A significant reduction in the rate of new COVID-19 positive test results in Detroit Michigan nursing homes from 35% to 18% is being attributed by the Centers for Disease Control and Prevention (CDC) to comprehensive testing and infection-control collaboration. See study at: https://www.cdc.gov/mmwr/volumes/69/wr/mm6927e1.htm?s_cid=mm6927e1_w
This improvement is attributed to the efforts by the Detroit Health Department in the early days of the COVID-19 pandemic to proactively work with the CDC, healthcare systems, local government, and academics to arrange testing and infection control support for metropolitan-area nursing homes. This project involved performing blanket Coronavirus testing for all residents and staff members despite the presence or absence of any symptoms.
As expected, the results of the first testing confirmed that COVID-19’s impact in long-term care was huge. Of the 26 facilities involved in the testing between March 7 and May 8, 44% of the residents and staff members tested positive, 24% of those died within three weeks, and 37% were hospitalized.
The second round of testing focused on 12 facilities and the results of that testing indicated that the positive rate declined from 35% to 18%. This reduction was attributed to facilities using testing information as a guide for their infection-control practices and “cohorting” strategies. Additionally, on-the-ground infection prevention and control (IPC) evaluations provided guidance on the use of personal protective equipment (PPE) and how to best utilize the layout of facilities to keep residents with the virus separated from non-infected residents.
Although the CDC analysis is preliminary, it seems to support many states’ decisions to implement baseline and repeat testing of nursing home residents and staff members.
Compliance Perspective
Failure to have access to repeated COVID-19 testing of residents and staff members may hinder a facility’s ability to effectively implement its infection control protocols, ensure a sufficient supply and use of PPE, and keep residents who are not infected with COVID-19 separate from those who have contracted the virus. This may result in greater incidences of infection, hospitalization, and death, and may be seen by regulators as a violation of state and federal regulations.
Discussion Points:
- Review policies and procedures regarding IPC, PPE, and cohorting of residents with and without COVID-19, as well as consistent assignments for staff caring for the two groups of residents. Review the status and availability for repeated testing as being provided by the state where the facility is located.
- Train staff regarding how effective IPC, PPE use, and cohorting can reduce the infection rate for COVID-19.
- Periodically audit to evaluate the effectiveness of the facility’s IPC protocols, use of PPE, and best use of the facility’s layout for effective cohorting of residents.
