Long-Term Care and Skilled Nursing Facility Prevention Resources

Alameda County Public Health Department (ACPHD) is committed to supporting our long-term care facilities (LTCFs) and skilled nursing facilities (SNFs) in infection control and prevention (IPC) and antibiotic stewardship activities. The Acute Communicable Diseases Section at ACPHD can be reached by phone or email for consultations or support with questions regarding infection prevention and control or antibiotic stewardship strategies. ACPHD also holds a monthly collaborative forum for healthcare facilities to discuss response to multidrug-resistant organism (MDROs).

To receive a Teams invite to the meeting please email Anna.Davies@acgov.org

Summary of the Prevention Initiative

In 2023, ACPHD received a grant from California Department of Public Health to strengthen IPC and antibiotic stewardship activities in Alameda County SNFs.  We partnered with 20 (~27%) SNFs over the course of six months. From December 2023 – May 2024, we completed 54 on-site visits. Each site received an initial and final assessment, and additional site visits were conducted as needed during the grant period to provide additional support. Informational interviews at the initial site visit were used to create individualized improvement plans for each SNF. Follow-up site visits were focused on implementing the improvement plan.

Other grant activities included hosting virtual bi-weekly office hours. This was an opportunity for Infection Preventionists (IP) and other facility staff to ask questions on implementing their improvement plan, consult with ACD and IP consultants. These office hours also provided an avenue for peer-to-peer collaboration among IPs across different facilities.

We found that facilities needed the most help with training and education of their staff, housekeeping training, building IPC infrastructure, and adhering to proper hand hygiene. We have provided resources below to help improve these aspects of infection prevention and control.

We also assessed appropriate antibiotic use. We focused on providing staff education on when antibiotics are appropriate to prescribe. We used AHRQ’s Minimum Criteria for Antibiotics Tool to help guide antibiotic prescription appropriateness. The point prevalence for antibiotic use decreased in 56% of participating facilities from the initial to final visit.  

Downloadable Resources

• Skin and Soft Tissue Pocket Card
• 4 Moments of Antibiotic Decision-making Pocket Card
• Suspected UTI Pocket Cards
• The Core Elements of Antibiotic Stewardship for Nursing Homes Checklist

Web Resources

• Adherence Monitoring for Contact Precautions
• Adherence Monitoring for EVS Staff
• Adherence Monitoring for Hand Hygiene
• EVS and Disinfection Responsibility Assessment
• EVS Terminal Cleaning Checklist
• Minimum Criteria for Antibiotics Interactive Tool