Doctors, researchers, and advocates working in the field of long-term care medicine recently expressed their concerns about the devastation of COVID-19 in long-term care facilities—more than 34,000 deaths of residents and staff has comprised 37 percent of the nation’s total deaths due to the disease.
Geriatric experts from across the country suggested several areas where changes could be made to provide better protection from future outbreaks. They are as follows:
- Expansion of rapid testing and tracking for residents and staff and the acquiring of sufficient personal protective equipment (PPE).
- Increasing infection control by giving the “infection preventionist” authority to oversee policies, train employees, and make that job a full-time position.
- Change the design of nursing homes to have primarily private rooms. It was noted that assisted living facilities have fared better due to their having individual apartments that make isolation easier.
- Increase employees’ wages, most notably for nursing aides who provide most of the hands-on care and whose median wage last year was reported as $13.38. Low wages were noted to cause these employees to work in multiple facilities, and this increases the potential for spreading infections.
One doctor specializing in geriatrics made this statement about the need to increase wages: “Our hospital workers are held up as heroes, and they are. Nursing home workers are too. And they’re making minimum wage.” - Review visitor policies and designate a friend or relative of residents to undergo regular testing and be trained in the proper use of PPE to allow them to provide care. The extent of care that families and friends provided residents became quite “eye-opening” after closing nursing homes to visitors.
Similar to how one nursing home administrator in France was reported to have protected her facility from being devastated by the Coronavirus, a few long-term care administrators are experimenting with have having staff live on campus during the crisis.
Compliance Perspective
Failing to effectively control the spread of an infection due to not allocating the infection preventionist the time and authority needed in the oversight of the facility’s Infection Control Plan during a pandemic like COVID-19, and having insufficient quantities of PPE and testing capability, the inability to limit the spread of the infection due to the facility’s design, and inability to isolate residents who contract the infection from those without infection may be viewed as provision of substandard quality of care, in violation of state and federal regulations.
Discussion Points:
- Review policies and procedures regarding the Infection Control Plan and the role of the infection preventionist. Review protocols for acquiring sufficient supplies of PPE and the ability to provide adequate testing of staff and residents. Also consider the need for updating infection control and emergency preparedness plans to cohort infected residents and plans that allow designated friends or family members of residents to be tested for infection, trained in the wearing of PPE, and other procedures to allow them to provide care for residents.
- Train staff regarding infection control protocols and wearing PPE.
- Periodically audit to determine if infection control protocols are being followed.
