| Nursing home infection prevention and control measures |
|
|
| Mass resident screening |
121, 122, 123
|
-
•
Rapid systematic review of European, American, and Asian studies, N = 38 studies: Supports use of mass testing in outbreak-affected facilities121
-
•
Cochrane Review, N = 11 modeling and 11 observational studies: Testing of new admissions and intensified testing of residents and staff after holidays may reduce infections123
-
•
Cochrane Review, N = 11 modeling and 11 observational studies: Routine testing may reduce infection rates123; however evidence noted as uncertain
|
| Resident cohorting and physical separation of infected residents |
121, 122, 123, 124, 125, 126, 127, 128, 129
|
-
•
Rapid systematic review of European, American, and Asian studies, N = 38 studies: supports cohorting protocols to reduce infection rates; however, data limited121
-
•
Cochrane Review, N = 11 modeling and 11 observational studies: supports use of cohorting to reduce new infections but evidence remains uncertain123
-
•
USA, N = 360 facilities: decline in weekly infection rates with implementation of infection prevention and control procedures122
-
•
UK, agent-based modeling study: supports ongoing use of cohorting protocols in outbreak-affected nursing homes129
|
| Promoting hand and respiratory hygiene |
121,122,130
|
|
| Environmental cleaning |
123,130
|
-
•
USA, N = 2580 residents: Greater implementation of environmental cleaning associated with lower infection rates130
-
•
Cochrane Review, N = 11 modeling and 11 observational studies: Cleaning and environmental hygiene measures may reduce infection rates but evidence uncertain123
|
| Personal protective equipment |
|
|
| Supply of personal protective equipment |
122,131,132
|
-
•
USA, N = 360 facilities: Rapid decline in infection rates following widespread use of personal protective equipment in a large cohort study122
-
•
Cyprus, N = 5115 facilities: decline in infection rates during intervention period with adoption of personal protective equipment131;
-
•
USA, stochastic modeling study: Supports continued need for use of personal protective equipment in outbreak-affected facilities despite mass vaccination132
|
| Training of staff in use of personal protective equipment |
133 |
|
| Wider societal measures |
|
|
| Visitation bans |
123,129,134,135
|
-
•
USA, meta-population modeling study: Reduction in infection rate in areas imposing visitation bans134
-
•
UK, agent-based modeling study: Reduced infections with visitation bans only when community prevalence where staff live considerably lower than prevalence where visitors live129
-
•
UK, N = 57,713 individuals: “shielded” individuals had higher rates of infection, after adjustment for nursing home status135
-
•
Cochrane Review, N = 11 modeling and 11 observational studies: Evidence uncertain to support visitation bans123
|
| Interventions to support outbreak-affected nursing homes |
|
|
| On site medicalization |
136,137
|
-
•
Spain, N = 272 residents: On-site medicalization associated with a significantly greater compositive of survival or optimal palliative care136
-
•
USA, N = 215 residents: partnering with local hospitals successfully implemented, descriptive study137
|
| Outreach teams |
138,139
|
-
•
Netherlands, N = 41 long-term care organizations: Outbreak team monitoring successfully implemented, descriptive study138
-
•
France, N = 63 facilities: Local multidisciplinary mobile team implemented to successfully manage outbreaks139
|
| Telemedicine |
140, 141, 142, 143
|
-
•
USA, protocol development to identify telemedicine disruptions and solutions in supporting long-term care facilities: development and validation of several telemedicine platforms through quality improvement cycles142
-
•
Europe, WONCA statement: expert consensus statement on the development of optimal telemedicine support143
|
