General practitioner care in nursing homes during the first wave of the COVID-19 pandemic in Germany: a retrospective survey among nursing home managers

Abstract

Background Though evidence on the detrimental impact of the COVID-19 pandemic in nursing homes is vast, research focusing on general practitioners’ (GP) care during the pandemic in nursing homes is still scarce. Methods A retrospective online survey among 1,010 nursing home managers in Germany was conducted during the first wave of the COVID-19 pandemic between November 2020 and February 2021. Associations between perceived deficits in GP care (routine and acute visits) and both general and COVID-19-related characteristics of nursing homes were analysed using multiple logistic regression analyses. Results The majority of nursing home managers reported no deficits in GP care (routine visits, 84.3%; acute visits, 92.9%). Logistic regression analyses revealed that deficits in GP care (routine visits) were significantly associated with visiting restrictions for GPs and nursing home size. Small nursing homes (1–50 residents) were significantly more likely to report deficits in GP care (routine visits) compared to medium (51–100 residents) and large nursing homes (> 100 residents). Further, deficits in GP care (acute visits) were significantly associated with dementia as a focus of care and the burden of insufficient testing for SARS-CoV-2 among residents. Moreover, visiting restrictions for GPs were significantly associated with dementia as the focus of care and the COVID-19 incidence at the federal state level. Finally, COVID-19 cases in nursing homes were significantly associated with size of nursing homes, COVID-19-incidence on the federal state level and the burden of insufficient testing capacities for SARS-CoV-2 among residents. Conclusion We found structural factors associated with GP care deficits during the pandemic. New concepts for GP care should be implemented in pandemic preparedness plans to ensure high quality, consistent, and reliable GP care as well as effective infection prevention measures in nursing homes.

Medical Team Intervention Into a Long-Term Care Health Facility in Japan During the First Wave of the COVID-19 Pandemic

“…Previous articles on nursing home interventions during the COVID-19 pandemic have reported that medical teams had to provide medical care only within their facilities despite the various difficulties they faced [ 10 - 12 ]. Moreover, some studies have emphasized the importance of structural control measures during the pandemic [ 13 , 14 ]. Referring to the literature, we discuss the countermeasures against infectious disease pandemics in long-term care facilities, dividing them into three phases: 1) preventing mass infection, 2) outbreak response, and 3) recovery from outbreaks.…”

Demenz-Screening- und testpsychologische Untersuchungen in deutschen Haus- und Facharztpraxen unter Bedingungen der Corona Pandemie

“…Zu berücksichtigen ist auch, dass durch Quarantänemaßnahmen geänderte Lebensbedingungen sich auf die Ausprägung neuro-kognitiver Störungen auswirken können [13]. Erste Hinweise gibt es auch, wie sich die Rahmenbedingungen von hausärztlicher Tätigkeit in Heimen strukturell geändert haben und Folgen für die Patientenversorung aufweisen [14]. In einer eigenen Studie konnten wir zeigen, dass die kognitiven Störungen im Rahmen einer COVID-19-Erkrankung zunahmen, aber dass dies im Praxisalltag ein sehr seltenes Ereignis darstellte [15].…”

Facilitators Associated with Nursing Burnout in the Ambulatory Care Setting as COVID-19 Subsides: A Rapid Review

“…Recent studies have shown that burnout has been linked to nurses' intention to quit the profession [8,26,35]. It was reported that moderate to high burnout has been reported among nurses and other healthcare professionals [7,8,26].…”

“…Recent studies have shown that burnout has been linked to nurses' intention to quit the profession [8,26,35]. It was reported that moderate to high burnout has been reported among nurses and other healthcare professionals [7,8,26]. High workload, years of practice, resilience, inadequate staffing, and lack of leadership support have been identified as some of the highest complaints amongst healthcare workers.…”