Complexities in Correctional Settings: Application of Epidemiology and Multiple Care Settings

Session Description: The United States (US) had an estimated 1.8 million individuals in custody (IIC) in 2023, or 531 per 100,000 of the nation's population. These individuals have higher rates of communicable disease compared to the non-incarcerated populations, including Hepatitis C Virus, ten times higher; Tuberculosis, six times higher; Coronavirus, three times higher; and acquired immunodeficiency syndrome, three times higher. Implementing infection prevention and control measures requires the incorporation of multiple different settings, including acute care, critical access, outpatient services, long-term care, behavioral healthcare, and congregate residential care. However, there are few educational opportunities or best practices to determine infection prevention applications. Both medical and non-medical employees must work together to understand and apply infection prevention and control (IPC) in the correctional setting to protect the IIC, coworkers, and visitors from physical harm and communicable pathogens. Knowing that successful transmission prevention efforts in the correctional setting can positively correlate with the general population, a site visit was conducted at the US's largest single-site county pre-detention facility to understand current facility standards, application, and outcome of infection prevention practices. Through research of current practices and facility-specific considerations, a determination of infection prevention and control best practice applications specific to carceral settings was completed. A daylong educational session and competency assessment were developed and delivered, including the application of standard precautions and effective measures, including screening, vaccination, care coordination, and the environment of care. The last step was developing and distributing a comprehensive correctional infection prevention toolkit to support the application across other jurisdictions with correctional settings. This presentation will share the setting challenges, known transmission risks and rates, presentation and competency subjects and methods, and resources generated, instilling confidence in the proposed solutions while allowing for an open conversation on the need for IPC standards in high-risk, congregate settings.