A multisociety group composed of American Geriatrics Society (AGS), Infectious Diseases Society of America (IDSA), Post-Acute and Long-Term Care Medical Association (PALTmed), Association for Professionals in Infection Control and Epidemiology (APIC), and The Society for Healthcare Epidemiology of America (SHEA) recently released an updated consensus statement focusing on infection prevention and control (IPC) in nursing homes in the United States.
The 2025 statement updates the previous, 2008 SHEA/APIC guideline, Infection Prevention and Control in the Long-Term Care Facility. In the 2025 update, reflecting the growing function of nursing homes in today’s clinical landscape, the statement modernizes nursing home IPC program recommendations.
With a total of 42 recommendations provided, the AGS/APIC/IDSA/PALTmed/SHEA guidance document Infection Prevention and Control in Nursing Homes is an extensive tool for IPC program leaders in US nursing homes. Today, we are summarizing a few key recommendations. For a complete look at the recommendations, consult the full text version.
2025 Infection Prevention and Control in Nursing Homes – Key Highlights
- Recommendation 1: The resources for a nursing home’s IPC program should include one or more infection preventionists and sufficient dedicated time for the preventionist(s) to manage the IPC program, as well as adequate staffing and supplies to maintain IPC best practices. There should also be dedicated time for staffing personnel to receive regular IPC training, IT training, and access to expert advice and infrastructure-related services to facilitate surveillance activities and public health surveillance programs.
- Recommendation 4: Nursing homes should perform risk assessments annually. The annual risk assessment should encompass all levels of care (resident, process, and facility). Resident-level assessment should consider the individual patient’s risk of infection based on the types of services and care needed and provided by the nursing home. Process-level risk factors are gaps that may affect HCP adherence to best practices. Facility-level risk factors include geographic location and infrastructure of the building (e.g., ventilation, water systems, heating).
- Recommendation 10: IPC-specific information that should be transmitted during resident/patient transfers includes vaccination status for relevant vaccines, current or recent antimicrobial exposure, any current skin conditions, identification of any indwelling medical devices, wounds, diarrhea, or uncontained secretions, the need for and type of Transmission-Based Precautions, any pending test results, relevant microbiological data, and a history of colonization or infection with MDROs.
- Recommendation 13: To decide which symptoms, syndromes, and microorganisms to include in a surveillance program, nursing homes should establish priorities for routine surveillance of healthcare-associated infections based on community risks, the needs of the facility, and regulator requirements. Nursing homes should adopt standardized definitions and methods of reporting.
- Recommendation 20: To ensure proper use of PPE, nursing homes should make PPE available at the point-of-care when residents are placed on Transmission-Based Precautions, ensure HCP use PPE based on the nature of their interactions with residents, develop a policy for Standard and Transmission-Based Precautions that describe the type of PPE, use indications, and donning/doffing procedures, provide HCP accessible PPE, monitor adherence practices, and provide feedback.
- Recommendation 25: For detecting and responding to outbreaks, nursing homes should be aware of viruses/pathogens circulating in the community, understand how pathogens spread and implement pathogen-specific screening, educate HCP on symptom reporting, implement sick leave policies for HCP, implement early diagnostic testing, implement appropriate Transmission-Based Precautions based on symptoms while awaiting a diagnosis, communicate with referral hospitals and public health departments, vaccinate residents and HCP, and identify strategies for the nursing home’s access to and use of therapeutics early on.
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