scholarly journals Evaluating intervention strategies in controlling COVID-19 spread in care homes: An agent-based model

2020 ◽  
pp. 1-60
Author(s):  
Le Khanh Ngan Nguyen ◽  
Susan Howick ◽  
Dennis McLafferty ◽  
Gillian Hopkins Anderson ◽  
Sahaya Josephine Pravinkumar ◽  
...  
Keyword(s):  
Uncertainty Analysis ◽  
Care Home ◽  
Transmission Probability ◽  
Intervention Strategies ◽  
Care Homes ◽  
Base Case ◽  
Agent Based Model ◽  
Home Setting ◽  
Routine Testing ◽  
Agent Based

ABSTRACT Background: Care homes are vulnerable to widespread transmission of COVID-19 with poor outcomes for staff and residents. Infection control interventions in care homes need to not only be effective in containing the spread of COVID-19 but also feasible to implement in this special setting which is both a healthcare institution and a home. Methods: We developed an agent-based model that simulates the transmission dynamics of COVID-19 via contacts between individuals, including residents, staff members, and visitors in a care home setting. We explored a representative care home in Scotland in our base case and explore other care home setups in an uncertainty analysis. We evaluated the effectiveness of a range of intervention strategies in controlling the spread of COVID-19. Results: In the presence of the reference interventions that have been implemented in many care homes, including testing of new admissions, isolation of symptomatic residents, and restricted public visiting, routine testing of staff appears to be the most effective and practical approach. Routine testing of residents is no more effective as a reference strategy while routine testing of both staff and residents only shows a negligible additive effect. Modelling results are very sensitive to transmission probability per contact, but the qualitative finding is robust to varying parameter values in our uncertainty analysis. Conclusions: Our model predictions suggest that routine testing should target staff in care homes in conjunction with adherence to strict hand hygiene and using personal protective equipment to reduce risk of transmission per contact.

scholarly journals Evaluating intervention strategies in controlling coronavirus disease 2019 (COVID-19) spread in care homes: An agent-based model – CORRIGENDUM

2021 ◽  
pp. 1-1
Author(s):  
Le Khanh Ngan Nguyen ◽  
Susan Howick ◽  
Dennis McLafferty ◽  
Gillian H. Anderson ◽  
Sahaya J. Pravinkumar ◽  
...  
Keyword(s):  
Intervention Strategies ◽  
Care Homes ◽  
Agent Based Model ◽  
Agent Based

scholarly journals IMPACT OF VISITATION AND COHORTING POLICIES TO SHIELD RESIDENTS FROM COVID-19 SPREAD IN CARE HOMES: AN AGENT-BASED MODEL

2021 ◽  
Author(s):  
Ms. Le Khanh Ngan Nguyen ◽  
Prof. Susan Howick ◽  
Mr Dennis McLafferty ◽  
Mrs. Gillian Hopkins Anderson ◽  
Dr. Sahaya Josephine Pravinkumar ◽  
...  
Keyword(s):  
Care Homes ◽  
Agent Based Model ◽  
Agent Based

scholarly journals A Spatial Agent-Based Model to Assess the Spread of Malaria in Relation to Anti-Malaria Interventions in Southeast Iran

2020 ◽  
Vol 9 (9) ◽  
pp. 549
Author(s):  
Navid Mahdizadeh Gharakhanlou ◽  
Navid Hooshangi ◽  
Marco Helbich
Keyword(s):  
Indoor Residual Spraying ◽  
Intervention Strategies ◽  
Agent Based Model ◽  
Malaria Endemic Area ◽  
High Coverage ◽  
Agent Based ◽  
The World ◽  
Coverage Rates ◽  
Long Lasting Insecticidal Nets ◽  
Malaria Interventions

Malaria threatens the lives of many people throughout the world. To counteract its spread, knowledge of the prevalence of malaria and the effectiveness of intervention strategies is of great importance. The aim of this study was to assess (1) the spread of malaria by means of a spatial agent-based model (ABM) and (2) the effectiveness of several interventions in controlling the spread of malaria. We focused on Sarbaz county in Iran, a malaria-endemic area where the prevalence rate is high. Our ABM, which was carried out in two steps, considers humans and mosquitoes along with their attributes and behaviors as agents, while the environment is made up of diverse environmental factors, namely air temperature, relative humidity, vegetation, altitude, distance from rivers and reservoirs, and population density, the first three of which change over time. As control interventions, we included long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS). The simulation results showed that applying LLINs and IRS in combination, rather than separately, was most efficient in reducing the number of infected humans. In addition, LLINs and IRS with moderate or high and high coverage rates, respectively, had significant effects on reducing the number of infected humans when applied separately. Our results can assist health policymakers in selecting appropriate intervention strategies in Iran to reduce malaria transmission.

scholarly journals Lockdowns to Contain COVID-19 Increase Risk and Severity of Mosquito-Borne Disease Outbreaks

2020 ◽  
Author(s):  
Akshay Jindal ◽  
Shrisha Rao
Keyword(s):  
Indoor Residual Spraying ◽  
Disease Outbreaks ◽  
Communicable Diseases ◽  
Intervention Strategies ◽  
Agent Based Model ◽  
Insecticide Treated Nets ◽  
Agent Based ◽  
Infected People ◽  
Increase Risk ◽  
The Impact

AbstractMany countries are implementing lockdown measures to slow the COVID-19 pandemic, putting more than a third of the world’s population under restrictions. The scale of such lockdowns is unprecedented, and while some effects of lockdowns are readily apparent, it is less clear what effects they may have on outbreaks of serious communicable diseases. We examine the impact of these lockdowns on outbreaks of mosquito-borne diseases. Using an agent-based model and simulations, we find that the risk and severity of such outbreaks is much greater under lockdown conditions, with the number of infected people doubling in some cases. This increase in number of cases varies by different mosquito-borne diseases, and is significantly higher for diseases spread by day-biting mosquitoes. We analysed various intervention strategies and found that during lockdowns, decentralised strategies such as insecticide-treated nets and indoor residual spraying are more effective than centralised strategies.

Experience of use of advance care planning in care homes

2018 ◽  
Author(s):  
Maggie Stobbart-Rowlands ◽  
Mandy Thorn
Keyword(s):  
Advance Care Planning ◽  
Best Practice ◽  
Care Home ◽  
Training Programme ◽  
Best Interests ◽  
Care Homes ◽  
Care Planning ◽  
Home Setting ◽  
People With Dementia ◽  
Advance Care

This chapter describes the care home setting, aspects that have an impact on use of Advance care planning (ACP) in care homes, examples of challenges and best practice, use of ACP in the GSF Care Homes Training Programme, ACP with people with dementia, and culture change. Many people in care homes are in the last year/s of life, and ACP discussions are especially important for them to ensure that the care they receive is in line with what they want. Care homes lead the way in their extensive use of ACP discussions. ACP is more routinely used by care home staff than is often recognized, and can be easier to introduce in care homes than in other settings. Key challenges include poor means of communication due to dementia/cognitive impairment or physical deterioration, and how staff address the expectations of families, and ensure any interventions are in the best interests of the person.

PP102 Developing A Contextually-Informed Deprescribing Intervention

2018 ◽  
Vol 34 (S1) ◽  
pp. 104-105
Author(s):  
Charlene Ronquillo ◽  
Ken Stein
Keyword(s):  
Health Care Professionals ◽  
Care Home ◽  
Stakeholder Involvement ◽  
Care Homes ◽  
Successful Implementation ◽  
Allied Health Professionals ◽  
Home Setting ◽  
Stakeholder Consultation ◽  
Care Home Staff ◽  
Local Stakeholder

Introduction:Deprescribing – a process for reducing or stopping drugs when the balance of benefits and harms may no longer be in a person's interests – is a key aspect of managing multimorbidity and polypharmcacy in older people. Several deprescribing interventions have been developed (e.g. in Australia and Canada), although significant challenges for successful implementation remain. Through key stakeholder consultation in the care home setting in South West England, we take the initial steps to develop a context-informed deprescribing approach. Engaging stakeholders from the outset gains insight into acceptability, feasibility, and relevance of deprescribing interventions developed elsewhere informing co-production of an effective, implementable approach.Methods:Consultation workshops were held with two groups of stakeholders: (i) care home residents and their families; (ii) care home staff and health care professionals (general practitioners, medical specialists, pharmacists, nurses, allied health professionals). Focus groups were held with each group separately to understand perspectives on: deprescribing in general; contextual considerations; and, perspectives on deprescribing interventions developed in other countries. A combined focus group then considered components of a deprescribing intervention for care homes. Qualitative data were audio recorded, transcribed, and thematically coded.Results:Participants described the nature of local relationships, dynamics, structures, and resources, as important considerations in the development of a deprescribing approach in care homes. Perspectives and concerns around deprescribing among the stakeholder groups varied, although the importance of eliciting local stakeholder feedback in the early stages of developing a deprescribing intervention was a common thread.Conclusions:Early engagement and co-production are crucial in developing an approach to deprescribing in care homes. The combination of stakeholder involvement and qualitative research is important for developing an effective, contextually relevant intervention as the balance between interests can be incorporated into the approach. Leveraging the experience in other countries is a novel and valuable step.

scholarly journals Implementation of the National Early Warning Score in UK care homes: a qualitative evaluation

2020 ◽  
Vol 70 (700) ◽  
pp. e793-e800
Author(s):  
Siân Russell ◽  
Rachel Stocker ◽  
Robert Oliver Barker ◽  
Jennifer Liddle ◽  
Joy Adamson ◽  
...  
Keyword(s):  
Early Warning ◽  
Care Home ◽  
Qualitative Evaluation ◽  
Acute Illness ◽  
Care Homes ◽  
Early Warning Score ◽  
Normalisation Process Theory ◽  
Home Setting ◽  
Care Home Staff ◽  
National Early Warning Score

BackgroundThe National Early Warning Score (NEWS) is a tool for identifying and responding to acute illness. When used in care homes, staff measure residents’ vital signs and record them on a tablet computer, which calculates a NEWS to share with health services. This article outlines an evaluation of NEWS implementation in care homes across one clinical commissioning group area in northern England.AimTo identify challenges to implementation of NEWS in care homes.Design and settingQualitative analysis of interviews conducted with 15 staff members from six care homes, five health professionals, and one clinical commissioning group employee.MethodInterviews were intended to capture people’s attitudes and experiences of using the intervention. Following an inductive thematic analysis, data were considered deductively against normalisation process theory constructs to identify the challenges and successes of implementing NEWS in care homes.ResultsCare home staff and other stakeholders acknowledged that NEWS could enhance the response to acute illness, improve communication with the NHS, and increase the confidence of care home staff. However, the implementation did not account for the complexity of either the intervention or the care home setting. Challenges to engagement included competing priorities, insufficient training, and shortcomings in communication.ConclusionThis evaluation highlights the need to involve care home staff and the primary care services that support them when developing and implementing interventions in care homes. The appropriateness and value of NEWS in non-acute settings requires ongoing monitoring.

scholarly journals Older care home residents’ and their relatives’ knowledge, understanding and views of shift handovers: an exploratory, focused-ethnographic qualitative study using interviews and observations

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032189
Author(s):  
Katharine Orellana ◽  
Valerie Lipman ◽  
Jill Manthorpe ◽  
Jo Moriarty ◽  
Caroline Norrie ◽  
...  
Keyword(s):  
Older People ◽  
Care Home ◽  
Care Homes ◽  
Clinical Settings ◽  
Study Participation ◽  
Underlying Assumption ◽  
Home Setting ◽  
Evidence Review ◽  
Administrative Procedures ◽  
South East England

ObjectivesTo investigate residents’ and relatives’ views and experiences of handovers in care homes. This paper reports residents’ and relatives’ awareness of handovers, knowledge of and views on handover practices and purpose, and views on handover effectiveness. Outcomes, safety and satisfaction in clinical settings are influenced by shift handovers. Despite this link with quality, residents’ increasing support needs and the provision of 24 hours care in care homes for older people, little is known about handovers in these settings from a resident and visiting relative perspective.SettingFive purposively sampled care homes for older people in South East England.ParticipantsHome managers (n=5), residents (n=16) relatives of residents (n=10) were interviewed; residents (n=15) and their interactions with staff were observed during handover periods. Participation was voluntary and subject to consent. Residents were identified by managers as having mental capacity to take a decision about participation which was then assessed. An ethnographic approach to data collection was taken, preceded by an evidence review.ResultsShift handovers were largely invisible processes to participating residents and relatives, many of whom had given little thought to handover practice, logistics or effectiveness prior to study participation. Their awareness and understanding of handovers, handover practices, and handover purpose and effectiveness varied. There appeared to be an underlying assumption that administrative procedures in care homes would operate without input from residents or relatives. A small number of residents, however, were highly aware of the routine of handovers and the implications of this for the timing of and response to their requests for care or support.ConclusionsThe care home setting and perspectives of the effectiveness of handovers may influence awareness of, knowledge of and levels of interest in involvement in handovers.

scholarly journals Approaching the end of life and dying with dementia in care homes: the accounts of family carers

2010 ◽  
Vol 20 (2) ◽  
pp. 114-127 ◽  
Author(s):  
J Hennings ◽  
K Froggatt ◽  
J Keady
Keyword(s):  
End Of Life ◽  
Terminal Illness ◽  
Care Home ◽  
Care Homes ◽  
Family Carers ◽  
Home Setting ◽  
Curative Care ◽  
The Family ◽  
Person With Dementia

SummaryResearch into end of life and dying with dementia in care homes from the family carer's perspective is limited. From the available evidence, it appears that family carers find themselves in an unfamiliar situation about which they lack knowledge and experience. Whilst dementia tends not to be acknowledged as a terminal illness by many family carers, they are expected to make end of life decisions on behalf of their relatives. Family carer decision-making is underpinned by values of quality of life, previously expressed wishes, comfort provision and dignity preservation. This is often approached when family carers are grieving for the anticipated loss of their relative and have their own personal needs that require to be addressed. Within a care home setting, a curative care–palliative care split is unhelpful in resolving these tensions and a model of comprehensive care appears a more appropriate approach. This requires ongoing communication between the person with dementia, family members and professionals from the early stages of the condition.

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