Rehabilitation Services

Author(s):
Amelia C. Bumsted, BA, BS, RN, CRRN, CIC Infection Control Coordinator

Marianjoy Rehabilitation Hospital
Wheaton, IL

Published:
October 3, 2014

Abstract

The rehabilitation setting is challenged with treating the entire patient: mind, body, and spirit. The conceptual framework of holistic nursing, a common practice model in the rehabilitation setting, views environment as healing.1This presents a challenge when the infection preventionist is faced with a patient with a multidrug-resistant organism that requires Contact Precautions, limiting the patient's movement in the environment. Rehabilitation facilities must evaluate the numerous factors that influence transmission risks and their unique settings to develop infection prevention policies and procedures that apply to the types of patients they treat and the services they provide. Transmission-based Precautions are based on the current knowledge of disease transmission and therefore need to be applied in the rehabilitation setting with the same principles. Team members may need to wear gowns, masks, or gloves in the hallways or in gym areas when working with a patient with an MDRO. Family members who assist with care need to be educated on MDROs and good hand hygiene practices while at the facility and in preparation for discharge. Equipment used to provide rehabilitative services to the patient may present increased risk of infection. Disinfection of the environment and equipment, along with frequent hand hygiene, are important infection prevention strategies to interrupt the chain of transmission of infectious pathogens in inpatient rehabilitation facilities. In the rehabilitation population as a whole, there are many specialty populations with unique needs and characteristics that affect their risk for and response to infection. In order to perform meaningful surveillance in these specialty populations, a thorough understanding of these unique characteristics and how they relate to traditional methods and surveillance definitions is required.