Analysis of Eleven Long-Term Care Facilities Frontline Nursing Staff Infection Prevention Knowledge

Abstract

Long-term care facilities (LTCFs) face significant challenges providing infection prevention education to staff. Given the increasing prevalence of healthcare-associated infections (HAIs) acquired in sub-acute care, effective strategies to disseminate basic infection prevention concepts and techniques across the continuum may provide substantial public health benefits. This study provides exploratory analysis of eleven LTCF’s frontline nursing staff infection prevention knowledge. During the final two quarters of 2014, frontline nursing staff (defined as Registered Nurse (RN), Licensed Vocational Nurse (LVN), and Certified Nursing Assistant (CNA)) from eleven LTCFs across Southern California participated in an infection prevention aptitude test. The test consisted of various TRUE or FALSE, matched-pair, and multiple-choice questions. The test content reflected infection prevention concepts and techniques, including pathogen transmission, isolation precautions, personal-protective equipment (PPE) use, and sterilization procedures. 177 (88 CNAs, 20 LVNs, 69 RNs) nurses participated in the test. All tests were administered under supervision of the primary investigator. The mean test score across nursing staff was 38.57% (SD 19.64%). The mean test scores for CNAs, LVNs, and RNs was 34.04% (SD 17.95%), 38.67% (SD 18.37%), and 44.30% (SD 20.80%), respectively. A Chi-square test determined there was no significant difference in the mean test score among the three nursing credentials (p = .5087) sampled. However, the observed means between facilities was significantly different (p = .001). These LTCF nursing infection prevention aptitude test results indicate frontline LTCF nursing staff need reinforcement of basic infection prevention education, regardless of credentials. Further, the difference in performance among facilities suggests regional infection prevention education campaigns may be most effective by targeting specific long-term care facilities.