Enabling Early and Accurate Detection of​ Infections

For all the strides healthcare has made using technology, many of the industry’s day-to-day processes rely on paper. In countless offices and facilities, paper processes are still the norm. While people are masterful at becoming as efficient as possible, there’s a limit to your efficiency when using a paper-driven process. I see it all the time in long-term care (LTC).

I’ve been in LTC for more than 30 years. I worked as a nursing assistant, became a registered nurse (RN), and obtained my nursing home administrator license after discovering my attraction to the sector. It’s rewarding to help aging individuals with their barriers and struggles and also support the families during these transitions.

I’ve been at Luthercare since 2019 and am currently the clinical systems administrator. We have several levels of care, and two communities offer skilled nursing as part of our continuum, which includes personal care, memory care, and independent living. In my current role, I support our skilled nursing healthcare centers from a clinical standpoint while managing PointClickCare, overseeing various modules, and educating and assisting staff in using them. 

I came to Luthercare from another long-term care provider that didn’t use PointClickCare, and I immediately noticed how much more user-friendly and advanced the PointClickCare platform was compared to other systems.

At the time, we only used the Core solutions including POC and eMAR. But we're growing and deepening our use of the platform. Over time, we've added a lot of modules and different integrations, like Skin & Wound, Lab and Imaging, Nursing Advantage, and most recently, Infection Prevention & Control (IPC). 

The Move Away from Paper

I’m certified in infection prevention, so I am very familiar with the processes surrounding infection control. Prior to using IPC, we relied on our paper workflows if a resident experienced any signs or symptoms of an infection.

While the information about suspected infections eventually made it into PointClickCare using Progress Notes, administrative staff or the infection preventionist had to search for that data and then put measures in place. They were analyzing the symptoms, reviewing the potential infection with a provider for a diagnosis, getting new orders, and establishing the proper precautions to prevent spread. Then, they had to manually communicate all that to staff.

It was very labor intensive, and we had to pull the information sporadically from multiple locations. These steps required extra time from multiple people to perform these manual actions.

Communicating consistently, efficiently, effectively, and quickly helps us find and respond to an infection and prevent or contain an outbreak. While our manual process worked, the new technology offered us ways to improve our communication, share information among teams, and evaluate trends in infection more efficiently. 

An Inspired Transition to IPC

LTC facilities experienced waxes and wanes in outbreaks and infections during the pandemic. As we began to emerge from the worst of the pandemic, we started to explore the benefits of IPC. Staffing was a huge concern. Our administration, nursing, and frontline staff had all taken on multiple tasks that weren’t in their roles before the pandemic. At this time, we found ourselves looking at our workflows, efficiencies, and ways to improve our communication.

The leadership team met to discuss IPC—a solution for real-time, actionable surveillance on emerging infection cases that’s fully integrated with the PointClickCare EHR. Could using the module give our team time back in their schedules? We are very fortunate that our corporate senior leadership team agreed IPC could make the infection control process more efficient, so they gave us the green light.

The PointClickCare team offered training and provided everything necessary for me to answer questions for our team. It was a smooth transition and implementation period, and we began using IPC in November 2022.

Updating Our Approach to Infection Prevention

Our process for infection prevention looks completely different these days. Now, when residents present with symptoms of an infection, the nurses complete an assessment in PointClickCare, documenting the type of symptoms and characteristics the resident presents. That information then becomes an alert for continued resident monitoring.

If a resident is suspected of having an infection, it goes to our facility infection case list, and from there, we can evaluate the symptoms and determine the next steps. IPC prompts for all the essential details, such as getting physician confirmation or diagnosis confirmation, new medications, and laboratory results. All the supporting documentation is in PointClickCare, attached to the resident case.

Another assessment called “antibiotic timeout” follows the regulation of antibiotic stewardship, ensuring that if a provider orders an antibiotic, we have documentation attached to the case. This evaluates whether the right type of antibiotic is being used, if there are any side effects or reactions, and the length of time a resident is on the antibiotic to ensure they are not taking it longer or more often than necessary. Our infection preventionist does that review, typically 48–72 hours after the resident starts the antibiotic course and again after treatment.

PointClickCare facilitates real-time communication through an IPC feature known as “the badge.” A red stop sign pops up when someone clicks into the resident’s chart. When someone hovers over that sign, they see that the resident has a suspected infection, whether it has been confirmed, and the appropriate personal protective equipment (PPE) requirements. This visibility makes it easier for staff who work with the residents, such as an activities team member or a chaplain, to prepare their day before going to the unit. And because it’s centralized in PointClickCare, staff can access it from anywhere, which makes them more efficient.

Before IPC, we had paper maps of the unit and building layouts, having color-coded the residents’ rooms to identify infections and trends. Creating, checking, and making changes to these paper maps took significant time. Now that the information is in IPC, staff can get a sense of the situation with the click of a button.

IPC Offers a Competitive Edge

The earlier we can identify an infection, the better. When a nurse suspects an infection, they can easily document it and put prevention measures in place. Actions and enhanced communication are critical to prevent the spread of infection. IPC enables our team to pull reports, view trends, infection rates and other important regulatory data within minutes. Compiling these types of reports previously would have been a time-consuming process.

Replacing our old manual processes has freed up time for our nurses to focus on their other responsibilities. They are more visible to residents and staff, helping with tasks on the units rather than being stuck in offices doing paperwork for hours on end. Any time anyone can spare to help with daily routines and resident needs makes a huge difference.

IPC also helps from a regulatory and compliance standpoint. Infection control is critically important, and IPC helps us stay compliant, from the antibiotic stewardship program to the role of infection preventionists in the workflow and mandatory infection reporting. We have access to daily, weekly, and monthly reporting, which is valuable for infection control meetings and at survey time, when infection preventionists sometimes have to pull data regarding infections from six months ago. Using IPC helps us ensure we have all the pieces in place. All the information is at our fingertips, and we don’t have to fight through bookshelves of binders filled with spreadsheets to find it. It also improves our communication with residents’ families, helping us more quickly notify families of infections.

We're trying to attract and retain the best staff in a very competitive market, and IPC has the potential to set us apart from other long- term care providers. As we recruit nurses and nurse aides, we discuss the importance of technology so they can see the difference informatics and workflow efficiency makes in their day-to-day workload, reducing the time they spend on paperwork and increasing the time they spend with residents.

We still must do the work, but we have changed how we do it. We work smarter, not harder, with the assistance of IPC.