10-144-113 Me. Code R. § 2

Current through 2024-51, December 18, 2024

Section 144-113-2 - Infection Prevention and Control

A.Infection Prevention and Control (IPC). The facility must establish, implement, and maintain an Infection Prevention and Control Plan (IPCP) to control the transmission of infectious diseases amongst residents, staff, visitors, and other individuals providing services under a contractual arrangement.

A.1 The facility must employ or contract with a person with certification or training in IPC to oversee the development and implementation of the IPCP.

a. The certification or training must include the following content areas, at a minimum:

i. Standard precautions;

ii. Transmission-based precautions;

iii. Respiratory protection; and

iv. Use of PPE and source control measures.

A.2 The facility must develop a written IPCP. The development process must include:

a. A risk assessment and overall program review. The risk assessment and program review must include:

i. Identification of resources necessary to care for residents during day-to-day operations and emergencies;

ii. Identification of any policies/protocols that need to be developed; and iii. Review of current Maine Center for Disease Control and Prevention (MeCDC) standards and federal Center for Disease Control (CDC) guidelines. The facility should keep a log noting specifically what guidelines were utilized, and identification of any changes needed to meet those standards.

b. The facility must review and update the plan and all related policies/protocols annually, and whenever there is any change or plan for change that would require a substantial modification to any part of the current IPCP.

c. The plan must be updated as needed to reflect current Maine Center for Disease Control and Prevention (MeCDC) standards and federal Center for Disease Control (CDC) guidelines. The facility should keep a log noting specifically what guidelines were utilized, and identification of any changes needed to meet those standards.

A.3 The IPCP must include policies and procedures for the prevention of the spread of any infectious disease, including:

a. Requirements for staff to perform hand hygiene before and after each direct and indirect resident contact for which handwashing is indicated by nationally recognized professional practice;

b. Use of PPE and source control measures;

c. A respiratory protection program;

d. Identification of the adequate amount of PPE to have on hand at all times, and measures to take when PPE is not readily available;

e. The conduct of environmental cleaning and disinfection, specifying the cleaning agents and processes to be used;

f. Documentation of random visual observations of staff use of PPE throughout an outbreak of an infectious disease;

g. Notification of the MeCDC, all other residents and their primary family contact, staff, and the Division of Licensing and Certification (DLC) in the event of an outbreak of a notifiable disease;

h. Transmission-based precautions and isolation of the resident, when the MeCDC determines that a resident needs isolation to prevent the spread of infection;

i. Work-exclusion processes and steps to be taken in the event of a staff or resident exposure, when the type of infectious disease requires instituting specific work restrictions;

j. An exposure control plan to address potential hazards posed by blood and body fluids and other potentially infectious material (OPIM) or infectious diseases;

k. A crisis staffing plan;

l. A process for reporting notifiable diseases to the MeCDC; and

m. A policy requiring consultation with the MeCDC in the management of any outbreak of a reportable infectious disease or novel virus.

A.4 The facility must implement any recommendations of the MeCDC, including but not limited to:

a. Universal testing and resident cohorting, when applicable;

b. Practices for safe visitation or alternatives to in-person visits, and practices to assure resident safety during departures from the facility;

c. Reasonable methods and processes to allow residents to communicate with family and friends in ways that maintain resident safety;

d. Conditions and protocols for screening all full and part-time staff, all essential healthcare individuals who enter the facility (such as hospice staff, physicians, etc.), and any other individual entering the facility.

A.5 The facility must provide education on IPC to all staff at hire.

a. The training must include:

i. Standard Precautions, including:

1. Hand hygiene, which must include procedures to be followed by staff involved in direct patient care or food preparation;

2. Bloodborne pathogens;

3. The proper selection and use of Personal Protective Equipment (PPE); to include putting on (donning) and taking off (doffing); and

4. Respiratory hygiene/cough etiquette;

ii. Environmental cleaning and disinfection;

iii. Transmission-based precautions; and iv. Sharps/injection safety, including immediate actions to take when exposure to blood or other potentially infectious material (OPIM) occurs.

b. Documentation of staff training and observed to be competency in Infection Prevention and Control must be maintained in each employee's personnel file.

c. In the event of an outbreak of an infectious disease, the facility must provide a refresher training to all employees.

d. The facility must maintain a copy of the IPC training curriculum utilized to provide education to staff.

10-144 C.M.R. ch. 113, § 2