Project Earns High Praise From Healthcare Professionals

The Michigan Antibiotic Resistance Reduction Coalition (MARR) has developed a Long-term Care Tool Kit, which was distributed free-of-charge to all Michigan-licensed LTC facilities in May 2008. It will also be available for download on the MARR website at www.reducemisuse.org. The project was made possible with generous funding from the Centers for Disease Control and Prevention, Blue Cross Blue Shield of Michigan, Pfizer and Elan Biopharmaceuticals.

The project is part of the Long-Term Care Initiative, a MARR-led collaboration with Michigan Department of Community Health, Michigan Society for Infection Prevention and Control (MSIPC), and the Centers for Disease Control and Prevention (CDC) Division of Healthcare Quality Promotion. It is designed to assist clinicians in implementing the “12 Steps to Prevent Antimicrobial Resistance Among Long-Term Care Residents,” a set of recommendations developed by the CDC as part of its Campaign to Prevent Antimicrobial Resistance in Healthcare Settings.

The CDC campaign promotes four infection prevention strategies: 1. Prevent infection; 2. Diagnose and treat infection effectively; 3. Use antimicrobials wisely; 4. Prevent transmission. Each strategy includes specific steps needed to accomplish the stated goal. For example, steps required to prevent infection include vaccinate, prevent conditions that lead to infection, and get the unnecessary devices out. Within each step, specific actions are required. For example, vaccinate includes giving influenza and pneumococcal vaccinations to residents, and promoting vaccination among all staff.

“These strategies sound simple,” said Ruth Anne Rye, Infection Prevention Consultant and co-author of the MARR LTC tool kit, “the devil is in the details. Implementation within an organization or facility requires policy, procedure and protocol, as well as assessment tools to ensure adherence.” That’s where the tool kit comes in. Rye added, “But it only beneficial if the organization implements the practices.”

The MARR LTC Tool Kit follows the CDC 12-step format and provides practical, easy-to-customize protocols, support materials and resources for each step. The materials and recommendations are developed from published evidence-based research, standards of practice, or recommendations obtained from CDC/HICPAC, professional organizations or other recognized sources. In cases where none of these sources are is available, the information provided represents effective “best practice.”

Infections are a significant source of illness and death in the long-term care setting. It is estimated that between 1.6 million and 3.8 million infections occur annually among residents in LTC facilities. Infections account for up to half of all transfers from LTC facilities to hospitals and result in an estimated 150,000 to 300,000 hospital admissions annually. Numerous studies indicate that pneumonia, urinary tract infections, and skin and soft-tissue infections account for nearly 75 percent of all infections acquired in the LTC setting.

“When all you have is a hammer, everything looks like a nail,” Rye added, “Our goal is to provide clinicians with a variety of tools that they can customize to the specific needs of their facility and thereby help prevent infection and reduce antimicrobial resistance among their residents.”

For more information about this or any MARR Coalition initiative, please contact Mary Eley, MARR Coaltion Executive Director.