Back to Basics

Hand hygiene supply chain challenges and opportunities in long-term care.

By Paul Girouard

You might have heard this story before, “It’s time to get back to basics with….” fill in the blank. That is the case with hand hygiene in the long-term care market (LTC) segment. The past few years have been the perfect storm of supply chain disruption. Demand for hand hygiene in LTC has always been strong with the market segment representing around a quarter of the market potential in healthcare.

on isolation/patient transfers to an acute care setting, and providing PPE to staff.

Another major change was, “increase the availability and accessibility of alcohol-based hand sanitizer (ABHS) and ensure ABHS is accessible in all resident-care areas including inside and outside resident rooms.” Essentially this was requiring nursing homes and other LTC facilities to double the number of dispensers in their facilities very quickly, and during a pandemic, no easy feat.

The supply chain was not ready for this. Manufacturers did not have enough production. Distribution did not have on-hand inventory. Remember how facilities were limiting outside visitation? Now there was a challenge of getting dispensers installed inside and outside of residents’ rooms.

Today’s challenges

Virtually all regulatory bodies that oversee clinical guidelines point to hand hygiene as the foundation of a good infection prevention program. The need for proper hand hygiene is critical for both LTC residents, their visitors, and staff due to employee safety and the resident’s compromised health.

In March 2020, CMS updated their guidelines with, Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes. Recommendations in the guidance included limiting visitors to facilities (we’ll come back to this later), monitoring health of staff, providing recommendations

Where are we today? Moving inventory through the supply chain has been slow. It’s like the example of turning around the super tanker. Challenges have always included staffing issues within all areas of healthcare, including long-term care. Outside visitors and suppliers have slowly been allowed back into nursing homes.

There is opportunity and work ahead. In other words, it’s time to get back to basics: ʯ Education is always important and desperately needed in LTC settings. ʯ Place alcohol-based hand sanitizer dispensers inside and outside of residents’ rooms. ʯ Check orders to make sure wall dispensers are filled and refilled. This sounds obvious, but remember, there are staffing issues. ʯ Review what products are being used. Many new manufacturers began making ABHS for the first time without knowledge of proper formulation. ʯ Provide a formulary of known hand hygiene items to help drive compliance.

CMS continues to survey facilities for infection prevention and control programs designed to “provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections.”

In conclusion, it’s easy to see the problem. The silver lining here is that we all now understand the importance of hand hygiene in long-term care. There is also a greater awareness of all our roles throughout the supply chain and our value proposition. Wash your hands.