Three-Tiered COVID-19 Cohorting Strategy and Implications for Memory-Care

Collison, Maggie; Beiting, Kimberly J.; Walker, Jacob; Huisingh-Scheetz, Megan; Pisano, Jennifer; Chia, Stephanie; Marrs, Rachel; Landon, Emily; Levine, Stacie; Gleason, Lauren J.

doi:10.1016/j.jamda.2020.09.001

Cited by 13 publications

(22 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, severe visiting restrictions were enforced to prevent external importation of the virus [ 51 ]. Many nursing homes implemented a 3-tier cohorting system (confirmed positive, suspected positive awaiting further testing, confirmed negative), as opposed to the 2-tier system used in previous influenza outbreaks [ 47 ]. In one study, 28% of exposed individuals who initially tested negative became positive shortly after [ 47 ].…”

Section: Resultsmentioning

confidence: 99%

“…Many nursing homes implemented a 3-tier cohorting system (confirmed positive, suspected positive awaiting further testing, confirmed negative), as opposed to the 2-tier system used in previous influenza outbreaks [ 47 ]. In one study, 28% of exposed individuals who initially tested negative became positive shortly after [ 47 ]. This does not necessarily reflect poor sensitivity of the test, but the fact that it takes time after exposure, for any test to become positive as the infection becomes established and the virus excreted in enough quantity to be detectable by any test.…”

Section: Resultsmentioning

confidence: 99%

“…Given the variable time latencies between testing and results [24], and the need to repeat testing in many instances, isolation and cohorting strategies were implemented in nursing homes to divide the residents into defined groups based on COVID-19 status. Many studies reported the common practice of cohorting positive cases within a separate COVID-19 unit [47][48][49]. It was recommended that specific staff members be allocated to these units to reduce dissemination and allow for more focused care [50].…”

Section: Isolation and Cohortingmentioning

confidence: 99%

See 2 more Smart Citations

Nursing homes during the COVID-19 pandemic: a scoping review of challenges and responses

2021

View full text Add to dashboard Cite

Introduction COVID-19 has caused unprecedented challenges in nursing homes. In this scoping review, we aimed to describe factors that contributed to the spread and mortality of COVID-19 in nursing homes and provide an overview of responses that were implemented to try to overcome such challenges. Methods The MeSH terms “Nursing homes” and “COVID-19” were searched in MEDLINE Ovid, and English language articles were retrieved that were published between 1 March 2020 and 31 January 2021. Article titles and abstracts were screened by two reviewers, and the results of included articles were grouped by themes. Results The search retrieved 348 articles, of which 76 were included in the thematic review. 8 articles related to COVID-19 disease characteristics (e.g. asymptomatic transmission), 24 to resident-related factors (e.g. comorbidities, nutrition, cognition), 13 to facility characteristics (e.g. physical space, occupancy, for-profit status), 21 to staffing (e.g. staffing levels, staff-to-resident ratio, staff multi-employment), and 10 to external factors (e.g. availability of personal protective equipment, prevailing health and social care policies). In terms of responses, identified themes included widespread testing, isolation and cohorting of residents, staff protection and support, promotion of residents’ well-being, and technological innovations. Conclusion COVID-19 exerted severe challenges on the nursing home population and its staff. Both internal and external factors predisposed nursing homes to an increased propensity of spread. Numerous strategies were employed to attempt to mitigate the negative impacts. Substantial learning occurred that may not only aid future pandemic preparedness but improve quality of care for nursing home residents at all times.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Isolation and Cohortingmentioning

confidence: 99%

See 1 more Smart Citation

Nursing homes during the COVID-19 pandemic: a scoping review of challenges and responses

2021

View full text Add to dashboard Cite

show abstract

“…28,29,99e101,104,106,110,111 Universal, serial testing of residents and staff Thirty-six articles described universal testing protocols for residents, staff, or both, 11,16,37,41,42,44,45,47e49,51e55,57e61,63e65,71e74,87 ,97,104e110 resulting in declines in new case numbers, 37,41,57,63,106 and early detection of COVID-19 cases. 59,68,70,72e74,105 Widespread testing was usually accompanied by rigorous IPC measures including isolation or cohorting of positive cases, 37,42,44,47,52,54,63,72,104,106 and often serial testing until all tests were negative. 49,72,106 Some facilities used serial point-prevalence studies of all staff and residents as an indicator of IPC effectiveness.…”

Section: Multifocal Infectious Disease Responsesmentioning

confidence: 99%

Protecting Nursing Homes and Long-Term Care Facilities From COVID-19: A Rapid Review of International Evidence

Dykgraaf

Matenge

Desborough

et al. 2021

Journal of the American Medical Directors Association

View full text Add to dashboard Cite

Objectives The COVID-19 pandemic has highlighted the extreme vulnerability of older people and other individuals who reside in long term care, creating an urgent need for evidence-based policy that can adequately protect these community members. This study aimed to provide synthesized evidence to support policy decision-making. Design Rapid narrative review investigating strategies that have prevented or mitigated SARS-CoV-2 transmission in long term care. Setting and Participants Residents and staff in care settings such as nursing homes and long term care facilities. Methods PubMed/Medline, Cochrane Library and Scopus were systematically searched, with studies describing potentially effective strategies included. Studies were excluded if they did not report empirical evidence (for example commentaries and consensus guidelines). Study quality was appraised on the basis of study design; data were extracted from published reports and synthesised narratively using tabulated data extracts and summary tables. Results Searches yielded 713 articles; 80 papers describing 77 studies were included. Most studies were observational with no randomized controlled trials identified. Intervention studies provided strong support for widespread surveillance, early identification and response, and rigorous infection prevention and control (IPC) measures. Symptom or temperature based screening, and single point-prevalence testing, were found to be ineffective, and serial universal testing of residents and staff was considered crucial. Attention to ventilation and environmental management, digital health applications and acute sector support were also considered beneficial although evidence for effectiveness was lacking. In observational studies, staff represented substantial transmission risk and workforce management strategies were important components of pandemic response. Higher performing facilities with less crowding and higher nurse staffing ratios had reduced transmission rates. Outbreak investigations suggested that facility-level leadership, inter-sectoral collaboration and policy that facilitated access to critical resources were all significant enablers of success. Conclusions and Implications High quality evidence of effectiveness in protecting LTCFs from COVID-19 was limited at the time of this study, though continues to emerge. Despite widespread COVID-19 vaccination programs in many countries, continuing prevention and mitigation measures may be required to protect vulnerable long term care residents from COVID-19 and other infectious diseases. This rapid review summarises current evidence regarding strategies which may be effective.

show abstract

“…Treating the infected, suspected, and uninfected HD patients at different times and in separate areas are common approaches followed in HD facilities to mitigate the risk of infection transmission among patients during the COVID-19 pandemic ( Boushab, Koné, Baba, El Mokhtar, Ahmed, Habiboullah, Baba, Mohamed, Basco, et al., 2021 , Kliger, Silberzweig, 2020 ). Different cohorting strategies, which involve defining patient types and assigning them to separate areas, have been implemented around the world (e.g., Collison et al. (2020) ; Whiteside, Kane, Aljohani, Alsamman, & Pourmand (2020) ), and there is no well-established standard yet.…”

Section: Introductionmentioning

confidence: 99%

Capacity planning for effective cohorting of hemodialysis patients during the coronavirus pandemic: A case study

Bozkir

Ozmemis

Kurbanzade

et al. 2023

European Journal of Operational Research

View full text Add to dashboard Cite

Three-Tiered COVID-19 Cohorting Strategy and Implications for Memory-Care

Cited by 13 publications

References 11 publications

Nursing homes during the COVID-19 pandemic: a scoping review of challenges and responses

Nursing homes during the COVID-19 pandemic: a scoping review of challenges and responses

Protecting Nursing Homes and Long-Term Care Facilities From COVID-19: A Rapid Review of International Evidence

Capacity planning for effective cohorting of hemodialysis patients during the coronavirus pandemic: A case study

Contact Info

Product

Resources

About