COVID-19 among nursing home residents: results of an urgent pre-hospital intervention by a multidisciplinary task force

Abstract

The current coronavirus disease-2019 (COVID-19) pandemic caused 10,541 deaths among nursing home residents in France, by July 17th, 2020. This study reported the results of an urgent pre-hospital intervention in eight French nursing homes. A retrospective study was conducted from March 26th to May 7th, 2020, before and after the intervention of a task force which took action from April 9th to April 11th, 2020. The task force included nurses and specialists of the county general hospital. The intervention had four steps: i) daily notification of deaths; ii) audit by infectious diseases and hygiene specialists focused on nursing team reinforcing, tracking of suspected cases, patients’ cohorting, review of preventive and protective measures, hydration, thromboembolism prevention; iii) intervention of an emergency team which urgently performed procedures suggested; and iv) relay with a geriatric team. There were a total of 770 residents distributed in eight facilities with capacity varying from 53 to 145 residents. The number of deaths peaked at 139 in week 2 and the trough at 0 occurred in weeks 6−7. Comparison between periods (before vs after intervention) showed a significant decrease in number of new deaths (83/770; 11% vs 35/687; 5%, p = 0.0001) and new COVID-19 cases (348/770; 45% vs 123/422; 29%, p < 0.001). The urgent pre-hospital intervention by a multidisciplinary task force achieved mortality reduction during COVID-19 outbreak in nursing homes. Pre-hospital intervention is a valid alternative to hospitalization in case of hospital saturation.

Impact of vaccination on the spread of SARS-CoV-2 infection in north-east Italy nursing homes. A propensity score and risk analysis

“…Besides vaccination, a more comprehensive organization for NH management is needed [ 33 , 34 ] in order to promote improved handling of COVID-19 and possibly of other epidemics in these facilities. Special attention should be paid also to enhance the engagement of physicians and nurse practitioners [ 35 ], with the aim to improve care for NH residents [ 36 , 37 ], also with prehospital interventions [ 38 ].…”

Promising Best Practices Implemented in Long- Term Care Facilities During the COVID-19 Pandemic to Address Social Isolation and Loneliness: A Scoping Review

“…They had been published in journals across a wide range of health science disciplines. The studies included different types of LTCF populations: older people who reside in nursing homes (Dichter, Sander, Seismann-Petersen, & Köpke, 2020;Dolveck et al, 2021;Gilbert, 2020;Mo & Shi, 2020;Wammes et al, 2020), nursing facilities (Maggie Collison et al, 2020;Song et al, 2020), as well as geriatric acute care units, long-term care, and nursing homes (E. E. Office, M. S. Rodenstein, T. S. Merchant, T. R. Pendergrast, & L. A. Lindquist, 2020; Sacco, Lléonart, Simon, Noublanche, & Annweiler, 2020). Several study designs were included in the review, as demonstrated in Supplementary Table 1.…”

“…All included articles were published in 2020 or 2021. In terms of geographical distribution, there are five studies from the USA (Abbasi, 2020;Maggie Collison et al, 2020;Lipsitz et al, 2020;Mo & Shi, 2020; E. E. Office et al, 2020), two from France (Dolveck et al, 2021;Sacco et al, 2020), two from Germany (Dichter et al, 2020;Follmann et al, 2021), one from Canada (Siu, Kristof, Elston, Hafid, & Mather, 2020), one from South Korea (Song et al, 2020), one from Australia (Gilbert, 2020), one from the Netherlands (Wammes et al, 2020), one from Brazil (Moraes et al, 2020), and two scoping reviews that include articles from varied countries around the world (Bethell et al, 2021;Mobasseri, Azami-Aghdash, Khanijahani, & Khodayari-Zarnaq, 2020).…”

“…Success was noted in systematic screening, as regular (twice daily) assignment of staff to specific residences or floors to help maintain prompt case detection and clinical management initiation (Song et al, 2020). These were supplemented through the prohibition of family visits and the isolation of staff and residents (Maggie Collison et al, 2020;Gilbert, 2020), as well as through the permanent presence of nursing staff (Dichter et al, 2020;Dolveck et al, 2021). Siu et al (2020), in the province of Ontario, laid out the following strategies: 1) the active and passive screening of visitors and staff, 2) the establishment of respiratory isolation procedures, and 3) the encouragement of sick staff to take time off work.…”

Zur Übersterblichkeit in Deutschland in den Jahren 2020 und 2021

“…Die Altersgrenze wurde auf 80 Jahre festgelegt, da das Durchschnittsalter der Pflegebedürftigen in den berücksichtigten Jahren bei ca. 80 Jahren liegt [14] und Pflegebedürftige besonders von COVID-19 betroffen waren [15]. Alle Auswertungen wurden mit dem Programm Origin © 8.5 (Fa.…”