scholarly journals Modeling Effectiveness of Testing Strategies to Prevent Coronavirus Disease 2019 (COVID-19) in Nursing Homes—United States, 2020

2021 ◽  
Author(s):  
Isaac See ◽  
Prabasaj Paul ◽  
Rachel B Slayton ◽  
Molly K Steele ◽  
Matthew J Stuckey ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Infection Control ◽  
Relative Sensitivity ◽  
Turnaround Time ◽  
Potential Effect ◽  
Infection Control Practice ◽  
Healthcare Personnel ◽  
Test Frequency ◽  
Testing Strategies ◽  
Serial Testing

Abstract Background Identifying asymptomatic individuals early through serial testing is recommended to control coronavirus disease 2019 (COVID-19) in nursing homes, both in response to an outbreak (“outbreak testing” of residents and healthcare personnel) and in facilities without outbreaks (“nonoutbreak testing” of healthcare personnel). The effectiveness of outbreak testing and isolation with or without nonoutbreak testing was evaluated. Methods Using published SARS-CoV-2 transmission parameters, the fraction of SARS-CoV-2 transmissions prevented through serial testing (weekly, every 3 days, or daily) and isolation of asymptomatic persons compared with symptom-based testing and isolation was evaluated through mathematical modeling using a Reed-Frost model to estimate the percentage of cases prevented (ie, “effectiveness”) through either outbreak testing alone or outbreak plus nonoutbreak testing. The potential effect of simultaneous decreases (by 10%) in the effectiveness of isolating infected individuals when instituting testing strategies was also evaluated. Results Modeling suggests that outbreak testing could prevent 54% (weekly testing with 48-hour test turnaround) to 92% (daily testing with immediate results and 50% relative sensitivity) of SARS-CoV-2 infections. Adding nonoutbreak testing could prevent up to an additional 8% of SARS-CoV-2 infections (depending on test frequency and turnaround time). However, added benefits of nonoutbreak testing were mostly negated if accompanied by decreases in infection control practice. Conclusions When combined with high-quality infection control practices, outbreak testing could be an effective approach to preventing COVID-19 in nursing homes, particularly if optimized through increased test frequency and use of tests with rapid turnaround.

scholarly journals Modeling effectiveness of testing strategies to prevent COVID-19 in nursing homes —United States, 2020

2020 ◽  
Author(s):  
Isaac See ◽  
Prabasaj Paul ◽  
Rachel B. Slayton ◽  
Molly K. Steele ◽  
Matthew J. Stuckey ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Infection Control ◽  
Case Fatality ◽  
Relative Sensitivity ◽  
Turnaround Time ◽  
Potential Effect ◽  
Healthcare Personnel ◽  
Test Frequency ◽  
Testing Strategies ◽  
Serial Testing

AbstractBackgroundSARS-CoV-2 outbreaks in nursing homes can be large with high case fatality. Identifying asymptomatic individuals early through serial testing is recommended to control COVID-19 in nursing homes, both in response to an outbreak (“outbreak testing” of residents and healthcare personnel) and in facilities without outbreaks (“non-outbreak testing” of healthcare personnel). The effectiveness of outbreak testing and isolation with or without non-outbreak testing was evaluated.MethodsUsing published SARS-CoV-2 transmission parameters, the fraction of SARS-CoV-2 transmissions prevented through serial testing (weekly, every three days, or daily) and isolation of asymptomatic persons compared to symptom-based testing and isolation was evaluated through mathematical modeling using a Reed-Frost model to estimate the percentage of cases prevented through either outbreak testing alone or outbreak plus non-outbreak testing. The potential effect of simultaneous decreases (by 10%) in the effectiveness of isolating infected individuals when instituting testing strategies was also evaluated.ResultsModeling suggests that outbreak testing could prevent 54% (weekly testing with 48-hour test turnaround) to 92% (daily testing with immediate results and 50% relative sensitivity) of SARS-CoV-2 infections. Adding non-outbreak testing could prevent up to an additional 8% of SARS-CoV-2 infections (depending on test frequency and turnaround time). However, added benefits of non-outbreak testing were mostly negated if accompanied by decreases in infection control practice.ConclusionsWhen combined with high-quality infection control practices, outbreak testing could be an effective approach to preventing COVID-19 in nursing homes, particularly if optimized through increased test frequency and use of tests with rapid turnaround.

Effectiveness of short-term, enhanced, infection control support in improving compliance with infection control guidelines and practice in nursing homes: a cluster randomized trial

2009 ◽  
Vol 137 (10) ◽  
pp. 1465-1471 ◽  
Author(s):  
G. GOPAL RAO ◽  
A. JEANES ◽  
H. RUSSELL ◽  
D. WILSON ◽  
E. ATERE-ROBERTS ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Hand Hygiene ◽  
Infection Control ◽  
Infection Control Practice ◽  
Short Term ◽  
Safe Disposal ◽  
Control Practice ◽  
Cluster Randomized ◽  
And Control ◽  
The Impact

SUMMARYIn this prospective cluster randomized controlled trial we evaluated the impact of short-term provision of enhanced infection control support on infection control practice in nursing homes in South London. Twelve nursing homes were recruited, six each in intervention (300 residents) and control (265 residents) groups. Baseline observations of hand hygiene facilities, environmental cleanliness and safe disposal of clinical waste showed poor compliance in both groups. Post-intervention observations showed improvement in both groups. There was no statistical difference between the two groups in the compliance for hand hygiene facilities (P=0·69); environmental cleanliness (P=0·43) and safe disposal of clinical waste (P=0·96). In both groups, greatest improvement was in compliance with safe disposal of clinical waste and the least improvement was in hand hygiene facilities. Since infection control practice improved in intervention and control groups, we could not demonstrate that provision of short-term, enhanced, infection control support in nursing homes had a significant impact in infection control practice.

Infection surveillance in nursing homes in Stockholm County, Sweden, 2005 - 2014

2016 ◽  
Vol 12 (3) ◽  
Author(s):  
Ann Tammelin
Keyword(s):  
Nursing Homes ◽  
Infection Control ◽  
Urinary Catheter ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
County Council ◽  
Antibiotic Prescribing ◽  
Viral Gastroenteritis ◽  
Stockholm County ◽  
Infection Surveillance

Swedish nursing homes are obliged to have a management system for systematic quality work including self-monitoring of which surveillance of infections is one part. The Department of Infection Control in Stockholm County Council has provided a simple system for infection surveillance to the nursing homes in Stockholm County since 2002. A form is filled in by registered nurses in the nursing homes at each episode of infection among the residents. A bacterial infection is defined by antibiotic prescribing and a viral infection by clinical signs and symptoms. Yearly reports of numbers of infections in each nursing home and calculated normalized figures for incidence, i.e. infections per 100 residents per year, as well as proportion of residents with urinary catheter are delivered to the medically responsible nurses in each municipality by the Department of Infection Control. Number of included residents has varied from 4,531 in 2005 to 8,157 in 2014 with a peak of 10,051 in 2009. The yearly incidences during 2005 - 2014 (cases per 100 residents) were: Urinary tract infection (UTI) 7.9-16.0, Pneumonia 3.7-5.3, Infection of chronic ulcer 3.4–6.8, Other infection in skin or soft tissue 1.4–2.9, Clostridium difficile-infection 0.2–0.7, Influenza 0–0.4 and Viral gastroenteritis 1.2–3.7. About 1 % of the residents have a suprapubic urinary catheter, 6–7 % have an indwelling urinary catheter. Knowledge about the incidence of UTI has contributed to the decrease of this infection both in residents with and without urinary catheter.

Healthcare personnel experiences implementing carbapenem-resistant Enterobacterales infection control measures at a ventilator-capable skilled nursing facility—A qualitative analysis

2021 ◽  
pp. 1-7
Author(s):  
Katharina R. Rynkiewich ◽  
Jinal Makhija ◽  
Mary Carl M. Froilan ◽  
Ellen C. Benson ◽  
Alice Han ◽  
...  
Keyword(s):  
Infection Control ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Healthcare Personnel ◽  
Skilled Nursing ◽  
Infection Control Measures ◽  
Carbapenem Resistant ◽  
Resident Care ◽  
Semistructured Interviews ◽  
Self Protection

Abstract Objective: Ventilator-capable skilled nursing facilities (vSNFs) are critical to the epidemiology and control of antibiotic-resistant organisms. During an infection prevention intervention to control carbapenem-resistant Enterobacterales (CRE), we conducted a qualitative study to characterize vSNF healthcare personnel beliefs and experiences regarding infection control measures. Design: A qualitative study involving semistructured interviews. Setting: One vSNF in the Chicago, Illinois, metropolitan region. Participants: The study included 17 healthcare personnel representing management, nursing, and nursing assistants. Methods: We used face-to-face, semistructured interviews to measure healthcare personnel experiences with infection control measures at the midpoint of a 2-year quality improvement project. Results: Healthcare personnel characterized their facility as a home-like environment, yet they recognized that it is a setting where germs were ‘invisible’ and potentially ‘threatening.’ Healthcare personnel described elaborate self-protection measures to avoid acquisition or transfer of germs to their own household. Healthcare personnel were motivated to implement infection control measures to protect residents, but many identified structural barriers such as understaffing and time constraints, and some reported persistent preference for soap and water. Conclusions: Healthcare personnel in vSNFs, from management to frontline staff, understood germ theory and the significance of multidrug-resistant organism transmission. However, their ability to implement infection control measures was hampered by resource limitations and mixed beliefs regarding the effectiveness of infection control measures. Self-protection from acquiring multidrug-resistant organisms was a strong motivator for healthcare personnel both outside and inside the workplace, and it could explain variation in adherence to infection control measures such as a higher hand hygiene adherence after resident care than before resident care.

scholarly journals Reducing Morbidity and Mortality Rates from COVID-19, Influenza and Pneumococcal Illness in Nursing Homes and Long-Term Care Facilities by Vaccination and Comprehensive Infection Control Interventions

Geriatrics ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 48
Author(s):  
Roger E. Thomas
Keyword(s):  
Nursing Homes ◽  
Infection Control ◽  
Strong Evidence ◽  
Disease Transmission ◽  
Long Term Care ◽  
Term Care ◽  
Care Facilities ◽  
Meta Analyses ◽  
Tract Infections

The COVID-19 pandemic identifies the problems of preventing respiratory illnesses in seniors, especially frail multimorbidity seniors in nursing homes and Long-Term Care Facilities (LCTFs). Medline and Embase were searched for nursing homes, long-term care facilities, respiratory tract infections, disease transmission, infection control, mortality, systematic reviews and meta-analyses. For seniors, there is strong evidence to vaccinate against influenza, SARS-CoV-2 and pneumococcal disease, and evidence is awaited for effectiveness against COVID-19 variants and when to revaccinate. There is strong evidence to promptly introduce comprehensive infection control interventions in LCFTs: no admissions from inpatient wards with COVID-19 patients; quarantine and monitor new admissions in single-patient rooms; screen residents, staff and visitors daily for temperature and symptoms; and staff work in only one home. Depending on the vaccination situation and the current risk situation, visiting restrictions and meals in the residents’ own rooms may be necessary, and reduce crowding with individual patient rooms. Regional LTCF administrators should closely monitor and provide staff and PPE resources. The CDC COVID-19 tool measures 33 infection control indicators. Hand washing, social distancing, PPE (gowns, gloves, masks, eye protection), enhanced cleaning of rooms and high-touch surfaces need comprehensive implementation while awaiting more studies at low risk of bias. Individual ventilation with HEPA filters for all patient and common rooms and hallways is needed.

scholarly journals How implementation of a national strategy for nursing homes is experienced by the healthcare personnel: A qualitative study with content analysis of interviews.

2020 ◽  
Author(s):  
Beate Andre ◽  
RN. Kjersti Grønning ◽  
Frode F. Jacobsen ◽  
Gørill Haugan
Keyword(s):  
Content Analysis ◽  
Nursing Home ◽  
Nursing Homes ◽  
Qualitative Content Analysis ◽  
Implementation Process ◽  
Care Quality ◽  
Healthcare Personnel ◽  
Health Promoting ◽  
Positive Experiences

Abstract Background: Nursing homes are under strong pressure to provide good care to the residents. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Home’ strategy to increase a health-promoting perception that focuses on the older persons` resources. Implementations represent introducing changes to the healthcare personnel; however, changing one’s working approaches, routines and working culture may be demanding. On this background, we explored how the ‘Joy-of-Life-Nursing-Home’ strategy is perceived by the employees in retrospective, over a period after the implementation and which challenges the employees experience with this implementation.Method: We used a qualitative approach and interviewed 14 healthcare personnel working in nursing homes in one Norwegian municipality, which had implemented the ‘Joy-of-Life-Nursing-Home’ strategy. The analysis was conducted following Kvale’s approach to qualitative content analysis.Results: The main categories were: (a) the characteristics of care activities before implementations of ‘Joy-of-Life-Nursing-Home’, (b) how ‘Joy-of-Life-Nursing-Home’ influenced the care activities, and (c) challenges with the implementation of ‘Joy-of-Life-Nursing-Home’. Some of the informants spoke well about the implementation concerning the care quality stating “to see the joy in the eyes of the resident then I feel we have succeeded”. For informants who experienced resistance toward the implementation, they felt it was too much to document, it was too complicated, and the requirements were too many. Conclusions: Quality of care seems to have increased after the implementation, as perceived by the informants. Nevertheless, the fact that the informants seemed to be divided into two different groups related to their main perspective of the implementation is concerning. One group has positive experiences with the implementations process and the benefits of it, while the other group focuses on lack of benefits and problems with the implementation process. In order to understand what facilitates and hinders the implementation, research on contextual factors like work environment and leadership is recommended.

scholarly journals HIV: Infection Control Issues For Oral Healthcare Personnel

2007 ◽  
Vol 8 (3) ◽  
pp. 1-12
Author(s):  
Geza T. Terezhalmy ◽  
Michaell A. Huber
Keyword(s):  
Occupational Exposure ◽  
Infection Control ◽  
Hiv Infection ◽  
Healthcare Setting ◽  
Essential Elements ◽  
Needlestick Injury ◽  
Healthcare Personnel ◽  
Emotional Impact ◽  
Control Plan ◽  
Exposure Prevention

Abstract Aim To present the essential elements of an infection control/exposure control plan in the oral healthcare setting with emphasis on HIV infection. Methods and Materials A comprehensive review of the literature was conducted with special emphasis on HIV-related infection control issues in the oral healthcare setting. Results Currently available knowledge related to HIV-related infection control issues is supported by data derived from well-conducted trials or extensive, controlled observations, or, in the absence of such data, by best-informed, most authoritative opinion available. Conclusion Essential elements of an effective HIV-related infection control plan include: (1) education and training related to the etiology and epidemiology of HIV infection and exposure prevention; (2) plans for the management of oral healthcare personnel potentially exposed to HIV and for the follow-up of oral healthcare personnel exposed to HIV; and (3) a policy for work restriction of HIV-positive oral healthcare personnel. Clinical Significance While exposure prevention remains the primary strategy for reducing occupational exposure to HIV, knowledge about potential risks and concise written procedures that promote a seamless response following occupational exposure can greatly reduce the emotional impact of an accidental needlestick injury. Citation Huber MA, Terezhalmy GT. HIV: Infection Control Issues For Oral Healthcare Personnel. J Contemp Dent Pract 2007 March;(8)3:001-012.

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