Safety

On December 2, 2009, CMS issued Transmittal 55, the final version of the Interpretive Guidelines for Long-Term Care Facilities Tag F441.

According to Tag F441, facilities must establish and maintain an infection control program designed to provide a safe, sanitary and comfortable environment that helps prevent the development and transmission of disease and infection. The interpretive guidelines clearly state that "hand hygiene continues to be the primary means of preventing the transmission of infection."

Surveyor Focus

Tag F441 directs surveyors to focus on infection prevention and control in all departments, and describes when and how staff should clean their hands. You should expect surveyors to closely observe the hand hygiene behavior of your staff. Tag F441 requires surveyors to observe hand hygiene and glove use during medication administration, dressing changes, insertion or removal of a catheter and any invasive procedure.

Tag F441 specifies that hand hygiene should occur before putting on sterile gloves and after taking off all gloves worn during resident care that requires the use of gloves. Except for situations where Tag F441 requires handwashing, alcohol-based hand rub is appropriate for cleaning hands. Staff members are required to wash hands with soap and water when hands are visibly soiled, before and after eating or handling food, after personal use of the toilet and after contact with a resident with infectious diarrhea.

Provide Access

You should ensure that staff members have access to hand washing sinks with soap, water and paper towels as well as conveniently located alcohol-based hand rub. Your staff should know when to clean their hands, the importance of doing so, and understand the consequences of neglecting to follow proper hand hygiene practices.

According to the Centers for Disease Control and Prevention, failure to perform appropriate hand hygiene is considered the leading cause of healthcare-associated infections and the spread of multidrug-resistant organisms.

Make it Cultural

Proper hand hygiene must simply become a part of your culture, if it's not already. Proper hand hygiene is the easiest, most cost-effective measure we can take to prevent the spread of infection. Everyone in the long-term care environment can make a difference: staff, residents, family members and visitors alike.

Consider implementing a resident and visitor hand hygiene education program. Working together as a team, staff and all involved parties can commit to having high infection prevention standards and feel proud to work in a long-term care facility that really cares about resident and staff safety.

Focusing on hand hygiene will help you become survey-ready each and every day.

Bonnie Cruz is a registered nurse with the Manor at Blue Water Bay in Niceville, Fla.