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A Proactive Approach to IPC for COVID-19 and Beyond -

Strategies to Achieve Early Detection and Minimized Outbreaks of Infectious Disease


April 9, 2021 | Cheryl Scalzo, RN, Clinical Account Specialist, Real Time Medical Systems


The emergence of COVID-19 has shed a bright light on Infection Prevention & Control (IPC) in nursing facilities. With clinical teams stretched beyond their limits, successful facilities are leaning on technology to help drive their IPC efforts.


We recently sat down with Registered Nurse and certified Infection Preventionist, Cheryl Scalzo, Clinical Account Specialist for Real Time Medical Systems, to discuss technology's role in achieving early detection and minimized outbreaks of infectious disease. She explains the value of leveraging live EHR data and documentation in highlighting the most subtle changes in resident condition in real time, utilizing it to call out the early warning signs and symptoms of potential infection.


From facility-wide centralized surveillance to assuring your families are doing everything possible to prevent infection and keep their loved ones safe, learn from first-hand experience how your facility can take a proactive approach to infection surveillance.


Real Time: What role does technology play in the infection prevention and control program?


Cheryl Scalzo: Technology's role in the IPC program is quite significant, especially as it pertains to surveillance aspects of the program. When I think back to my role as an Infection Preventionist, we didn't have the technology to access live data within the EHR. Instead, we manually sifted through each resident chart, battled with illegible handwritten narratives, and then tried to conduct a thorough tracking and trending analysis on the infections that were occurring within the facility.


The capabilities of what technology offers nursing homes today is incredible. The ability to instantly pull live data from the EHR and identify early warning signs of potential infections and automate tracking and trending analysis, saves time and allows us to be better caregivers to our residents.


Real Time: What role does technology play in the infection prevention and control program?


Cheryl Scalzo: Technology’s role in the IPC program is quite significant, especially as it pertains to surveillance aspects of the program. When I think back to my role as an Infection Preventionist, we didn’t have the technology to access live data within the EHR. Instead, we manually sifted through each resident chart, battled with illegible handwritten narratives, and then tried to conduct a thorough tracking and trending analysis on the infections that were occurring within the facility.

The capabilities of what technology offers nursing homes today is incredible. The ability to instantly pull live data from the EHR and identify early warning signs of potential infections and automate tracking and trending analysis, saves time and allows us to be better caregivers to our residents.


Real Time: What specifically should clinicians be doing in order to minimize infectious diseases within their facilities and to avoid potential outbreaks?


Cheryl Scalzo: There are a few key focuses here, I think the most vital are 1) identifying early warning signs and symptoms of potential infections among residents, 2) mapping the infections within the facility to conduct trend analysis, and 3) communicating IPC protocols with your nursing staff.


We are all too familiar with the CDC’s early warning signs and symptoms of COVID-19 and influenza – so I won’t reiterate those, but there are many other infectious diseases that nursing facilities deal with on a daily basis, from urinary tract infections to pneumonia, and C. difficile. The key is being able to easily identify early warning signs associated with these infections, such as increased temperature or sudden change in bowel movements. These subtle changes in condition may seem minor and may be hard to detect among a 200-plus resident population, but they are key to early identification.


Once infections have been identified, it is a requirement within the IPC program to know where within your facility these occurrences are happening. By mapping the infections within your facility, you are able to easily conduct trend analysis to see if the infection may have spread and to isolate that specific unit early before an outbreak occurs across the entire facility. The trending analysis can also help the facility’s designated Infection Preventionist determine if the nursing staff isn’t properly documenting early warning signs of potential infections. This is why it is extremely important to ensure your facility’s nursing staff are informed of what early signs to look for and the protocols to take when identified.


Real Time: Is most of this data found within the EHR?


Cheryl Scalzo: It is, but here again we have some caveats. It is imperative to work closely with your facility’s nursing staff and communicate what early signs and symptoms to look for, but most importantly to document them. As they say, “If we didn’t document it, it didn’t happen.”


However, even with proper documentation, the sheer magnitude of looking through every resident’s medical record can be extremely time consuming and if we have learned anything from COVID-19, it is that time is of the essence to intervene in care and isolate immediately to avoid a facility-wide outbreak. This is where the role of technology becomes essential – having an analytics solution that can analyze live data and documentation within the EHR and immediately notify you of potential infections not only saves time but can help save lives.


Real Time: How does establishing a centralized surveillance system across a multi-facility network improve the tracking and trending components for the IPC Program?

Cheryl Scalzo: Surveillance has to be one of those key pieces in our IPC program. We can’t have anything happen in a facility or across a chain of facilities that relates to infectious processes and not know about it.


The key to establishing a successful surveillance program across multiple facilities is having access to live data from the EHRs as it is being documented. But, can you imagine what that would entail if you are having to establish surveillance and conduct tracking and trending analysis across 5 or even 10-plus facilities? Reading each resident record and sourcing through countless nursing notes, not to mention reviewing all of the assessments and reports for every resident at every facility? This could take days and possibly even weeks to extract the needed data just to begin the analysis.


This is why implementing the right analytics solution is going to help centralize the data, allowing the Infection Preventionist to easily identify early warning signs and automate tracking and trending across multiple facilities. This time saved will allow the Infection Preventionist to focus on the outcomes of the trend analysis and determine how to better improve IPC management.


Real Time: How can facilities use the data, particularly the data analytics you mentioned, to reassure families that their loved ones are in a facility that is proactively taking steps to avoid potential outbreaks?


Cheryl Scalzo: This is a great question, especially with how nursing homes were negatively perceived during the height of the COVID-19 pandemic.

First and foremost, it is essential that every facility have a designated Infection Preventionist on staff. This is a mandatory requirement issued by CMS, but most importantly, it shows the families of your residents that you have a dedicated individual who is monitoring early warning signs and symptoms of infection and proactively working toward the reduction of infectious diseases throughout the facility.


As an added layer of protection, families can be reassured you are doing everything possible to prevent infections in the facility with the help of technology that monitors all residents for the early warning signs of any type of infection 24/7. You will also have the metrics to back up your IPC efforts, should a family member or potential new resident wish to view the history of infection within the facility.


Most importantly, incorporating a data analytics solution into your IPC program will help improve timely communications to the family. Because your facility is using live data analysis to identify early warning signs, you are now able to inform family members early, educate them on when and where (mapping) their loved one first showed early symptoms, and reassure them on the proactive steps your facility is issuing to treat the infection before an adverse situation occurs.


About Cheryl Scalzo, RN, Clinical Account Specialist, Real Time Medical Systems

In her role with Real Time, Cheryl uses her knowledge within the industry to guide clients in unlocking the power of EHR data to improve clinical performance. As a former Director of Nursing, Cheryl has dedicated her career to improving resident care. Cheryl has served as a Certified Infection Preventionist as well as Director of Nursing, where she established and implemented best practices to improve quality outcomes.


About Real Time Medical Systems

Real Time Medical Systems is the industry-leading Interventional Analytics platform that turns data into actionable insights. Serving healthcare organizations nationwide, Real Time improves clinical performance by reducing avoidable hospital admissions and readmissions, managing care coordination efforts, and detecting early warning signs of infectious disease.

www.realtimemed.com

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