Table 4.
Changes in Nursing Home Knowledge and Practices in a Randomly Selected Subset of Facilities Following Remote Infection Control Consultations, n = 154
| n/n (%) | |
|---|---|
| Increased understanding of 1 or more practices for preventing COVID-19 transmission | 95/154 (62) |
| Actions facility could take to prevent the spread of COVID | 71/95 (75) |
| Recommended practices for PPE supplies and use | 52/95 (55) |
| Recommended practices for environmental cleaning and disinfection | 46/95 (48) |
| Recommended practices for hand hygiene | 40/95 (42) |
| Recommended practices for resident source control and social distancing | 33/95 (35) |
| Recommended practices for staff source control and social distancing | 29/95 (31) |
| Recommended practices for cohorting of residents | 22/95 (23) |
| Facility reported change to ≥1 practices and/or policies after consultation | 107 (69) |
| Processes implemented or improved, by domain | |
| Domain 1: Visitor or nonessential personnel restrictions | 1/107 (1) |
| Process for screening visitors and staff | 1/1 (100) |
| Domain 2: Health care personnel COVID-19 training and symptom monitoring | |
| Social distancing, source control, screening of staff | 26/107 (24) |
| Screening of HCP at the start of shift | 11/26 (42) |
| Adherence to universal masking of staff | 6/26 (23) |
| HCP social distancing | 3/26 (12) |
| Other | 7/26 (27) |
| Domain 3: Education, monitoring, screening, and cohorting of residents | |
| Social distancing, source control, screening of residents | 32/107 (30) |
| Admission and daily fever and symptom screening | 15/32 (47) |
| Wearing face masks or cloth face covers and performing hand hygiene when leaving room | 9/32 (28) |
| Screening ill residents at least 3 times daily | 1/32 (3) |
| Encourage residents to stay in rooms | 1/32 (3) |
| Other | 11/32 (34) |
| Planning for care of residents with COVID-19 | 11/107 (10) |
| Dedicated space for residents with confirmed COVID-19 | 4/11 (36) |
| Created staffing plan for care of residents with confirmed COVID-19 | 4/11 (36) |
| Created policy that residents with suspected COVID are immediately placed in appropriate transmission-based precautions | 2/11 (18) |
| Created plan for monitoring residents who develop COVID-19 | 1/11 (9) |
| Other | 3/11 (27) |
| Domain 4: Personal protective equipment supply | |
| Changes in PPE use practices and policies | 51/107 (48) |
| Additional PPE training for staff | 15/51 (29) |
| Instituted PPE optimization strategy | 10/51 (20) |
| Increased audit | 8/51 (16) |
| Reached out to contacts if PPE shortages identified | 7/51 (14) |
| Increased availability and accessibility of PPE | 7/51 (14) |
| Trained staff to clarify use of face mask or cloth face cover for source control vs PPE for resident care | 5/51 (10) |
| Resolved PPE shortage | 4/51 (8) |
| Began to use burn rate calculator | 1/51 (2) |
| Improved bundling of resident care | 0 (0) |
| Other∗ | 12/51 (24) |
| Domain 5: Core infection prevention and control practices | |
| Changes in hand hygiene practices and policies | 38/107 (36) |
| Increased audits | 13/38 (34) |
| Clarified preference for ABHS | 12/38 (32) |
| Additional hand hygiene training for staff | 9/38 (24) |
| Increased availability of ABHS | 6/38 (16) |
| Other | 2/38 (5) |
| Changes in environmental cleaning and disinfection | 23/107 (21) |
| Implemented appropriate contact time for disinfectants | 6/23 (26) |
| Additional education and training of environmental services workers | 6/23 (26) |
| Used EPA List N to choose appropriate disinfectants | 3/23 (13) |
| Increased cleaning of nondedicated, nondisposable equipment | 2/23 (9) |
| Other† | 13/23 (57) |
∗
N95 fit testing accounted for 5 of 12 (42%) of other changes.
†
Increased disinfection and/or auditing of high-touch surfaces accounted for 5 of 13 (38%) of other changes.