High Staff Turnover in Long-Term Care Homes and Its Impact on Infection Control

Persistently high staff turnover rates in long-term care has become a silent crisis, particularly when it comes to infection control. Today, I will be focusing on the challenges posed by the loss of trained infection control staff and the subsequent influx of untrained replacements. I will then explore the implications of this issue and propose strategies to mitigate its effects on resident health, based on my experience both as a Registered Practical Nurse for 7 years and 3 years as an infection control practitioner. 

High staff turnover and low staffing rates in long-term care has long been a concern, probably for as long as Canadians can remember. This issue is further worsened when staff responsible for infection control, be it IPAC leads/practitioners or infection control “champions” within the departments, leave the profession or pursue new opportunities. The departure of trained infection control staff leaves facilities vulnerable to a host of challenges, including increased infection rates and a strain on resources.  

Trained infection control staff are vital in preventing the spread of infectious diseases within long-term care homes. These professionals possess the knowledge and experience to implement appropriate and timely infection control measures and educate other staff members on best practices. However, when they leave due to high turnover rates, several issues arise:  

Firstly, the departure of trained staff disrupts the progression of infection control measures, potentially leading to lapses in protocol. Secondly, the new hires/agency/temporary staff who replace those who left may not receive proper training in infection control, leaving them unable to handle the responsibilities effectively. In addition to this, the ensuing poor infection control practices lead to higher facility costs due to additional precautions and outbreaks. Finally, and most importantly, with inexperienced staff and lapses in infection control, residents and staff are put at greater risk of harm. 

Mitigating the Impact 

Addressing the difficulties, as listed above, from staff turnover, especially regarding infection control, requires a multi-faceted approach:  

• Implement thorough and ongoing infection control training programs for all staff. 

• Allocate sufficient resources to infection control, including PPE, cleaning supplies, and new technology to streamline processes. 

• Establish monitoring (auditing) and accountability programs to ensure compliance with infection control protocols.

• Develop strategies with administration to retain trained staff, such as improved compensation, benefits, and recognition programs.

The high staff turnover rates in care homes in Ontario has had far-reaching consequences, especially when it comes to infection control. If you, the reader, experienced the worst of the COVID-19 pandemic while working in long-term care, you know this very well. The departure of trained staff members and the subsequent introduction of untrained replacements put residents at risk, strain resources, and compromise the overall quality of care. Addressing this issue demands a collaborative effort from administration. By implementing comprehensive training programs, improving staff retention, and prioritizing infection control measures, we can mitigate the difficulties caused by high staff turnover and ensure the safety and well-being of our most vulnerable populations. 

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