Long-Term Care

SARS-CoV-2 is aerosolized. If a non-vaccinated person who is shedding the virus visits a vaccinated relative in a nursing home, he can easily spread the virus to all who reside in the facility.

COVID-19 outbreak hits Kentucky nursing home a week after CMS relaxes visiting restrictions.

The CMS update on when nursing home residents can have visitors raises grave concerns. The recommendation appears to assume that herd immunity is reached at 70%.

In CMS’ official announcement easing restrictions for visiting nursing homes, no mention was made of the year anniversary—marked today—of when the WHO officially labeled COVID-19 a global pandemic. Still, in so many words, the agency said enough is enough.

Difficulties in communicating with the elderly necessitate close speaking. These circumstances are a ripe atmosphere for spreading respiratory diseases. While residents were largely isolated from the broader population, their caretakers were not.

The Association for Professionals in Infection Control and Epidemiology (APIC) argues that nursing homes in New York should have a fulltime IP on staff.

“Infection control measures, including surveillance, education, cleaning/disinfection, patient cohorting, isolation, and hand hygiene, effectively contained the outbreak; it was declared over within 2 months.”

Though tough months lie ahead for infection preventionists and other healthcare professionals, hope remains that at some point in 2021 things will begin to settle down. In the end, it comes down to a simple formula: We win, COVID-19 loses.

CDC’s Jay Butler, MD: “It is critical that every healthcare worker in the United States has the training, information, and resources they need to protect themselves, their patients, colleagues, families, and communities from infections, and Project Firstline is designed to meet that need.”

There are 4 “moments” involved as a healthcare professional at a long-term care facility (LTCF) weighs whether to prescribe an antibiotic to a patient or resident.

Cedric Steiner: “We had to address the ability to say good-bye to loved ones. A big guy, with tears in his eyes. He was so thankful that they had a place to go for their mother, because at the hospital they couldn’t see her. He wanted to give me a bear hug, but we did the ‘elbow thing’ instead.”

Despite a clear record of violations across the country, amid a culture where sick staff were asked to show up for work, lawmakers in several states have also potentially disincentivized improvement of infection control standards in long-term care facilities by providing legal liability protections ahead of time.

Nancy Moureau, PhD, RN, CRNI, CPUI, VA-BC: “We see the competency of a vascular access specialist or team validated by the outcomes, by the level of infection with their patients, with other complications that may be present.”

Infection control at LTCFs needs to be a balanced approach that addresses the risk of infection, and not just the treatment of infection. Money is saved when this approach is used.

Many healthcare facilities, not only LTCFs, have turned to online training for staff and then designate the employee as competent to do their job. Online training does not prove competency; it provides training.

Most likely the COVID death count of nursing homes will mount as more information comes to light, as only about 80% of the nation’s approximately 15,400 nursing homes have reported their data.

The media, public health officials, and politicians are accused of being too quick to find fault with nursing home providers.

These pathogens are relentless, they are evolutionarily programed to win, and they are currently doing just that.