Department of Epidemiology, Fulton County Board of Health, Atlanta, Georgia, USA.
Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
J Am Geriatr Soc. 2021 Mar;69(3):581-586. doi: 10.1111/jgs.17001. Epub 2021 Jan 6.
BACKGROUND/OBJECTIVE: Recommendations for infection prevention and control (IPC) of COVID-19 in long-term care settings were developed based on limited understanding of COVID-19 and should be evaluated to determine their efficacy in reducing transmission among high-risk populations.
Site visits to 24 long-term care facilities (LTCFs) in Fulton County, Georgia, were conducted between June and July 2020 to assess adherence to current guidelines, provide real-time feedback on potential weaknesses, and identify specific indicators whose implementation or lack thereof was associated with higher or lower prevalence of COVID-19.
Twenty-four LTCFs were visited, representing 2,580 LTCF residents, among whom 1,004 (39%) were infected with COVID-19.
Overall IPC adherence in LTCFs was analyzed for 33 key indicators across five categories: Hand Hygiene, Disinfection, Social Distancing, PPE, and Symptom Screening. Facilities were divided into Higher- and Lower-prevalence groups based on cumulative COVID-19 infection prevalence to determine differences in IPC implementation.
IPC implementation was lowest in the Disinfection category (32%) and highest in the Symptom Screening category (74%). Significant differences in IPC implementation between the Higher- and Lower-prevalence groups were observed in the Social Distancing category (Higher-prevalence group 54% vs Lower-prevalence group 74%, P < .01) and the PPE category (Higher-prevalence group 41% vs Lower-prevalence group 72%, P < .01).
LTCFs with lower COVID-19 prevalence among residents had significantly greater implementation of IPC recommendations compared to those with higher COVID-19 prevalence, suggesting the utility in adhering to current guidelines to reduce transmission in this vulnerable population.
背景/目的：针对长期护理机构（LTCF）的 COVID-19 感染预防和控制（IPC）建议是基于对 COVID-19 的有限了解而制定的，应进行评估以确定其在降低高危人群传播方面的效果。
2020 年 6 月至 7 月，在佐治亚州富尔顿县对 24 家长期护理机构（LTCF）进行了现场访问，以评估对当前指南的遵守情况，对潜在的弱点提供实时反馈，并确定实施或缺乏特定指标与 COVID-19 更高或更低的流行率相关的具体指标。
共访问了 24 家 LTCF，代表了 2580 名 LTCF 居民，其中 1004 名（39%）感染了 COVID-19。
在五个类别（手部卫生、消毒、社交距离、个人防护设备和症状筛查）中对 LTCF 中的 33 个关键指标进行了整体 IPC 遵守情况分析。根据 COVID-19 感染累积患病率，将设施分为高患病率和低患病率组，以确定 IPC 实施的差异。
IPC 实施最低的是消毒类别（32%），最高的是症状筛查类别（74%）。在高患病率和低患病率组之间观察到 IPC 实施方面存在显著差异的类别是社交距离（高患病率组 54%，低患病率组 74%，P < 0.01）和个人防护设备（高患病率组 41%，低患病率组 72%，P < 0.01）。
与 COVID-19 患病率较高的 LTCF 相比，居民 COVID-19 患病率较低的 LTCF 实施 IPC 建议的比例显著更高，这表明在这一弱势群体中坚持当前指南以减少传播是有用的。
