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Short-Staffing Increases Poor Infection Control

Published on March 20th, 2020

NPR had a great article explaining the history of problems the nursing home industry has containing infections and contagious diseases.  As nursing home abuse and neglect attorneys, we have seen multiple cases of scabies, sepsis, Norovirus, and other infectious conditions run rampant in poor nursing homes.

Long before coronavirus, the nation’s nursing homes were struggling to comply with basic safety infection prevention protocols designed to prevent the spread of viruses and bacteria. Since the beginning of 2017, government health inspectors have cited more nursing homes for failing to ensure that all workers follow those prevention and control rules than for any other type of violation, according to a Kaiser Health News analysis of federal records.

In all, 9,372 nursing homes, or 61%, were cited for one or more infection-control deficiencies, the analysis showed. It also found violations were more common at homes with fewer nurses and aides than at facilities with higher staffing levels.  Inadequate staffing is the main cause of everything that goes wrong in a nursing home. 

KHN’s analysis found that 53% of homes with the most nurses and aides had been cited for infection-control violations in the past three years. But 65% of homes with the fewest staff — garnering only one star — were cited for the same type of failing. The staffing stars make up one component of the overall rating.

“So many times, when there aren’t enough staff, the aides and nurses are literally trying to do 50 things at once, running from person to person,” said Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care, a nonprofit based in Washington, D.C. “That’s when things fall through the cracks, like handwashing, which is the most useful thing to do to prevent infections.”

Even among nursing homes crowned with the maximum government rating of five stars for overall quality, 4 in 10 have been cited for an infection-control lapse. Inspection reports from around the country show many errors are rudimentary, such as workers not washing their hands as they moved to the next patient, or failing to don masks, gloves and gowns when in the rooms of contagious patients in isolation.

In 2016, CMS updated and expanded its infection-control rules, requiring among other things that each facility appoint one person to be in charge of infection control. CMS required the employee in that position, known as an infection preventionist, to complete specialized training and work at the facility either part time or full time. The Trump administration has proposed eliminating the on-site requirement.

 

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