title: Impact of infection preventionists on Centers for Medicare and Medicaid quality measures in Maryland nursing homes.
abstract: BACKGROUND
  Health care-associated infections are the leading cause of morbidity and mortality in US nursing homes (NHs). The objective of the research is to assess the impact of Maryland NH infection preventionists (IPs) on NH quality measures.
  
  
  METHODS
  Two hundred thirty-four NHs were queried through mailed survey. These survey data were then linked with 2008 quality data from Nursing Home Compare and the On-line Survey Certification of Automated Records.
  
  
  RESULTS
  Three of the 8 quality measures examined-influenza vaccination for both short- and long-stay residents and pressure ulcer prevention in high-risk residents-were significantly associated with the number of IPs. None of the quality measures were shown to be significant with IPs who received specialized training on infection prevention and management compared with those who did not receive specialized training.
  
  
  CONCLUSIONS
  IPs play a critical role in preventing and managing health care-associated infections in nursing homes, especially in the areas of influenza vaccination and pressure ulcer prevention among high-risk nursing home residents. Quality measures that reflect the effects of IP training may not have been elucidated yet. Further research is needed to support the IP role in order for policy to advocate for increased IP funding.
authors.affiliation: University of California, San Francisco, School of Nursing, Department of Community Health Systems, San Francisco, CA. Electronic address: laura.wagner@nursing.ucsf.edu.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Wagner
authors.affiliation: Department of Infection Prevention and Control, Prevention and Health Promotion Administration, Infectious Disease Bureau, Office of Infectious Disease Epidemiology and Outbreak Response, Maryland Department of Health and Mental Hygiene, Baltimore, MD.
authors.forename: Brenda J
authors.initials: BJ
authors.lastname: Roup
authors.affiliation: Department of Health Policy & Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Nicholas G
authors.initials: NG
authors.lastname: Castle
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D006302:Health Services Research; D017053:Infection Control / Q000379:methods*; D008396:Maryland / Q000453:epidemiology; D008484:Medicaid / Q000592:standards*; D006278:Medicare / Q000592:standards*; D009735:Nursing Homes; D014481:United States
keywords: Long-term care; Outbreak; Patient safety; Quality improvement