Preventing Infections In Long-term Care Settings

With this at-risk population, prevention and overall cleanliness are critical.


According to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 1 to 3 million serious infections occur annually in long-term care facilities.

Additionally, as many as 380,000 people die of infections in these facilities every year.1

With so much at risk for elderly, often immunocompromised, residents, infection prevention and overall facility cleanliness are critically important.

Long-term care facilities function as both a healthcare facility and a home for their residents, meaning that the environment needs to be clean and comfortable as well as disinfected to reduce exposure to disease-causing pathogens.

This not only impacts residents but also consumers’ perception of facilities.

A recent Clorox Professional Products Company survey of U.S. adults with a friend or family member in a long-term care facility found four in five surveyed (79 percent) are concerned about the risk of infection in long-term care facilities.2

Pathogens Of Concern

Two of the major pathogens of concern in long-term care facilities are norovirus and Clostridium difficile (C. difficile).

Norovirus is considered the most common cause of acute gastroenteritis in these facilities and can affect both residents and staff.3

From 2009 to 2013, 62.5 percent of norovirus outbreaks reported to the CDC’s CaliciNet reporting tool occurred in long-term care facilities.4

Learn more from the CMM Infection Control Spotlight issue.

Elderly populations are also at increased risk for C. difficile infection.

According to recent CDC estimates, 75 percent of healthcare-associated C. difficile infections first show up in long-term care facility residents or in patients who have recently received medical treatment.5

Infection Prevention

The good news is that norovirus, C. difficile and many other types of infections are preventable.

This means staff can help protect residents from potentially dangerous pathogens by implementing infection prevention strategies.

There are five key success drivers that infection prevention staff in long-term care facilities should focus on:

  1. Teamwork – Infection prevention is a team effort, involving the facility’s administration and leadership, nursing professionals and environmental services staff.
  2. Education and training – Everyone at the facility needs to understand their role and responsibilities and follow established infection prevention protocols.
  3. Evaluating competency It’s important for staff to frequently show they comprehend protocols and can implement them effectively.
  4. Ensuring proper cleaning and disinfection – One of the most important steps involves knowing what products to use and how to use them for effective disinfection. Manufacturers often have resources available to aid in correct product usage.
  5. Ongoing surveillance – Monitoring daily cleaning and disinfecting practices for effectiveness and providing staff with timely feedback is very important. However, quality improvement requires collaboration because many facilities do not have a dedicated infection preventionist on staff.

Routine cleaning and disinfecting plays a big role in maintaining a healthy and comfortable environment for residents.

Cleaning professionals can build on these five principles and help prevent the spread of pathogens that cause infections in long-term care facilities by implementing the further steps listed here.

1Centers for Disease Control and Prevention. “Nursing Homes and Assisted Living (Long-term Care Facilities).” 22 Jan. 2014. Available from:
2Clorox Professional Products Company and Ipsos. (December 2013). Long-Term Care Consumer Survey. (Survey of 1,019 U.S. adults).
3Schweon, SJ, et al. "Infection Preventionists Guide to Long-Term Care" Association for Professionals in Infection Control and Epidemiology. Washington, DC. 2013.
4Vega, E, et al. “Genotypic and Epidemiologic Trends of Norovirus Outbreaks in the United States, 2009 to 2013.” Journal of Clinical Microbiology 52.1 (2014): 147–155.
5McDonald, LC, et al. “Vital signs: preventing Clostridium difficile infections.” Morbidity and Mortality Weekly Report 61 (2012): 157-62.


Posted On April 24, 2014

Sarah C. Bell-West

Scientist at Clorox Professional Products Company

Sarah C. Bell-West is a scientist at Clorox Professional Products Company. She is a member of the Association for Professionals in Infection Control and Epidemiology (APIC) and holds a B.S. in chemistry from the University of Pittsburgh and a Ph.D. in chemistry from the University of California, Berkeley. To learn more about Clorox Professional and its products for long-term care, visit

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