Four residents at a long-term care facility in Washington State died after contracting the coronavirus (COVID-19). The deaths of these four elderly patients have raised concerns for families with loved ones residing in nursing homes and those considering moving their loved one into a facility. With thousands potentially exposed to the virus in San Antonio, nursing homes in Texas need to begin taking steps to prevent COVID-19 from affecting sick and elderly residents.
The Centers for Disease Control and Prevention is warning that Americans should be prepared for the possibility of a COVID-19 outbreak in their communities. Recently, the agency released guidelines on preventing the spread of COVID-19 in long-term care facilities. These policies should be taken seriously by all nursing homes and long-term care facilities.
Families touring nursing homes or those with family members already in nursing facilities should be unafraid to ask facilities how they’re implementing the CDC’s measures.
Are viral outbreaks something nursing homes should worry about?
Yes. For starters, residents live in close quarters in nursing homes. As a result, infections spread easily. The second reason to worry about viruses in nursing homes, particularly the coronavirus, is that because a majority of the deaths have occurred among the elderly population or those with underlying conditions. In China, for example, deaths have disproportionately affected people over 80.
While the coronavirus is not widespread in the United States, there have been about 100 people who have tested positive for the virus as of March 1 and six deaths.
For this reason, it is important to nursing home facilities to curb the possibility of introducing the virus into their elderly resident population.
Why is infection prevention important?
More than 4 million Americans reside in longterm care facilities and another one million live in assisted living facilities. Preventing infection is the first line of defense in protecting many of these patients.
The coronavirus can spread rapidly in nursing home facilities because of the following reasons:
- Weakened immune systems. As we age, our immune systems begin to weaken, making us more susceptible to germs. Elderly immune systems can’t fight off bugs in the same way a younger person can.
- More ways for germs to enter the body. While open wounds should be covered with a clean bandage, this doesn’t always happen in understaffed facilities. Additionally, an employee who doesn’t practice proper hand hygiene could infect a patient during wound care.
- Improper sanitizing. Disinfecting equipment is a major component in preventing infection and controlling the spread of disease. For example, items that come in contact with mucous membranes or bodily fluids require high-level disinfection.
- Staff not following cleanliness protocol. Nursing home staff can be quite busy from the moment they enter the doors for their shift. As a result, they may rush from patient to patient without realizing they’ve forgotten to wash their hands.
Preventing the introduction of COVID-19 in Longterm Care Facilities
To prevent COVID-19 from affecting nursing home residents, the CDC recommends that nursing homes focus on preventing the introduction of respiratory germs. The guidelines that the CDC recommends for nursing homes are the same precautions it recommends during flu season.
To prevent the introduction of the coronavirus to nursing homes, the CDC recommends the following prevention strategies:
- Entrances should have signs instructing visitors not to visit loved ones if they have any kind of respiratory infection or symptoms.
- Sick leave policies that allow employees to stay home if they respiratory infection symptoms.
- Monitor newly admitted residents for respiratory infection symptoms.
If a resident is found to have a respiratory infection, the nursing facility should implement appropriate policies that prevent the spread of the infection.
Nursing Home Infection Prevention Best Practices
Nursing homes should prioritize keeping their residents, families and employees informed about how they intend to prevent COVID-19. Facilities need to have a clear outline of what they’re doing to prevent the spread of germs and how residents, employees and family members can be proactive in protecting nursing home residents.
To prevent the spread of respiratory germs within longterm care facilities, consider the following:
- Restrict residents with fever or acute respiratory symptoms to their rooms.
- Employees caring for residents with undiagnosed respiratory infections should use Standard, Contact, and Droplet Precautions. If officials suspect a patient of having an airborne, take airborne precautions.
- Monitor local and state public health sources for COVID-19 activity in their community.
- Ensure employees, residents and visitors are practicing good hand and respiratory hygiene as well as cough etiquette.
- Employees should wash their hands before and after contact with residents, contaminated surfaces or equipment and after removing personal protective equipment.
- Alcohol-based hand rub should be in every resident room, both inside and outside.
Further, nursing facilities should designate certain employees to care for COVID-19 patients. These employees should receive infection control training.
Finally, if a patient being transferred is suspected or confirmed to have the coronavirus, the facility receiving the patient should be notified. Any possible COVID-19 illness in residents or employees should be reported to the local health departments and HAI/AR coordinator.
Prevent COVID-19 Spread: Questions to Ask Nursing Homes
Nursing homes often have lax systems for controlling the spread of illness in their facilities. However, they also have a responsibility to protect the residents in their facilities. It is imperative that they follow CDC guidelines to prevent the spread of COVID-19, flu and other illnesses that can spread rapidly in these facilities. When staff fail to follow procedures, they can lead to deadly conditions in our most vulnerable populations.
If your loved one is in a longterm care facility, asking the following questions can help you determine if they’re being protected:
- What policies are in place to prevent the introduction of COVID-19?
- Does the facility have a plan in place if the COVID-19 is confirmed or suspected?
- How does staff clean and sanitize equipment, surfaces and other items?
- What kind of testing for COVID-19 is being done?
- What are the handwashing policies for residents, visitors and employees?
- Will the facility have dedicated employees to COVID-19 patients?
- What are the facility’s wound care policies?
While there are some who don’t view the coronavirus as a threat, the virus can have serious consequences to our most vulnerable populations. Stopping the virus from entering into nursing homes is the first line of defense for many of the residents living in nursing homes. You can ensure that your loved ones are safe by asking nursing home facilities the hard questions.