Distancing Measures and Challenges Discussed by COVID-19 Outbreak Teams of Dutch Nursing Homes: The COVID-19 MINUTES Study

Abstract

The most severe COVID-19 infections and highest mortality rates are seen among long-term care residents. To reduce the risk of infection, physical distancing is important. This study investigates what physical distancing measures were discussed by COVID-19 outbreak teams of Dutch long-term care organizations and what challenges they encountered. The COVID-19 MINUTES study is a qualitative multi-center study (n = 41) that collected minutes of COVID-19 outbreak teams from March 2020 to October 2021. Textual units about distancing measures were selected and analyzed using manifest content analysis for the first wave: early March–early May 2020; the intermediate period of 2020: mid-May–mid-September 2020; and the second wave: late September 2020–mid-June 2021. During all periods, COVID-19 outbreak teams often discussed distancing visitors from residents. Moreover, during the first wave they often discussed isolation measures, during the intermediate period they often discussed distancing staff and volunteers from residents, and during both the intermediate period and the second wave they often discussed distancing among residents. During all periods, less often admission measures were discussed. Challenges persisted and included unrest among and conflicts between visitors and staff, visitors violating measures, resident non-adherence to measures, and staffing issues. The discussed distancing measures and corresponding challenges may guide local long-term care and (inter)national policymakers during the further course of the COVID-19 pandemic, outbreaks of other infectious diseases, and long-term care innovations.

Priority measures to prevent infections and maintain residents’ well-being during COVID-19 outbreaks in nursing homes: Consensus among staff and resident representatives determined in an online nominal group technique study

“…Despite these norms and obligations, internationally involvement of nursing home residents in care and policy decisions remains difficult ( Lynch and Ryan, 2022 ). With regard to COVID-19 measures, researchers have also advised tailor-made measures and the involvement of residents, family, and staff ( Van Tol and Smaling, 2022 ; Dutch, 2019 , Van Der Roest and Prins, 2020 , Dichter and Sander, 2020 , Dohmen and Van Den Eijnde, 2022 ). However, our study shows that resident representatives and nursing home staff were less involved in policy making during the first months of the COVID-19 pandemic than before.…”

“…To protect vulnerable nursing home residents from COVID-19, many local and (inter)national guidelines and restrictions were applied during the first months of 2020, such as isolation measures, visiting bans or regulations, other distancing measures, testing, and use of personal protective equipment ( Van Tol and Smaling, 2022 ; Dutch, 2019 , British Broadcasting Corporation (BBC) , Ecdc (2021 a, 2021 b), Comas-Herrera A and Lorenz-Dant, 2020 ). Although these measures should prevent COVID-19 transmission, public concerns arose about the lack of attention for nursing home residents’ well-being during spring and summer ( WHO, 2021 , Chason, 2020 ).…”

COVID-19 measures implemented for nursing home staff and their perspectives on the importance of the measures: A qualitative study

“…For the analysis, two researchers assigned text units coded under the topic of “staff” to one of the subtopics. A text unit is a piece of text of one to a few sentences from the minutes that relate to one measure ( van Tol et al., 2022 ). Subsequently, all text units coded under the subtopics were checked.…”

“…The high risk of SARS-CoV-2 (COVID-19) transmission in nursing homes, attributed to communal living, personal care necessitating close contact, and clients’ frailty, required management to institute drastic measures to prevent infection transmission ( Davidson and Szanton, 2020 ; Dykgraaf et al., 2021 ; van Tol et al., 2022 ). This also applied to home care provided by nursing homes, as several clients required daily visits, which increased the risk of transmission ( Veldhuizen et al., 2021 ).…”

“…COVID-19 outbreak teams in Dutch nursing homes consisted mainly of management, medical staff, support services, and communication specialists. Some included nursing staff and resident representatives ( van Tol et al., 2022 ).…”