Nursing Home Infections

When you entrust your family member’s well-being to a nursing facility, you expect they will be safe and cared for. Unfortunately, nursing home residents are at an increased risk of infections, such as staph infections, which can be harmful and even deadly. 

Below is a deep dive into the causes and types of nursing home infections, ways to prevent them, and legal options for families of nursing home residents who suffered a serious infection because of a home’s negligence. 

Why Are Nursing Home Residents Vulnerable?

Elderly nursing home residents are more susceptible to infections due to age-related and environmental risk factors, including:

• Weakened immune systems – The immune system naturally weakens with age, so the body has more difficulty fighting pathogens, including skin infections.
• Chronic health conditions – Chronic diseases like diabetes, heart disease, or respiratory issues weaken immunity and increase the risk of infection complications.
• Close living quarters – Pathogens can spread quickly in shared living spaces in nursing homes, such as dining rooms and common areas. 
• Invasive medical procedures – Procedures such as catheterization, IV therapy, and wound care create open wounds that allow bacteria and viruses to enter the body. This is one of the most common risk factors for urinary tract infections. Frequent procedures increase the risk of infections.

Common Types of Nursing Home Infections

Some of the most common infections in long-term care facilities include respiratory, gastrointestinal, soft tissue, and urinary tract infections. These common infections increase the risk of sepsis and death. 

Urinary Tract Infections (UTIs)

Urinary tract infections are the second-most common infections among nursing home residents, but they are also the main cause of hospitalization. 

UTIs are especially common in people with indwelling urinary catheters due to the bacteria colonizing the medical device. Each day people spend with a catheter increases the chance of getting a urinary tract infection by 3% to 8%, and women are more prone to contracting a UTI. [1]

Also, this is an over-diagnosed infection in the nursing home population, with reports showing a prevalence between 0.6% and 21.8%. [1]

Respiratory Infections

Besides being the most common infection type, respiratory infections are also the most fatal type. Research shows that respiratory tract infections had a mortality rate of 37% for nursing home patients, while the rate for those who lived in their own homes was 19.3%. [2] 

• Upper respiratory tract infections – Infections that affect the nose, sinuses, and throat are usually mild, but they can escalate in elderly residents and spread to the lower respiratory tract. 
• Lower respiratory tract infections – Bronchitis and pneumonia affect the lungs and airways and are more severe in older adults. 
• Influenza – The flu spreads rapidly through nursing homes, posing a significant risk of complications and death. 
• COVID-19 – COVID-19 spreads quickly, and it can lead to complications such as pneumonia and death. The U.S. Department of Health and Human Services (HHS) reports that 1,300 nursing homes had 75% or higher infection rates during surge periods. [3]

Residents with feeding tubes are at a higher risk of developing pneumonia, as well as residents in nursing homes that do not pay enough attention to oral health.

Skin and Soft Tissue Infections

Soft-tissue and skin infections are a severe health risk in nursing homes, with some studies showing they have a prevalence of 17%. [4] Common skin infections include:

• Cellulitis – A bacterial infection affecting deeper layers of skin, causing redness, warmth, and swelling. These skin and soft tissue infections can cause complications such as gangrene, amputation, shock, and death. 
• MRSA (methicillin-resistant staphylococcus aureus) – This is one of the most dangerous healthcare-associated infections because antibiotic-resistant organisms cause it. It affects open wounds and ulcers and may spread quickly.
• Chronic wound infections – Open wounds that fail to heal over time can become infected. This leads to diabetic wound infections, infected pressure ulcers, and venous ulcers.

Gastrointestinal Infections

Gastrointestinal infections are common causes of outbreaks in skilled nursing facilities. These are the top culprits:

• Norovirus – Norovirus outbreaks are the leading cause of infectious gastroenteritis in nursing homes. The virus is accompanied by contagious diarrhea, vomiting, fever, and dehydration.
• Salmonella and E. Coli  – They spread through improperly prepared food or contaminated water and cause symptoms like nausea, vomiting, diarrhea, and fever, 
• Clostridium difficile  – A common secondary infection that attacks patients with weak immunity. It’s resistant to many antibiotics and disinfectants, making it highly contagious. 

Sepsis

Sepsis is a life-threatening complication of infection in which the immune system goes into overdrive, leading to widespread inflammation and organ failure. If left untreated, it can quickly cause septic shock and death. 

Viral and bacterial infections, such as pneumonia, urinary tract infections (UTIs), pressure ulcers, and gastrointestinal infections, can trigger sepsis if they are not promptly treated.

According to the National Institute of Health, nursing home residents are seven times more likely to suffer severe sepsis compared to non-nursing home residents (14% vs. 1.9%). They also have higher mortality and hospitalization rates. [5] 

Causes of Nursing Home Infections

Nursing homes must protect residents from infections and follow healthcare standards and procedures. Risk factors for increased infection rates include poor infection control and prevention, unsanitary conditions, and inappropriate antibiotic use. 

Poor Infection Control Practices

Infection prevention and control practices are key to preserving the health of nursing home residents. Poor implementation can result in violations, and it typically includes one or more of these issues:

• Lack of hand hygiene – Staff members who do not wash their hands or use sanitizers properly can quickly spread pathogens, especially norovirus and MRSA, from one person to another. 
• Improper cleaning and disinfection – Medical equipment, surfaces, shared spaces, and high-touch areas must be regularly cleaned and disinfected. 
• Inadequate isolation of infected residents—Failure to isolate infected patients can cause rapid spread throughout the facility, especially with flu, COVID-19, and other respiratory illnesses.
• Poorly trained staff – Untrained staff can underestimate the importance of hygiene, personal protective equipment, vaccination, disinfection, and isolation procedures. 

Unsanitary Conditions

Maintaining cleanliness and following disease control procedures can prevent the spread of infections. Pathogens usually spread through:

• Contaminated surfaces – High-touch surfaces, such as doorknobs, light switches, and countertops, can harbor harmful bacteria and viruses, spreading them to staff and other residents.
• Improper handling of laundry and waste – Inadequate sanitation of laundry and waste can contribute to transmitting staph infections, infectious diarrhea, and other illnesses. 
• Poor food handling practices – Food in nursing homes must be obtained, stored, prepared, and served according to industry standards. Any failure can cause the spread of bacteria such as Salmonella and E. Coli. 

Overuse of Antibiotics

Overuse of antibiotics can lead to antibiotic resistance, where bacteria evolve to survive treatment. This makes infections more complicated to treat, as standard antibiotic treatment becomes ineffective.

In assisted-living facilities, antibiotic-resistant infections, like MRSA and C. diff, are particularly dangerous for vulnerable residents, requiring stronger, more expensive medications and prolonged treatment.

Preventing Nursing Home Infections

While infections in nursing homes are common, they can still be prevented and controlled by following standardized protocols, hiring and training enough staff, and providing residents with a quality diet. 

Effective Infection Control Programs

Infection prevention and control programs consist of the following elements:

• Hand hygiene protocols – Regular hand-washing with soap and water and using alcohol-based sanitizers. 
• PPE – The proper use of gloves, masks, gowns, and eye protection.
• Environmental cleaning and disinfection – Routine cleaning and disinfecting of high-touch surfaces, rooms, and equipment.
• Isolation precautions – Isolating infected nursing home residents to prevent further spread. 
• Vaccination programs – Regular COVID-19 and influenza vaccination.
• Antibiotic stewardship – Ensuring antibiotics are prescribed and used properly, without overprescribing. 

Staff Training and Education

Healthcare workers must be educated on proper control and prevention measures, including ongoing training on best practices and emerging threats like antibiotic resistance.

Regular training also reinforces this knowledge, ensuring the staff can recognize the early signs of infection, treat existing infections, and prevent their spread through the facility. 

Proper Nutrition and Hydration

Maintaining residents’ overall health makes their immune systems more resilient to severe infection. This includes:

• Adequate nutrition – Nursing home residents have the right to a balanced, healthy diet that will satisfy their needs. 
• Adequate hydration – Adequate water intake is essential for skin integrity, immunity, and overall health. 
• Physical activity – Regular exercise, rehabilitation, and efforts to maintain mobility can help prevent and fight infections. 
• Mental health – Social activities and good mental health services are crucial for the residents’ well-being and immune response. 

Nursing Home Negligence and Infections

Sometimes, nursing homes don’t comply with their legal duties to protect residents from infections and provide them with adequate, timely treatment. When this leads to resident harm, it can be considered negligent behavior and result in legal consequences. 

Failure to Prevent Infections

The most common nursing home infections are usually preventable. If a nursing home fails to follow infection control protocols and causes harm to a resident, it can be considered negligent. Preventable UTIs, pressure ulcers, and other serious infections can indicate the following:

• Failure to adhere to hand hygiene protocols
• Failure to educate residents and staff on vaccination and document vaccination status
• Failure to use PPE correctly
• Failure to isolate patients and track infections
• Inadequate cleaning and disinfection
• Improper handling of food

Failure to Identify and Treat Infections Promptly

When diseases occur in a nursing home setting, detecting and treating them early is important to prevent more serious infections. Delays in treatment can lead to complications such as chronic illness, endocarditis, increased risk of hospitalization, antibiotic resistance, sepsis, and death. 

Neglect can take multiple forms, including:

• Poor ulcer care
• Failure to provide adequate respiratory care
• Poor colostomy, urostomy, or ileostomy care
• Failure to provide emergency care
• Failure to properly administer medications

Holding Nursing Homes Accountable

If someone you love suffered infection-related injuries due to a nursing home’s negligence, you can hold them accountable by filing a complaint or pursuing compensation through a lawsuit.

Federal and state agencies that oversee nursing homes can investigate your complaint and the facility’s practices. If they find deficiencies, the nursing home can face fines, penalties, or even lose its license. 

You can also file a lawsuit against the home for negligence or medical malpractice. To do this successfully, you must prove that the actions or inactions of the facility directly caused the injuries to your loved one.  

The Role of a Nursing Home Injury Lawyer

Infections in nursing homes sometimes lead to severe injuries or even death. However, investigating the case and proving the facility’s negligence can be complex, time-consuming, and emotionally draining. 

A nursing home injury lawyer can help you hold the facility accountable and reduce the impact of the legal process on your family. 

Investigating Infection Cases

A personal injury lawyer can investigate how the infection developed and whether and how the nursing home contributed to the outcome. They can collect evidence such as:

• Photographs and surveillance footage
• Medical records
• Expert testimonies
• Witness testimonies

Proving Negligence

To ensure a strong case, your lawyer will focus on establishing the four elements of negligence.

Duty of care is the first element, and your lawyer will establish that the facility has a legal and ethical duty to prevent infection and treat your family members according to standards.

Your lawyer will then demonstrate a breach of duty — all the ways in which the facility disregarded the standards. This can include failure to maintain hygiene or detect and treat the infection on time. They will use evidence such as inspection reports, medical records, and witness testimonies.

Causation is the third element of negligence. Your lawyer will have to prove a direct connection between the facility’s action or inaction and your loved one’s illness. For example, the evidence will show that the staff failed to reposition your family member regularly, which made their pressure sores deeper and led to infection.

Finally, the fourth element is damages. Your lawyer will present the medical costs, pain and suffering, loss of quality of life due to the extent of injuries, and other damages.

Seeking Compensation for Damages

In a nursing home infection case, plaintiffs can usually recover the following damages:

• Medical expenses  – This includes treatment and rehabilitation costs, medication expenses, and any assistive devices your loved one may need.
• Pain and suffering – Infections can cause immense pain, suffering, and emotional distress, for which you can also recover compensation. 
• Punitive damages  – In cases of gross negligence, the court may award punitive damages to punish the facility and deter others from acting similarly.

Secure Expert Legal Representation!

Nursing home residents deserve to be safe from infections and their complications. When facilities fail to respect their duty, victims have the right to be compensated for their losses.  

If someone you love has suffered from a nursing home’s negligence, the Nursing Home Law Center can help you hold the facility accountable. Schedule a case evaluation by calling (800) 926-7565 or through our contact form.

References: [1] National Library of Medicine;  [2] National Library of Medicine; [3] Department of Health and Human Services; [4] National Library of Medicine; [5] National Library of Medicine