      • Isolation and Barrier Precautions: Adhere to isolation and barrier precautions as recommended by infection control guidelines when caring for MDRO-infected or colonized residents.
      • Education and Training: Provide regular education and training to staff on MDROs, infection prevention practices, and the importance of early detection and reporting.

Infection prevention in nursing homes is paramount in safeguarding the well-being of residents. The rise of multidrug-resistant organisms presents a formidable challenge that demands a comprehensive and proactive approach. By understanding the essentials of identification, prevention, and management of MDROs, you can play a pivotal role in curbing their spread and protecting those under your care. Together, through dedication, education, and vigilance, we can create safer environments for our residents and work towards a future where MDROs are no longer a looming threat.

Written By: Shelly Maffia RN, MSN, MBA, LNHA, QCP, CHC, CLNC, CPC
Director of Regulatory Services

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