1. Identify residents at risk.

These are residents who: [1,2,9,10,11]

o Are older
o Live in close proximity to others
o Are confined to bed
o Have had a recent hospitalization
o Experience episodes of aspiration (Residents with dementia, stroke, or feeding
tubes are particularly at risk.)
o Develop viral respiratory infections, especially Influenza.
o Have certain chronic conditions

 Pulmonary diseases such as asthma, bronchitis, ephesema, bronchiectasis,

as well as those who smoke
 Heart disease
 Alcoholism
 Malnutrition
 Immunosuppression
2. Immunize these residents with polyvalent Streptococcal vaccine. [6,8]
3. Reduce opportunities for transmission by separating residents with symptoms of active
pneumonia from asymptomatic residents at risk of becoming infected.

Table 1: Infection Control Activities and Their Relevance to Pneumonia Control in LTC

Infection Control Technique Relevance Comments and Links

Work rules for employees with active respiratory
Barriers to entry infections. Restricting visits from persons with active
respiratory infections.

Immunize all residents and staff who meet the

conditions for pneumococcal vaccination. Although there
is some debate on the efficacy of the pneumococcal
Immunization / Vaccination
vaccine for the prevention of pneumonia, the CDC's
Advisory Committee on Immunization Practices (ACIP)
recommends that the vaccine be used more extensively.

Proper hand hygiene is essential to reducing the spread

Handwashing
of infectious diseases in LTC.
Universal precautions
Wearing gloves
Wear masks to prevent inhalation of infected air droplets
Face and eye protection
during the first 24 hours after the start of treatment.
Aprons or gowns
There are no specific isolation recommendations for
residents with pneumonia.[3] However, isolation is
Resident isolation warranted for the first 24 hours after the start of
treatment since respiratory secretions may still be
infective.
Vaccinate all employees who meet the conditions of
pneumococcal vaccination. In addition, employees
Employee health
should practice proper hand hygiene, use masks when
indicated, and take sick leave when ill.
Educate employees on proper infection control
techniques to prevent the spread of pneumonia. Topics
should include:

Employee education • What is pneumonia?

• How is it spread?

• How can staff and residents be protected against

pneumonia?
Cleaning / Disinfection