title: Effect of a comprehensive infection control program on the incidence of infections in long-term care facilities.
abstract: BACKGROUND
  Control of infection within the long-term care facility is a daunting problem. Elderly patients are at high risk for contracting infection because of reduced innate immunity, malnutrition, and the presence of chronic medical conditions. This small study tested the effect of developing and implementing a comprehensive preventive infection control program in the long-term care setting and examined the resultant incidence of infections.
  
  
  METHODS
  Eight private, freestanding, long-term care facilities in urban and suburban settings were selected for the study. The 4 test sites had a total of 443 beds; there were 447 beds in 4 matched control sites. Data on infection rates were accrued in both preintervention and intervention years. The control homes maintained their existing infection control policies and procedures. The test homes were provided with an infection control educational program and replaced all currently used germicidal products with single-branded products for a 12-month period. A criteria-based standardized infection control surveillance system was used to monitor and report infections in all facilities.
  
  
  RESULTS
  In the preintervention year, the test sites experienced 743 infections (incidence density rate, 6.33) and the control homes experienced 614 infections (incidence density rate, 3.39). In the intervention year, the test homes reported 621 infections, a decrease of 122 infections (incidence density rate, 4.15); in the control homes, the number of infections increased slightly, to 626 (incidence density rate, 3.15). The greatest reduction in infections in the test homes was in upper respiratory infections (P =.06).
  
  
  CONCLUSIONS
  This study provides additional evidence that a comprehensive infection control program that includes handwashing and environmental cleaning and disinfecting may help reduce infections among the elderly residing in long-term care settings.
authors.affiliation: Department of Infectious Diseases, Our Lady of Lourdes Medical Center, Camden, New Jersey, USA.
authors.forename: A T
authors.initials: AT
authors.lastname: Makris
authors.forename: L
authors.initials: L
authors.lastname: Morgan
authors.forename: D J
authors.initials: DJ
authors.lastname: Gaber
authors.forename: A
authors.initials: A
authors.lastname: Richter
authors.forename: J R
authors.initials: JR
authors.lastname: Rubino
mesh_terms: D017677:Age Distribution; D000368:Aged; D003408:Cresols; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D003691:Delaware; D004202:Disinfectants; D006282:Health Personnel / Q000193:education; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D007318:Inservice Training; D009515:New Jersey / Q000453:epidemiology; D016730:Program Development; D015397:Program Evaluation; D012307:Risk Factors; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*
chemical_list: D003408:Cresols; D004202:Disinfectants; C045926:Lysol