COVID‐19 Infection Prevention and Control Adherence in Long‐Term Care Facilities, Atlanta, Georgia

Abstract

Background/Objective Recommendations for infection prevention and control (IPC) of COVID‐19 in long‐term care settings were developed based on limited understanding of COVID‐19 and should be evaluated to determine their efficacy in reducing transmission among high‐risk populations. Design and Setting Site visits to 24 long‐term care facilities (LTCFs) in Fulton County, Georgia, were conducted between June and July 2020 to assess adherence to current guidelines, provide real‐time feedback on potential weaknesses, and identify specific indicators whose implementation or lack thereof was associated with higher or lower prevalence of COVID‐19. Participants Twenty‐four LTCFs were visited, representing 2,580 LTCF residents, among whom 1,004 (39%) were infected with COVID‐19. Measurements Overall IPC adherence in LTCFs was analyzed for 33 key indicators across five categories: Hand Hygiene, Disinfection, Social Distancing, PPE, and Symptom Screening. Facilities were divided into Higher‐ and Lower‐prevalence groups based on cumulative COVID‐19 infection prevalence to determine differences in IPC implementation. Results IPC implementation was lowest in the Disinfection category (32%) and highest in the Symptom Screening category (74%). Significant differences in IPC implementation between the Higher‐ and Lower‐prevalence groups were observed in the Social Distancing category (Higher‐prevalence group 54% vs Lower‐prevalence group 74%, P < .01) and the PPE category (Higher‐prevalence group 41% vs Lower‐prevalence group 72%, P < .01). Conclusion LTCFs with lower COVID‐19 prevalence among residents had significantly greater implementation of IPC recommendations compared to those with higher COVID‐19 prevalence, suggesting the utility in adhering to current guidelines to reduce transmission in this vulnerable population.

The obedience of medical personnel to using personal protective equipment in preventing the transmission of COVID-19 at a private hospital in Indonesia

“…The adherence of healthcare workers to using PPE is varied around the world. A study in Egypt found the adherence to IPC (Infection Prevention and Control) measures was a significant determinant of COVID-19 cases among health workers (El-Sokkary et al, 2021;Telford et al, 2020). One preventive way to increase awareness about COVID-19 is by providing training.…”

Impact of long-term care facility size on preparedness and adherence to infection prevention and control guidance for the mitigation of COVID-19

“…In the United States, COVID-19 mortality was found to be higher in significantly more crowded facilities (9.7%) than in less crowded ones (4.5%), regardless of facility size. 23 The size of LTCFs was strongly associated with COVID-19 outbreaks (odds ratio per 20-bed increase 3.35, 95% confidence interval 1.99–5.63). 24 Meanwhile, in the UK, the likelihood of spread of COVID-19 was higher for larger LTCFs (>20 beds) and when workers and facilities did not adhere to IPC measures to mitigate infection risk.…”

“…In a study of high-risk populations in a high-income country, IPC implementation significantly differed between higher- and lower-prevalence groups in the social distancing and PPE categories. 23…”

“…Coronavirus outbreaks will probably continue to occur worldwide for the following years, similar to other respiratory viruses. 23,27 The effects of vaccination and immunity rates remain largely unknown, and they may be lower in LTCF residents due to immunosenescence. 28…”

COVID-19 Prevention Assessments: A Promising Tool for Preventing Outbreaks in Long-Term Care Homes

“…Several analyses have suggested LTCH factors contributing to outbreaks. 2,5,6 Often, these are less modifiable facility-level factors (eg, public vs private ownership, facility age) or highly residentspecific (eg, residents who wander). Our results indicate that assessment tools assessing LTCH IPC measures and pandemic preparedness may play an important role in preventing large outbreaks from occurring independent of these other risk factors.…”