Supplementary Table 2.
Gaps in Nursing Home Implementation of Recommended Infection Control Practices to Prepare for COVID-19, Among Long-Term Care Facilities Participating in Remote Infection Control Consultations, N = 629
| Infection Control Elements Assessed | Facilities With Element Not Implemented, n/n (%) |
|---|---|
| Any element (58 questions) | 524/629 (83) |
| Visitor and nonessential personnel restrictions | 30/627 (5) |
| Facility restricts all visitation other than compassionate care | 4/628 (0.6) |
| Decisions about visitation are made on a case-by-case basis. | 12/625 (2) |
| Potential visitors are screened prior to entry | 7/623 (1) |
| Visitors that are permitted inside must wear a cloth face mask | 2/617 (0.3) |
| Facility has restricted nonessential personnel | 10/623 (2) |
| Facility has sent a communication to families | 1/625 (0.2) |
| Facility has provided alternative methods for visitation | 1/616 (0.2) |
| Facility has posted “No Visitors” signs at entrances to the facility | 1/618 (0.2) |
| HCP COVID-19 training and symptom monitoring | 103/588 (18) |
| HCP 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) |
| Facility has implemented universal use of face masks or cloth face coverings | 7/584 (1) |
| Facility has provided staff with education to use face mask or respirator | 38/581 (7) |
| HCP reminded to practice social distancing in break and common areas | 6/616 (1) |
| HCP are screened at the beginning of their shift | 0/628 (0) |
| If they are ill, they are instructed to keep their cloth face covering or face mask on | 1/615 (0.2) |
| Facility keeps a list of symptomatic HCP | 12/617 (2) |
| Education, monitoring, screening, and cohorting of residents | 291/620 (47) |
| Facility provided resident education on COVID-19 prevention† | 66/629 (10) |
| Facility assesses residents for fever and symptoms of COVID-19 | 4/625 (0.6) |
| Residents with suspected COVID-19 are immediately placed in appropriate precautions | 14/605 (2) |
| Facility keeps a list of symptomatic residents | 11/599 (2) |
| Facility has stopped group activities inside the facility and field trips | 36/625 (6) |
| Facility has stopped communal dining | 45/622 (7) |
| Residents are encouraged to remain in their rooms | 18/626 (3) |
| 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) |
| 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 dedicated primary HCP staff who work only in COVID area | 54/574 (9) |
| Facility has a plan for how residents who develop COVID-19 will be managed | 20/570 (4) |
| Personal protective equipment supply | 101/613 (16) |
| Facility has assessed current supply of PPE and other critical materials | 13/624 (2) |
| If needed, facility has contacted HD for assistance with PPE shortage | 27/607 (4) |
| Facility has implemented measures to optimize current PPE supply | 34/610 (6) |
| PPE is available in resident care areas | 48/613 (8) |
| Tissues and trash cans are available in common areas | 6/589 (1) |
| Core infection prevention and control practices | 428/625 (68) |
| HCP perform hand hygiene at 5 recommended moments‡ when performing patient care | 45/629 (7) |
| Facility uses recommended personal protective equipment§ for care of residents with suspected or confirmed COVID-19 | 51/629 (8) |
| Hand hygiene and PPE compliance are audited | 18/627 (3) |
| Selection and use of PPE are audited | 43/627 (7) |
| Cleaning and disinfection of environmental surfaces is audited | 119/627 (19) |
| Facility has preference for alcohol-based hand sanitizer over soap and water | 242/620 (39) |
| PPE are removed in a manner to prevent self-contamination and hand hygiene is performed immediately after removal | 13/603 (2) |
| Hand hygiene supplies are available in all resident care areas | 48/625 (8) |
| Hand hygiene and PPE compliance are audited | 72/616 (12) |
| Nondedicated, nondisposable resident care equipment is cleaned | 13/608 (2) |
| EPA-registered disinfectants available for frequent cleaning high touch resident areas | 72/597 (12) |
| EPA-registered disinfectants are prepared and used in accordance with label instructions | 32/601 (5) |
| Facility is aware of the contact time for the EPA-registered disinfectant | 150/613 (24) |
| Communication about suspected or confirmed COVID-19 cases | 68/620 (11) |
| Facility notifies health department about | |
| Suspected or confirmed COVID-19 in resident or HCP | 6/622 (1) |
| Resident with severe respiratory infection resulting in hospitalization or death | 46/562 (8) |
| Cluster of new-onset respiratory symptoms occurs in residents or HCP | 51/622 (8) |
| Facility has process to notify residents, families, and staff about facility COVID-19 cases | 6/618 (1) |
| Facility communicates information about residents with known or suspected COVID-19 to appropriate personnel prior to transfer | 2/618 (0.3) |
EPA, Environmental Protection Agency; HCP, health care professional; PPE, personal protective equipment.
Domain-level analysis (boldface) was limited to facilities for which ≥75% of elements in the domain were assessed.
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).
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.
Gown, gloves, eye protection, and N95 or higher-level respirator (or face mask, if N95 respirator unavailable).