How Maryland increased infection prevention and control activity in long-term care facilities, 2003-2008

BackgroundIn January 2003, the Maryland Department of Health and Mental Hygiene (DHMH) assessed the state of infection prevention and control (IPC) resources and practices in all long-term care facilities (LTC) in the state. Only 8.1% of facilities that responded employed a trained IPC professional (IP) who managed the facility IPC program.MethodsBetween 2003 and 2008, the DHMH partnered with long-term care industry trade associations and spearheaded regulatory, educational, and financial initiatives to improve this situation. In January 2008, all LTC facilities in the state were resurveyed to determine the impact of these initiatives on IPC activities.ResultsThe 2008 survey indicated that 44% of LTC facilities used a trained IP who managed the IPC program, a 5-fold increase from 2003. Unpublished DHMH outbreak data indicated that LTC facilities with a trained IP recognized and reported outbreaks to the local health department 2 days sooner than facilities without a trained IP, resulting in fewer cases of disease.ConclusionsMultiple initiatives with concerned stakeholders and LTC partners over the course of 5 years resulted in increased numbers of LTC facilities with trained IPs who recognized and responded to outbreaks sooner than facilities without trained IPs.