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Implementation of COVID-19 infection control best practices in nursing homes amid the pandemic

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2024年8月17日

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  • Gail C. D’Souza,
  • Jennifer L. Kraschnewski,
  • Erica Francis,
  • Emily Heilbrunn,
  • Lan Kong,
  • Erik Lehman,
  • Nicole Osevala,
  • Jennifer Urso,
  • Linda Chamberlain,
  • Kim M. Suda,
  • Laura McNeil,
  • William A. Calo

摘要

Background

The COVID-19 pandemic has claimed around 170,000 lives among nursing home residents and staff in the United States through April 2023. In a cluster randomized controlled trial (RCT) with 136 nursing homes, we delivered training to improve COVID-19 infection control best practices. We sought to assess the implementation of infection control practices in participating nursing homes.

Methods

Concurrent with the delivery of the RCT (January-November 2021), we surveyed nursing home administrators (NHAs, n = 38) at baseline and 6-month follow-up. Using validated items from the Centers for Disease Control and Prevention (CDC), the surveys inquired about 80 infection control best-practice activities (yes/no). The survey also asked seven scales corresponding to inner setting factors that may have impacted implementation. We assessed changes in infection control practices and inner setting factors between baseline and 6-month follow-up.

Results

Overall, the implementation of 11 best practices changed over time. NHAs reported an increase in the availability of informational materials for residents and families (84% vs. 100%, p = 0.031), the use of alcohol-based hand sanitizer over soap (76% vs. 97%, p = 0.008), and the development of contingency plans for increased postmortem care (53% vs. 82%, p = 0.013). The implementation of four best-practice visitation policies and three communal restrictions decreased between baseline and 6-month follow-up (all p < 0.05). Regarding inner setting factors, only culture stress (perceived strain, stress, and role overload) increased between surveys (mean scores: 3.14 vs. 3.58, p = 0.004).

Conclusion

This study was among the first to report changes in implementing COVID-19 infection control best practices in nursing homes amid the pandemic. Culture stress was an important inner setting factor that may have impacted implementation activities.

Trial registration

NCT04499391

Date of registration

August 3rd, 2020