COVID-19 resources on infection control

Results 31 - 40 of 332

Order by    Date Title

Could we have done better with COVID-19 in nursing homes?

Editorial. Analysis from the first wave of COVID-19 coronavirus pandemic to identify which features of long-term care (LTC) did and did not work. The editorial covers: organization and structure limitations; lack of infection control; education via e-learning; insufficient human resources; emotional burden of the staff; ethical crisis; lack of plan for a crisis situation. Citation: Szczerbinska, K. Could we have done better with COVID-19 in nursing homes?. European Geriatric Medicine 11, 639–643 (2020). https://doi.org/10.1007/s41999-020-00362-7

Last updated on hub: 13 November 2020

Finding the right balance: an evidence-informed guidance document to support the re-opening of Canadian nursing homes to family caregivers and visitors during the coronavirus disease 2019 pandemic

Journal of the American Medical Directors Association

During the first few months of the coronavirus disease 2019 (COVID-19) pandemic, Canadian nursing homes implemented strict no-visitor policies to reduce the risk of introducing COVID-19 in these settings. There are now growing concerns that the risks associated with restricted access to family caregivers and visitors have started to outweigh the potential benefits associated with preventing COVID-19 infections. Many residents have sustained severe and potentially irreversible physical, functional, cognitive, and mental health declines. As Canada emerges from its first wave of the pandemic, nursing homes across the country have cautiously started to reopen these settings, yet there is broad criticism that emerging visitor policies are overly restrictive, inequitable, and potentially harmful. We reviewed the nursing home visitor policies for Canada's 10 provinces and 3 territories as well as international policies and reports on the topic to develop 10 provi-informed, data-driven, and expert-reviewed guidance for the re-opening of Canadian nursing homes to family caregivers and visitors.

Last updated on hub: 13 November 2020

A study of universal SARS-CoV-2 RNA testing of residents and staff in a large group of care homes in South London

Corrected proof first published 5 September 2020. Background: Care homes have experienced a high number of coronavirus disease 2019 (COVID-19)–related deaths among residents since the onset of the pandemic. However, up to May 2020, there has been a lack of information about the extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among residents and staff in care homes and limited testing in this setting. Methods: Combined nose and throat swab testing for SARS-CoV-2 RNA was carried out in 2455 residents and staff across 37 care homes in the London Borough of Bromley across a 3-week period. Results were reported within 24 hours of sample delivery, and data were collected on the presence or absence of symptoms. Results: Overall, the point prevalence of SARS-CoV-2 infection was 6.5%, with a higher rate in residents (9.0%) than in staff (4.7%). A key finding was the high proportion of asymptomatic infection detected in staff (69%) and residents (51%), with evidence of underdetection of symptoms by care home staff. Conclusions: The high proportion of asymptomatic infection combined with underdetection of symptoms by care home staff indicates that offering a test to all residents and staff in care homes with rapid reporting of results would assist accurate identification of infected individuals, facilitating prompt infection prevention and control action. Citation: Marossy, A. et al. (2020). A Study of Universal Severe Acute Respiratory Syndrome Coronavirus 2 RNA Testing Among Residents and Staff in a Large Group of Care Homes in South London. The Journal of Infectious Diseases.

Last updated on hub: 13 November 2020

Medicine is a social science: COVID-19 and the tragedy of residential care facilities in high-income countries

Commentary published in BMJ Global Health, 5(8) 2020. Comments on the pandemic spread of COVID-19 in high-income countries that have witnessed an extraordinary high death toll of people living in residential care facilities. Provides insights from a social sciences and public health perspective about infections. Citation: Krones, T., Meyer, G., & Monteverde, S. (2020). Medicine is a social science: COVID-19 and the tragedy of residential care facilities in high-income countries. BMJ Global Health, 5(8), e003172.

Last updated on hub: 13 November 2020

Practical steps to improve air flow in long-term care resident rooms to reduce COVID-19 infection risk

Journal of the American Medical Directors Association

The potential for spread of COVID-19 infections in skilled nursing facilities and other long-term care sites poses new challenges for nursing home administrators to protect patients and staff. It is anticipated that as acute care hospitals reach capacity, nursing homes may retain COVID-19 infected residents longer prior to transferring to an acute care hospital. This article outlines 5 pragmatic steps that long-term care facilities can take to manage airflow within resident rooms to reduce the potential for spread of infectious airborne droplets into surrounding areas, including hallways and adjacent rooms, using strategies adapted from negative-pressure isolation rooms in acute care facilities.

Last updated on hub: 13 November 2020

Lessons Learned - outbreaks of COVID-19 in nursing homes

Letter to the editor published in the American Journal of Infection Control on 30 July 2020. Provides five key lessons learned and guidance for preventing the introduction of COVID-19 into the local nursing homes, and subsequently preventing its spread within these facilities. Citation: Kim, J. J. et al. (2020). Lessons learned - Outbreaks of COVID-19 in nursing homes. American Journal of Infection Control.

Last updated on hub: 13 November 2020

Did the UK government really throw a protective ring around care homes in the COVID-19 pandemic?

Journal of Long-Term Care

Context: COVID-19 has disproportionately impacted mortality in English care homes. Objectives: To examine COVID-19 policies for care homes in England and to describe providers’ experiences of those policies in May and June 2020. Methods: Mixed methods including policy analysis and an anonymous online survey of English care home providers, recruited using webinars and WhatsApp groups about their experiences of funding, testing, PPE, isolation and staffing until the end of May and early June 2020. Findings: Although social care policies in England have aligned with those advised by the World Health Organization, they were arguably delayed and were not implemented effectively. Testing had taken place in 70% of care homes surveyed but only 36% of residents had been tested, of whom 16% were positive. Managers were unable to effectively implement isolation policies and reported that workforce and funding support did not always reach them. Guidance changed frequently and was conflicting and could not always be implemented, for example when personal protection equipment was extremely expensive and difficult to source. Limitations: Although this was not a representative sample, care homes responded from across the country and this study reports the most consistent themes. Potentially, care homes that found it harder to implement national guidance may have been more inclined to respond to the survey than those who more easily changed practice, although those with outbreaks may also have had less capacity to respond. Some aspects of policy will have also changed since early June. Implications: Despite policies that were put in place, care homes amongst the survey respondents were still unable to access sufficient funding, testing, PPE, workforce support and practical support to isolate residents by the end of May and early June. Future cross-country policy analyses must examine policy implementation as well as content.

Last updated on hub: 11 November 2020

Adult social care winter preparedness plan 2020-21

Scottish Government

This Plan sets out the winter preparedness measures already in place that must be retained and those that need to be introduced across the adult social care sector in the midst of the global pandemic of COVID-19. The Plan is centred around four key principles: learning from evidence to protect people who use social care support from the direct impact of COVID-19, and wider winter viruses; ensuring that people have good physical and mental health and wellbeing through provision of high quality integrated care services; supporting the social care workforce to enable the delivery of safe support and care and to have positive mental health and wellbeing; working in collaboration to plan and deliver quality care. Within these categories, the Plan provides specific guidance on a range of critical issues such as: infection control; testing and vaccination; PPE; hospital discharge; mental health; staff movement; outbreak management; new funding; and fair work.

Last updated on hub: 11 November 2020

Care home review: a rapid review of factors relevant to the management of Covid-19 in the care home environment in Scotland

Scottish Government

Findings of the rapid review of COVID-19 outbreaks in four care homes, including a list of recommendations based on risk factors that were found to be common in at least two of the homes. The review aimed to collate and evaluate local level experiences and responses to the resurgence of COVID-19 outbreaks within care homes and to support learning and practice across the sector through the sharing of learning identified and approaches to improvement. High community prevalence and slow confirmation of an outbreak after the first case was detected was a common cause of the high attack rate identified. Many of the positive cases were not identified quickly because they were asymptomatic or there was a lack of awareness in those interviewed of the wider spectrum of symptom presentation in older people. This resulted in testing not done in a timely manner. As a result additional control measures were put in place too late to stop the widespread transmission. Key to this is timely testing and reporting of results, in order that control measures can be put in place. The challenges with high community prevalence in the local areas, testing availability and turnaround times, combined with high occupant density, staff shortage indicators and the built environment risks re isolation or cohorting capability, placed care home residents at risk of the swift spread of COVID-19. Once COVID-19 has been introduced into a care home, it has the potential to result in high attack rates among residents, staff members, and visitors, and this occurred in each of the homes within this review. It is therefore critical that all long-term care facilities (care homes, residential settings and community hospitals) implement active measures to prevent introduction of COVID19, and are supported to do so.

Last updated on hub: 11 November 2020

The impact of Covid-19 on nursing homes in Italy

Politecnico di Milano

This brief note examines the interplay between the institutional context of care homes in Italy and the spread of the pandemic. As they faced the pandemic, care homes had both internal and external problems. On the internal side, they had to face the entry of the virus into their structures with inadequate medical staff and insufficient resources and capacity to implement distancing and other preventive actions. They were also unable to provide adequate health care to their Covid-19 patients, and very often unable to send them to hospitals. On the external side, their situation was ignored for a long time by policy makers, who were mainly focused to face the emergency in hospitals. The national lockdown of nursing homes regarding the access of relatives and external visitors – a crucial measure in order to prevent possible transmission of infection – was established only on March 4, about two weeks later the spreading of the infection. Furthermore, for many weeks not adequate attention has been paid to testing and monitoring activities among healthcare staff and patients: a priority for the implementation of such preventive activities in nursing homes was established only at the beginning of April. The paper argues that most of the criticalities came from the pre-existent difficult condition of these institutions. The more nursing homes have specialised in the intensive-health treatment of seriously non-self-sufficient elderly, the more the quality of their services had been hampered by very precarious financial and organisational conditions, co-determined by the lack of public investment in these structures. The pandemic has acted as a “focusing event”, revealing the structural weakness of this sector and the main critical problems affecting it.

Last updated on hub: 11 November 2020

Order by    Date Title