Table 2.
Selected Gaps in Nursing Home Implementation of CDC-Recommended Infection Control Practices to Prepare for COVID-19, Among Nursing Homes Participating in Remote Infection Control Consultations, N = 629
| Infection Control Element Assessed | Nursing Homes with Element Not Implemented, n/n∗ (%) |
|---|---|
| Any element (58 questions) | 524/629 (83) |
| Domain 1: Visitor and Nonessential personnel restrictions | 30/627 (5) |
| Domain 2: Health care personnel COVID-19 training and symptom monitoring | 103/588 (18) |
| Facility has provided staff with education to use face mask or respirator | 38/581 (7) |
| Health care personnel trained on COVID-19, sick leave, and source control† | 39/629 (6) |
| Facility is aware of staffing needs and has plan in the event of staffing shortages | 28/619 (5) |
| Domain 3: Education, monitoring, screening and cohorting of residents | 291/620 (47) |
| If residents leave their rooms, they wear a cloth face covering or face mask | 79/560 (14) |
| Facility bundles resident care and treatment activities to minimize room entry | 80/587 (14) |
| Facility provided resident education on COVID-19 prevention‡ | 66/629 (10) |
| Facility has dedicated primary HCP staff who work only in COVID area | 54/574 (9) |
| Facility has stopped communal dining | 45/622 (7) |
| The facility monitors ill residents at least 3 times daily | 38/598 (6) |
| Facility has dedicated a space in the facility to care for residents with COVID-19 | 37/578 (6) |
| Facility has stopped group activities inside the facility and field trips | 36/625 (6) |
| Domain 4: Personal protective equipment supply | 101/613 (16) |
| PPE is available in resident care areas | 48/613 (8) |
| Facility has implemented measures to optimize current PPE supply | 34/610 (6) |
| Domain 5: Core infection prevention and control practices | 428/625 (68) |
| Facility has preference for alcohol-based hand sanitizer over soap and water | 242/620 (39) |
| Facility is aware of the contact time for the EPA-registered disinfectant | 150/613 (24) |
| Cleaning and disinfection of environmental surfaces is audited | 119/627 (19) |
| EPA-registered disinfectants available for frequent cleaning of high-touch resident areas | 72/597 (12) |
| Hand hygiene and PPE compliance are audited | 72/616 (12) |
| Facility uses recommended personal protective equipment§ for care of residents with suspected or confirmed COVID-19 | 51/629 (8) |
| Hand hygiene supplies are available in all resident care areas | 48/625 (8) |
| HCP perform hand hygiene at 5 recommended moments‖ when performing patient care | 45/629 (7) |
| Selection and use of PPE are audited | 43/627 (7) |
| EPA-registered disinfectants are prepared and used in accordance with label instructions | 32/601 (5) |
| Domain 6: Communication about suspected or confirmed COVID-19 cases | 68/620 (11) |
| Facility notifies health department about suspected or confirmed COVID-19, including clusters of new-onset respiratory symptoms in resident or health care personnel∗∗ | 62/561 (11) |
EPA, Environmental Protection Agency.
Domain-level analysis (boldface) was limited to nursing homes for which ≥75% of elements in the domain were assessed. Elements shown are those that at least 5% of nursing homes reported not implementing. Proportion of nursing homes with gaps for all elements assessed under each domain shown in Supplementary Table 2.
Denominator varies by small numbers because of missing responses for individual elements.
Includes the following elements: COVID-19 (1/629; 0.2%), sick leave policies and importance of not reporting to work when ill (27/629; 4.3), and new policies for source control while in facility (19/569; 3.3).
Includes the following elements: COVID-19 and actions residents and the facility can take (11/629; 1.7%), importance of immediately informing HCP if they feel feverish or ill (54/629; 8.6), actions residents can take to protect themselves (18/629; 2.9), and actions the facility is taking to keep residents safe (9/629; 1.4).
Gown, gloves, eye protection, and N95 or higher-level respirator (or face mask, if N95 respirator unavailable).
Before and after contact with the resident, after contact with blood, body fluids, or contaminated surfaces or equipment, before performing an aseptic task, and after removing PPE.
Includes the following elements: suspected or confirmed COVID-19 in resident or health care personnel (6/622; 1.0%), resident with severe respiratory infection resulting in hospitalization or death (46/562; 8.2%), cluster of new-onset respiratory symptoms in residents or health care personnel (51/622; 8.2).