The Pennsylvania Patient Safety Authority began work in 2010 to assess how implementing evidence-based infection control best practices impacted healthcare-associated infection (HAI) rates in Pennsylvania nursing homes. Ten nursing homes with high HAI rates (H-HAI) and 10 with low HAI rates (L-HAI) were evaluated and compared using a standardized assessment tool in tandem with site visits by an Authority patient safety analyst. The evaluation showed limited adoption of best practices in H-HAI nursing homes. In 2012, the 10 H-HAI nursing homes were reassessed using the same standardized assessment tool and a follow-up interview. Improvements to implementation of best practices were reported for all infection control domains and implementation categories. Infection rates from March through May 2012 were compared with the same baseline period for 2010. The analysis showed a 16% decrease in the mean overall infection rate for these 10 H-HAI facilities. Follow-up assessment identified facilitators and successful methods for implementing best practices in infection control, as well as continued barriers and opportunities for improvement. These results suggest that incorporation of infection control best practices in nursing homes may be associated with decreased infection rates and that identification of focus areas for improvement may be achieved through self-assessment using a standardized assessment tool.
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