Design and Implementation of a Skilled Nursing Facility COVID-19 Unit

Abstract

Coronavirus disease 2019 (COVID-19) has challenged the healthcare system’s capacity to care for acutely ill patients. In a collaborative partnership between a health system and a skilled nursing facility (SNF), we developed and implemented a SNF COVID-19 unit to allow expedited hospital discharge of COVID-positive older adults who are clinically improving, and to provide an alternative to hospitalization for those who require SNF care but do not require or necessarily desire aggressive disease-modifying interventions.

Support from Work and Intent to Stay Among Nurses During COVID-19

“…17,20,21 The care environment affects dimensions of well-being and productivity 22 and can mitigate risk and increase staff safety. 23 Yet most participants intended to remain with their employer, contrasting with other research linking COVID-19-related fears to turnover intention. 19,24 Our results indicate that Support from Work had the strongest influence on Intent to Stay.…”

The implications of the COVID-19 pandemic for long term care facilities

“…Based on this and similar experiences, a number of recommendations to adapt LTCF infrastructure should be implemented where possible. These include rethinking facility regulations and, where possible adjusting the physical layout of LTCFs in conjunction with the recommendations of enhanced traffic control bundling (ETCB) [8 ▪▪ ,16 ▪ ,57–59,60 ▪ ]. ETCB incorporates clear delineation of risk zones and rezoning into contaminated (for infected residents), intermediate (asymptomatic pending testing), and clean zones to differentiate care pathways and optimize residents’ safety.…”

“…To ensure effective response, emphasis should be on integrating and strengthening coordination between the healthcare system and LTCFs [8 ▪▪ ,59,71]. During a pandemic it is likely that even with the preparedness efforts taken by LTCF leadership, LTCFs will struggle with infection control.…”