Infection prevention and control in nursing homes during COVID-19: An environmental scan

Abstract

To examine processes and programmatic elements of infection prevention and control (IPC) efforts and identify themes and promising approaches in nursing homes (NHs), an environmental scan was conducted. Data sources included a literature search, relevant listservs and websites, and expert consensus based on a virtual summit of leaders in IPC in long-term care settings. Three thematic areas emerged which have the potential to improve overall IPC practices in the long-term care setting: staffing and resource availability, training and knowledge of IPC practices, and organizational culture. If improved IPC practices and reduced cross-transmission of infections in NHs are to be sustained, both short-term and long-term changes in these areas are essential to fully engage staff, build trust, and enhance a ‘just’ organizational culture.

Between a Rock and a Hard Place: COVID-19 Lessons Learned From Providers Rounding at Skilled Nursing Facilities in the Rural Midwest

“…Factors that contribute to barriers to infection control observed by our team include the communal living environment, the large number of staff needed to care for the residents, including certified nursing assistants (CNA), licensed practical nurses (LPN), registered nurses (RN), dietary staff, therapy staff, activity staff, social work, environmental services, maintenance staff, and the number of volunteers and visitors entering the facility. This is similar to findings found in the literature [ 22 ]. Additional contributors are residents with multiple medical comorbidities that increased infection risk whether through immune suppression or cognitive impairment that leaves affected residents unable to comply with the infection control policies meant to protect them.…”

“…From an infection prevention point of view, we need to start by identifying how strong our current infection prevention strategies are in the SNF setting and ensure there is an infection preventionist for every site [ 6 , 7 ]. It would be important to then leverage leadership to help perform additional needs assessments that include communication, equipment resources, staffing resources and training, and community outreach [ 22 , 23 ].…”

The association of nursing home infection preventionists' training and credentialing with residentCOVID19 deaths

“…20 Furthermore, an environmental scan identified training and knowledge in infection control as one of the areas to improve NH infection prevention and control during COVID-19 pandemic. 21 Despite these findings regarding the role of IP training in infection control, there is wide variation in IP training standards across NHs. 18 About 46% of NHs in the national survey reported that their IP had no specific infection control training, and most of them were not certified or trained in infection control.…”

Evaluation of a Virtual Training to Enhance Public Health Capacity for COVID-19 Infection Prevention and Control in Nursing Homes

“…Identifying methods to increase the number of public health professionals capable of responding to emerging health threats is also included as part of national public health objectives,19 and the COVID-19 pandemic only reinforced its importance. In particular, methods to enhance healthcare IPC capacity among the public health workforce were needed to ensure that health department staff were prepared to support nursing homes in preventing and responding to the high incidence of COVID-19,4,5 as nursing homes commonly experience high healthcare personnel turnover and lack time and other resources for IPC training 20. Evaluation findings suggest that the CDC's virtual COVID IPC 101 course was effective in increasing knowledge and confidence among new or less-experienced HAI/AR Program staff in supporting COVID-19 healthcare IPC for nursing homes.…”