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Post-Wanaque Policy Report to Improve Infection Control at Long-Term Care Facilities Issued by NJDOH

New Jersey

The Department of Health today released a report recommending all long-term facilities with pediatric and adult ventilator beds have an infection control plan that allows for separation of sick and well residents—and the staff caring for them—as quickly as possible and monitoring of staff and residents for illness.

The Department recommended that some of its policy changes be included in statute (others in regulation) and today the Senate and Assembly Health committees introduced legislation to address key recommendations in response to the deadly adenovirus virus outbreak last fall at the Wanaque Center for Nursing and Rehabilitation.

“There is much that our healthcare system can learn to make long-term care more prepared and responsive to outbreaks when they occur. We appreciate that the chairs of the Senate and Assembly health committees have adopted several key recommendations to ensure infection control protocols are state of the art in long-term care facilities caring for New Jersey’s most vulnerable patients,” said Health Commissioner Dr. Shereef Elnahal. “Ensuring that all staff are regularly trained in proper handwashing protocols and other infection control procedures is the best way to prevent the spread of respiratory viruses in long-term care facilities.”

A key Department recommendation requires all long-term care facilities with ventilator beds to have an outbreak plan that addresses:

Policies for patient and staff notification;

Availability of lab testing;

Protocols to assess if visitors are ill;

Protocols to identify/exclude sick staff from the facility;

Separation of sick and well patients at the outset of an outbreak to prevent spread of illness.

The Governor’s proposed budget includes $2.5 million in competitive grant funding to address another recommendation in the report—to strengthen the ability of local health departments to respond to outbreaks of infectious diseases.

The report also recommends amending state regulations to require long-term care facilities with ventilator beds to implement protocols to ensure that parents and guardians of residents are immediately notified of outbreaks; hire a full-time infection control professional; and have an agreement in place to consult with an infectious disease specialist during an outbreak. In addition, all staff would have to be trained in infection control policies every six months—including protocols for identifying employees and visitors who display signs of illness.

In addition, the Department’s Communicable Disease Service will develop a respiratory virus outbreak preparedness checklist to help facilities prepare for outbreaks. Before the next outbreak season, the Department will also develop and present respiratory virus outbreak response training materials via webinar or in-person trainings.

“The way to deal with a tragedy of this magnitude is to take direct action so that it does not happen again,” said Senator Joseph F. Vitale (D-Middlesex). “I’m glad the legislature and the Department of Health responded with such immediacy to analyze what went wrong and what changes must be made to prevent such heartbreaking outcomes in the future. Together we will ensure that the facilities taking care of our most vulnerable residents have the proper plans in place to effectively respond to outbreaks.”

Other recommendations include continued funding for state lab testing respiratory virus outbreak specimens and for the Department’s Infection Control Assessment and Response Team (ICAR) and state funding for staff dedicated to respiratory virus surveillance.

“I look forward to working closely with Chairman Vitale on crafting legislation to ensure long term care facilities are prepared to deal with inevitable infectious disease outbreaks,” said Assemblyman Herb Conaway (D-Burlington).

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