CMS Manual System - Louisiana Department of Health and Hospitals

Essential topics of infection control training include, but are not limited to routes of disease
transmission, hand hygiene, sanitation procedures, MDROs, transmission-based precaution
techniques, and the federally required OSHA education.
Antibiotic Review
Because of increases in MDROs, review of the use of antibiotics (including comparing
prescribed antibiotics with available susceptibility reports) is a vital aspect of the infection
prevention and control program. It is the physician‘s (or other appropriate authorized
practitioner‘s) responsibility to prescribe appropriate antibiotics and to establish the indication
for use of specific medications. As part of the medication regimen review, the consultant
pharmacist can assist with the oversight by identifying antibiotics prescribed for resistant
organisms or for situations with questionable indications, and reporting such findings to the
director of nursing and the attending physician. See the Guidance at §483.65, Tag F329
regarding use of a medication without adequate indication for use and at §483.65, Tag F428
regarding medication regimen review.
PREVENTING THE SPREAD OF INFECTION
Factors Associated with the Spread of Infection in Nursing Homes
Many factors contribute to a substantial severity and frequency of infections and infectious
diseases in nursing homes. These infections can arise from individual or institutional factors, or
both. Modes of transmission of infection include, but are not limited to:
Contact;
Droplet; and
Airborne.
Individual Factors
Examples of individual factors contributing to infections and the severity of the infection
outcomes in facility residents include, but are not limited to the following:
Medications affecting resistance to infection such as corticosteroids and
chemotherapy;
Limited physiologic reserve (e.g., decreased function of the heart, lungs, and
kidneys);
Compromised host defenses (e.g., decreased or absent cough reflex predisposing
to aspiration pneumonia, thinning skin associated with pressure ulcers, decreased
tear production predisposing to conjunctivitis, vascular insufficiency, and
impaired immune function);
Coexisting chronic diseases (e.g., diabetes, arthritis, cancer, COPD, anemia);