Identifying the gaps in infection prevention and control resources for long-term care facilities in British Columbia

Background: Infection prevention and control (IPC) is a critical, although often neglected, part of long- term care (LTC) management. Little is known about what IPC resources are available for LTC and how that impacts patient care and safety.
Methods: One hundred eighty-eight LTC facilities were randomly selected out of all British Columbia facilities and surveyed using a validated survey tool. The tool was used to collect data regarding IPC resources grouped within 6 indices: (1) leadership, (2) infection control professionals (ICP) coverage, (3) policies and procedures, (4) support through partnerships, (5) surveillance, and (6) control activities. All components measured have been identified as key for an effective IPC program. Survey responses were used to calculate scores for IPC programs as a whole and for each of the 6 indices.
Results: Of 188 randomly selected facilities, 86 institutions participated. Facilities were compared by region, funding source, and ICP coverage. Overall, LTC facilities lacked IPC leadership, especially physician support. Having no dedicated ICP was associated with poorer scores on all indices. Only 41% of practicing ICPs had more than 2 years experience, and only 14% were professionally certified. Twenty-two percent of ICPs had additional roles within the institution, and 44% had additional roles outside of the institution. Thirty-five percent of institutions had no IPC dedicated budget.
Discussion: LTC institutionsdwith bed numbers exceeding those in acute caredrepresent an important aspect of health services. These data show that many LTC facilities lack the necessary resources to provide quality infection control programs.