Infection Prevention: Getting Back to the Basics

Fact: Although COVID-19 spreads mainly through respiratory droplets, you can get sick if you touch something that has live virus on it and then touch your face before washing your hands. This research finding from the National Institutes of Health is important to know because the virus that causes COVID-19 can stay live on plastic and stainless steel surfaces for up to three days.

Learning about the “dwell time” of disinfectants was just one of the many things the therapy staff at Jones County Rest Home discovered as they investigated the cause of a COVID-19 outbreak at the Ellis, Mississippi, facility. This new understanding led to a back-to-basics intervention: proper hand hygiene (PDF).

“What we learned was that infection control is a team effort,” said Gwen Martin, the TMF Quality Innovation Network-Quality Improvement Organization (QIN-QIO) specialist who worked with Jones County Rest Home. “We all focus on nursing extensively, as they have the highest level of interaction with the residents. But when your nursing staff is doing everything correctly, it is time to look elsewhere.”

The TMF QIN-QIO assisted Jones County Director of Nursing Justin Mann in his quality improvement efforts. “We completed a root-cause analysis (PDF) and a virtual on-site infection control assessment (PDF) that identified how we needed to modify our infection control practices,” said Mann.

Contact tracing revealed that the therapy department was the common denominator for the continued outbreak. While the therapy team members wore masks, practiced social distancing and wiped chairs between use, they noticed during the on-site infection control assessment that there was a deficit in hand hygiene between each resident — knowing the proper times to wash with soap and water, how to effectively use environmental cleaning and knowing dwell time of the disinfectant (PDF).

In addition to emphasizing hand washing, “Our assessment revealed the need to designate a ‘clean’ and ‘dirty’ area for equipment to prevent cross contamination,” Mann said. Visual reminders, such as High Five: The Correct Way to Wash Your Hands (PDF), helped reinforce the message about hand hygiene and the need to keep sterile equipment separate from the soiled.

The interventions, Mann said, “had a direct positive impact on patients who get therapy at the facility and indirectly helped safeguard the health of everyone in our home.”

Mann is happy to report that ongoing audits “reveal that there is 100% compliance” with the new protocols. What’s more, the activities department now follows the infection control processes, and Jones County Rest Home “has not had any new COVID-19 outbreaks.”