Project Development to Address Knowledge Gaps Identified in Long Term Care Related to Water Management Programs and Legionnaires’ Disease

BACKGROUND Legionnaires’ Disease (LD) is a growing concern in the United States. The number of LD cases has increased almost 4.5?times from 2000-2015. Most outbreaks have occurred in long term care (LTC), hospital and hotel settings. The Centers for Medicare and Medicaid Services, released a memo in 2017, which included requirements for LTC facilities to reduce Legionella risk in water systems to help prevent LD cases and outbreaks. However, limited tools and time are available to long term care facilities to meet requirements. A state health department received grant funding to create a video series to help LTC facilities implement and maintain water management programs (WMP). METHODS Key stakeholders were identified and interviewed. Key stakeholders were representatives from LTC facilities- infection preventionists (IP), administrators, and maintenance staff, local public health, state government representatives including an officer overseeing LTC facility surveyors, quality improvement organizations, and presidents of local LTC associations. WMPs were reviewed for 3 LTC facilities. An informal survey of LTC IPs was conducted at a local infection control conference, where participants were invited to write down questions related to LD and WMP, and what would be the most useful tool or activity to assist with implementation of a WMPs in their facility. RESULTS Key stakeholder (n=14) one-on-one interviews were completed. In each interview (n=12) knowledge gaps related to WMP requirements, implementation, and maintenance were mentioned. These gaps were found among LTC IPs, administration, maintenance, and surveyor staff. Knowledge gaps were also found related to what LD is, who is at risk, signs and symptoms and when to test for it. CONCLUSIONS There is a knowledge deficit in LTC facilities related to WMPs and LD. The series of videos created will need to address all steps of WMP creation and LD information to increase LTC staff knowledge, especially among IPs and maintenance.