scholarly journals Introduction to and spread of COVID-19-like illness in care homes in Norfolk, UK

2020 ◽  
Author(s):  
Julii Brainard ◽  
Steven Rushton ◽  
Tim Winters ◽  
Paul R Hunter
Keyword(s):  
Residential Care ◽  
Secondary Analysis ◽  
The Elderly ◽  
Care Homes ◽  
Personal Protection ◽  
Personal Protection Equipment ◽  
Eye Protection ◽  
Homes For The Elderly ◽  
Care Workers ◽  
Working Practices

Abstract Background Residential care homes for the elderly are important settings for transmission of the SARS-CoV-2 virus that causes COVID-19 disease. Methods We undertook secondary analysis of 248 care homes in Norfolk, UK. The dataset counted nurses, care workers and non-care workers, their status (available, absent due to leave or sickness and extra staff needed to address the coronavirus pandemic) and residents (if any) with suspected COVID-19 in the period 6 April to 6 May 2020. Concurrent descriptions of access by the home to personal protection equipment (PPE: gloves, masks, eye protection, aprons and sanitizer) were in the data. PPE access was categorized as (most to least) green, amber or red. We undertook two-stage modelling, first for suspected COVID-19 cases amongst residents and second relating any increases in case counts after introduction to staffing or PPE levels. Results Counts of non-care workers had strongest relationships (P < 0.05) to introduction of suspected SARS-CoV-2 to the homes. Higher staff levels and more severe PPE shortages were linked to higher case counts (P < 0.05) during the monitoring period. Conclusion Managing aspects of staff interaction with residents and some working practices might reduce ingression to and spread of COVID-19-like illness within care homes.

scholarly journals Introduction to and spread of COVID-19 in care homes in Norfolk, UK

2020 ◽  
Author(s):  
Julii Suzanne Brainard ◽  
Steven Rushton ◽  
Tim Winters ◽  
Paul R Hunter
Keyword(s):  
Care Home ◽  
Secondary Analysis ◽  
The Elderly ◽  
Staff Nurses ◽  
Care Homes ◽  
Personal Protection ◽  
Personal Protection Equipment ◽  
Homes For The Elderly ◽  
Care Workers ◽  
Working Practices

BACKGROUND: Residential care homes for the elderly have been important settings for transmission of the SARS-CoV-2 virus that causes COVID-19 disease. METHODS: We undertook a secondary analysis of a dataset about 248 care homes in the county of Norfolk, eastern England. The dataset recorded categories of staff (nurses, care workers and non-care workers), their status (available, absent due to leave or sickness and extra staff needed to address the coronavirus pandemic) in the period 6 April -6 May 2020. Counts of residents (if any) at each care home with COVID-19 were also available, as well as descriptions of access by the home to personal protection equipment (PPE: gloves, masks, eye protection, aprons and Sanitiser). PPE access was categorised as (most to least) green, amber or red. We undertook two stage modelling, first for any detection of COVID-19 in the homes, and a second model to relate any increases in case counts after introduction to staffing or PPE levels. RESULTS: We found that the counts of non-care workers had strongest relationships (and only link significant at p < 0.05) to any introduction of SARS-CoV-2 to the homes. After a home had at least one detected case, higher staff levels and more severe PPE shortages were most linked to higher case counts (p < 0.05) during the monitoring period. CONCLUSION: Better managing aspects of staff interaction with residents and some working practices should help reduce ingression to and spread of COVID-19 within residential homes for the elderly.

The Effects and Costs of a Hearing Screening and Rehabilitation Program in Residential Care Homes for the Elderly in the Netherlands1

2013 ◽  
Vol 22 (1) ◽  
pp. 186-189 ◽  
Author(s):  
A. M. Linssen ◽  
M. A. Joore ◽  
E. J. J. M. Theunissen ◽  
L. J. C. Anteunis
Keyword(s):  
Hearing Loss ◽  
Residential Care ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Pure Tone Audiometry ◽  
The Elderly ◽  
Rehabilitation Program ◽  
Hearing Screening ◽  
Care Homes ◽  
Homes For The Elderly

Purpose This study describes the effects and costs of hearing screening and rehabilitation in residential care homes for the elderly. It was hypothesized that offering an in-house hearing screening and rehabilitation program would be an effective strategy to increase hearing aid ownership among the residents. Method All 705 residents of 8 residential care homes in the Netherlands were invited to participate in a hearing screening (pure-tone audiometry) and rehabilitation (hearing aids) program. Resident participation was analyzed, and the costs were calculated. Results A total of 243 residents (34%) participated in the screening, 222 (91%) of whom had hearing loss. Ninety-one (41%) of the screening participants with hearing loss started rehabilitation, which was successful for 50 (55%) of them. Hearing aid ownership among the residents with hearing loss increased from 28% at the start of the program to 33% at the end. The costs were €1,896 (US $2,480) per successfully rehabilitated resident. Hearing aid trials and hearing aids together accounted for 83% of the total costs. Conclusion The effectiveness of the program was limited, as hearing aid ownership increased only slightly. Cost reduction measures should focus on decreasing the number of unsuccessful hearing aid trials.

scholarly journals Role of Hand Hygiene Ambassador and Implementation of Directly Observed Hand Hygiene Among Residents in Residential Care Homes for the Elderly in Hong Kong

2018 ◽  
Vol 39 (5) ◽  
pp. 571-577 ◽  
Author(s):  
Vincent C. C. Cheng ◽  
Hong Chen ◽  
Shuk-Ching Wong ◽  
Jonathan H. K. Chen ◽  
Wing-Chun Ng ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Residential Care ◽  
Environmental Contamination ◽  
The Elderly ◽  
Multidrug Resistant ◽  
Care Homes ◽  
Controlled Study ◽  
Acinetobacter Species ◽  
Homes For The Elderly ◽  
Communal Areas

OBJECTIVEMultidrug-resistant organisms (MDROs) are increasingly reported in residential care homes for the elderly (RCHEs). We assessed whether implementation of directly observed hand hygiene (DOHH) by hand hygiene ambassadors can reduce environmental contamination with MDROs.METHODSFrom July to August 2017, a cluster-randomized controlled study was conducted at 10 RCHEs (5 intervention versus 5 nonintervention controls), where DOHH was performed at two-hourly intervals during daytime, before meals and medication rounds by a one trained nurse in each intervention RCHE. Environmental contamination by MRDOs, such as methicillin-resistant Staphylococcus aureus (MRSA), carbapenem-resistant Acinetobacter species (CRA), and extended-spectrum β-lactamse (ESBL)–producing Enterobacteriaceae, was evaluated using specimens collected from communal areas at baseline, then twice weekly. The volume of alcohol-based hand rub (ABHR) consumed per resident per week was measured.RESULTSThe overall environmental contamination of communal areas was culture-positive for MRSA in 33 of 100 specimens (33%), CRA in 26 of 100 specimens (26%), and ESBL-producing Enterobacteriaceae in 3 of 100 specimens (3%) in intervention and nonintervention RCHEs at baseline. Serial monitoring of environmental specimens revealed a significant reduction in MRSA (79 of 600 [13.2%] vs 197 of 600 [32.8%]; P<.001) and CRA (56 of 600 [9.3%] vs 94 of 600 [15.7%]; P=.001) contamination in the intervention arm compared with the nonintervention arm during the study period. The volume of ABHR consumed per resident per week was 3 times higher in the intervention arm compared with the baseline (59.3±12.9 mL vs 19.7±12.6 mL; P<.001) and was significantly higher than the nonintervention arm (59.3±12.9 mL vs 23.3±17.2 mL; P=.006).CONCLUSIONSThe direct observation of hand hygiene of residents could reduce environmental contamination by MDROs in RCHEs.Infect Control Hosp Epidemiol 2018;39:571–577

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