New standard for safer long-term care homes

By CSA Group

The global pandemic has shone a light on the unique challenges in Canada’s long-term care (LTC) sector. CSA Group has recently published a new national standard CSA Z8004:22, Long-term care home operations and infection prevention and control, that aims to help create safer LTC homes.

Driving Principles Of The New Standard

While the Standard was developed by CSA Group members - experts across a range of different areas representing various stakeholders and perspectives, it was informed by insights and experiences of LTC homes residents, their families communities, caregivers, and staff. In the public consultation sessions and surveys, they emphasized that LTC facilities should first and foremost feel like homes for their residents. This notion is reflected in the driving principles of the new Standard: person-centred care balancing residents’ autonomy and safety, equity, diversity, and inclusion (EDI), and gender and sexual inclusivity.

What Is In The Standard

The CSA Z8004:22 standard covers topics including:

• Organizational commitments. LTC providers and management are encouraged to embrace collaborative decision-making and principles of person-centred care, EDI, and gender and sexual inclusivity in order to create an inclusive and supportive environment for residents and staff. Design, IPAC policies and procedures, and operations in LTC homes should meet the needs of residents and ensure their safety, autonomy, and respect for cultural and religious differences. LTC providers and management should also promote and support positive interactions and relationship-building between staff and residents, their families, and caregivers.

• Operations and catastrophic event management. The guidance for LTC home operations includes recommendations for meaningful activities based on knowing residents and their abilities. The Standard helps establish policies and procedures for visitors, including support for visitation during outbreaks, epidemics, or pandemics, and offers provisions for cleaning and other environmental services that contribute to clean and sanitary environments within LTC homes.

Food and nutrition management is an important part of the Standard, with recommendations to create tailored and culturally appropriate meal plans and provide mealtime flexibility and environments that promote quality of life.

The Standard also helps LTC homes develop plans to minimize operations disruptions during extreme weather events, loss of power, airborne and organic contamination, or other catastrophic events.

• Infection prevention and control (IPAC). The Standard can assist LTC homes in developing and implementing IPAC programs based on best practices, guidelines, and recommendations from national and international authorities and the scientific literature. It recognizes the importance of hand hygiene and personal protective equipment, as well as cleaning and disinfection policies and procedures.

• Design, building systems, and information technology (IT). The Standard promotes the residential design of LTC homes, maximizing the dignity, privacy, and autonomy of residents and connection of LTC homes with surrounding communities. The recommendations apply to residents’ bedrooms and washrooms as well as visitor and outdoor spaces, kitchen, dining, and laundry areas, and also address materials, finishes, furniture, fittings, equipment, signage, and wayfinding systems.

Building systems, such as electrical, plumbing, HVAC, and medical gas systems or electronic build- ing and security systems contribute to a safe and comfortable environment for residents, staff, and visitors of LTC homes. CSA Z8004:22 provides requirements and recommendations for their design and maintenance.

IT plays an important role in keeping LTC home residents connected with their families and care providers. The Standard guides LTCH homes through the design, selection, and implementation of IT systems, as well as data management and privacy.

• Training and simulation. The Standard also outlines training and education LTC homes staff should receive on various topics, including sexual expression and intimacy, inclusive language, waste management, IPAC, IT systems, and catastrophic event management.

Helping Stakeholders Understand The Requirements

A set of self-directed and instructor-led online courses can help LTC homes administrators and staff, architects, health care engineers, and other stakeholders better understand the requirements and recommendations of the new Standard and their application. These courses cover operations, management, and maintenance of LTC homes, person-centered care, and IPAC in LTC homes.

CSA Group is also having ongoing conversations with various government and industry stakeholders to help ensure that they have the information and tools needed to voluntarily utilize CSA Z8004:22 and consider it for potential referencing in regulations.

For more information on the new standard CSA Z8004 and training related to LTC homes, visit www.csagroup.org/LTCStandard.