Coordination + Communication = An Effective Infection Prevention and Control Program

By: M. Caleb Beary, PT, Senior Director of Therapy, ATS

The importance of maintaining proper infection prevention and control (IPC) best practices has never been more critical. As skilled nursing providers continue to care for patients with higher acuity and invasive devices, the potential for health care-associated infections continues to increase. (source: Office of Disease Prevention and Promotion)

Developing a coordinated approach to IPC to decrease the potential spread of COVID-19 and other infections is key to ensuring the best patient outcome is achieved.

To reach a plan of care goals, it is now normal for several members of the IDT to directly provide multiple therapy modalities (e.g., ultrasound, electrical stimulation, Transcutaneous Nerve Stimulation (TENS), wound care management, etc.). Also, due to the COVID-19 pandemic, the patient receives in-room treatments, that could include working on ADLs with Occupational Therapy, gait training with Physical Therapy, dysphasia and cognitive training with Speech Therapy and wound care management with physicians and nursing.

The Advanced Therapy Solutions (ATS) team is ready to support patients to achieve their functional goals while maintaining effective IPC best practices. Below is a brief Q&A of the approaches our team is taking to help maintain IPC compliance at Generations at Neighbors Rehabilitation & Post-Acute Care.

Q: What are a few of the unique aspects of Generations at Neighbors’ (Neighbors) Rehabilitation Care program?

A: The primary goal is to help patients regain their maximum functional capacity while ensuring the shortest stay possible. ATS’ therapists and therapy assistants are integral members of the Interdisciplinary team (IDT). Our therapists provide individualized therapy services for many conditions, including ortho rehab, joint replacement, amputation recovery, wound care, and more. Throughout the COVID-19 pandemic, we are still caring for patients with multiple therapy needs.

Q: What changes have been made to your approach to providing therapy during the COVID-19 health emergency?

A: Fortunately, Neighbors was well-prepared for COVID-19 due to its comprehensive Infection Prevention and Control (IPC) program, which includes policies & procedures, use of PPE, routine handwashing, equipment cleaning, etc. Even prior to the COVID-19 pandemic, our team has been following best practices for IPC, including proper masking and gowning, and wiping down all equipment and modalities to limit other infections, like MRSA and C.diff.

The biggest adjustment has been to providing individual therapy in the patient’s room vs. in a larger group or in the rehab gym. To complete in-room therapy, our team has had to be more creative, for example, using cones and other equipment to complete balance training and gate training. Since most patients are in private rooms, our therapists have been able to provide an even more personalized approach to supporting ADL goals and independent function. As appropriate, therapists keep patients’ necessary equipment for specific modalities in their room. When that is not possible, strict sanitization procedures are implemented. Also, before COVID-19, our team was able to complete face-to-face meetings with caregivers/family members to review the patient’s home environment and prepare for discharge. Now we use the phone to relay information. For updates to the patient’s plan of care, if we are unable to meet directly, we use video calls to communicate therapy progress and discharge plan updates.

Q: What advice do you have for other clinicians as they care for residents to ensure IPC best practices during COVID-19 pandemic and beyond?

A: As with everything we do as healthcare professionals, communication remains key especially between members of the IDT. Frequent meetings help to identify and reinforce IPC best practices that can be shared across disciplines. Our therapy team has a standing meeting each Monday to review any updates to our patients’ functional status and upcoming discharge plans and discuss goals and any obstacles to returning home. After gathering feedback from the therapy team, I meet with the other IDT members to further discuss the plan of care. This helps to ensure we are all focused on achieving the patients’ goals.

Leadership Recommendations

  • Ensure the IDT discusses specific IPC best practices during care planning meetings to ensure consistency across all disciplines.
  • If a patient is in quarantine or isolation, think ahead about items and equipment needed prior to entering the room to help reduce the risk of contaminating the patient’s environment.
  • Dedicate consistent staff to assigned patients, where possible, to help reduce the risk of cross-contamination.
  • Provide appropriate PPE and other resources to maintain IPC compliance.
  • Support the IDT with the resources, tools and training needed to foster a collaborative environment and staff competency.