Impact of long-term care facilities’ size on adherence to COVID-19’ infection prevention guidance

Abstract

Objective: to evaluate the adherence of Brazilian long-term care facilities to the World Health Organization Infection Prevention and Control guidance, and assess the association of their size with the adherence to these recommendations. Method: cross-sectional study conducted with facilities’ managers. Authors developed a 20-item questionnaire based on this guidance, and a global score of adherence, based on the adoption of these recommendations. Adherence was classified as (1) excellent for those who attended ≥14 out of 20 recommendations; (2) good for 10 to 13 items; and (3) low for those with less than ten items. Facilities’ sizes were established as small, intermediate, and large according to a two-step cluster analysis. Descriptive statistics and chi-square tests were used at a 5% significance level. Results: among 362 included facilities, 308 (85.1%) adhered to 14 or more recommendations. Regarding its size, adherence to screening COVID-19 symptoms of visitors (p=0.037) and isolating patients until they have had two negative laboratory tests (p=0.032) were lower on larger ones compared to medium and small facilities. Conclusion: adherence to COVID-19 mitigation measures in Brazilian facilities was considered excellent for most of the recommendations, regardless of the size of the units.

Long‐term care facilities' response to the COVID‐19 pandemic: An international, cross‐sectional survey

“…At the country level, levels of national preparedness (Chaudhry et al, 2020), economic status (e.g., gross domestic product) (Chaudhry et al, 2020; Leffler et al, 2020), healthcare system‐related factors (e.g., health professionals‐to‐population ratio) (Chaudhry et al, 2020; Kumar et al, 2020), political factors (e.g., worldwide governance indicators) (Haider et al, 2020), population characteristics (e.g., population density) (Chaudhry et al, 2020; El Mouhayyar et al, 2022; Foo et al, 2021) and stringency of the response to the pandemic (e.g., restricting international travel) (El Mouhayyar et al, 2022; Leffler et al, 2020) were found to be significant predictors of COVID‐19 related outcomes, such as transmissibility (Kumar et al, 2020), caseload (Chaudhry et al, 2020), death (El Mouhayyar et al, 2022; Foo et al, 2021; Leffler et al, 2020) and patient recovery rate (Chaudhry et al, 2020). At the facility level, some characteristics of the facility could be linked to the risk of COVID‐19 cases, such as the facility size, staffing levels and availability of single rooms (Frazer et al, 2021; Wachholz et al, 2022).…”