Preparing nursing homes for a second wave of coronavirus disease 2019 (COVID-19)

• Published in: Infection control and hospital epidemiology 2021-10, Vol.42 (10), p.1251-1254
• Main Authors: Murthy, A Rekha, Hanrahan, Jennifer A, Advani, Sonali D, Ashraf, Muhammad Salman, Mills, John P, Mody, Lona, Henderson, David K, Hayden, Mary K, Weber, David J, Wright, Sharon B, Babcock, Hilary, Guzman-Cottrill, Judith, Haessler, Sarah D, Rock, Clare, Van Schooneveld, Trevor, Forde, Corey, Logan, Latania K, Malani, Anurag
• Format: Article
• Language: English
• Subjects: Collaboration; Coronaviruses; COVID-19; Gloves; Humans; Masks; Nursing Homes; Pandemics; Personal protective equipment; Prevention; Protective equipment; SARS-CoV-2; State of the Pandemic
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1017/ice.2020.1283

During the COVID-19 pandemic, nursing homes have faced challenges including inadequate infrastructure to support isolation units, difficulties in securing timely diagnostic testing, high staff turnover, space limitations, personal protective equipment (PPE) shortages, and frequently evolving guidance for prevention and treatment of COVID-19. Testing Healthcare personnel (HCP) performing testing should wear appropriate PPE and should be trained in specimen collection. Because of ongoing supply issues, nursing homes may decide to implement >1 type of test. The Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS) released guidance on antigen testing in nursing homes, and the CMS is sending antigen testing kits to nursing homes with the expectation that they will be used to test asymptomatic staff.7 These tests have not been validated for screening asymptomatic individuals yet. Use of Personal Protective Equipment Measure HCP Non-HCP staff Residents Visitors Universal precautions (at all times, in all spaces of facility and grounds) Medical mask Consider eye protection Medical mask, if interacting with resident(s) Medical mask or cloth mask acceptable, if not interacting with resident(s) If tolerated, medical mask preferred when interacting with HCP, staff, residents, or visitors, or cloth mask acceptable Medical mask, if interacting with resident(s) Medical or cloth mask, if not interacting with resident(s) Ongoing community transmission and/or new/first case detected in nursing home Medical mask Eye protection Gown Gloves Care of resident with COVID-19 Medical mask or N95 (if supplies permit) Eye protection Gown Gloves Medical mask (eg, end-of-life visit), AGP on resident with COVID-19 N95 Eye protection Gown Gloves N/A AGP on resident without COVID-19 Medical mask or N95 (if supplies permit) Eye protection Gown Gloves Note.