Chapter 66 – Rehabilitation Services

• 
• 
• 
• 

ABSTRACT

In the postacute rehabilitation setting, interdisciplinary care is the primary medium for delivery of care. The team concept used in the interdisciplinary process allows for ongoing communication and collaboration among caregivers. Teamwork can result in successful outcomes due to the open communication and support of team members. However, the rehabilitation team is most complete if it also involves patients’ families and significant others within the rehabilitation process.

Because rehabilitation patients often experience multiple complications or comorbidities following acute hospitalization, it is especially essential for all team members to collaborate and gain information and insight about the patient’s needs across the continuum of care. A crucial area where good communications is of paramount importance is the identification of any infection prevention concerns or challenges to facilitate appropriate management and intervention to reduce infection risks and improve outcomes. Patients and families also are critical participants in preventing infection and mitigating risks and need to understand key elements related to infection prevention.

If a patient develops an infection during a stay at a rehabilitation hospital, it can contribute to a longer length of stay and decreased improvement in functional status.¹ The literature clearly identifies specific methods to reduce the potential for development of healthcare-associated infections (HAIs). Many of these options exist as process-related “bundles” of care that when implemented appropriately are intended to prevent infection.^2–9

There are no formal infection prevention guidelines that apply specifically to the rehabilitation setting. The rehabilitation facilities should evaluate acute setting infection prevention guidelines, adapt and apply the general principles and strategies to their setting, and develop innovative approaches to prevent infections among patients.² Additional strategies include the application of Isolation Precautions or Transmission-Based Precautions in the rehabilitation setting to accommodate the patient’s rehabilitation needs while adapting practices to reduce the risk of transmission. The rehabilitation infection preventionist should adapt the recognized guidelines and evidence-based practice recommendations along with implementing the bundle approach used by Institute of Healthcare Improvement (IHI), the Centers for Disease Control and Prevention (CDC), and professional societies. By applying evidence-based practices from acute care, the rehabilitation team will be able to deal with their patients’ increased complexities following acute care and improve their outcomes.^4–9

Last Revised: 12/13/09 10:30 PM