According to a recent report from the Chinese Centers for Disease Control, for about 80% of the persons infected with the coronavirus, the effects being tracked are mild. However, the highly transmissible aspect of this Covid-19 coronavirus is cause for serious concern worldwide.
For persons 80 and older, the death rate is significantly higher than for others. Consequently, the older adult demographics for most nursing homes residents puts them at higher risk of death should they contract Covid-19.
There are no specific guidelines currently offered regarding the care of elderly adults believed to have been infected with Covid-19, and this leaves nursing homes with the responsibility of developing their own guidelines. In this environment, prevention becomes the main focus for healthcare providers. Fluids, steroids to reduce lung inflammation, and ventilators to assist with breathing are being used to provide supportive care.
The director of the American Academy of Family Physicians made this statement, “If I were the medical director of a nursing home, I’d be thinking ‘Do I need to quarantine a person?’ ” For this physician who practices in Philadelphia, this translates into long-term care facilities needing to be proactive about managing any person having coronavirus-like symptoms: breathlessness, fever, or coughing. She advises nursing homes and all long-term care facilities to plan now for how staff will be organized if faced with an outbreak. She stated that, if possible, staff should be divided into two groups-one group that works with those who are sick and the other with those who are healthy to lessen cross contact between the two groups.
Ultimately, according to a University of Iowa immunologist studying coronaviruses, handwashing for at least 20 seconds, sneezing or coughing into elbows instead of hands, and staying away from others who are sick will help stop transmission.
Even though it does not protect against Covid-19, the US Centers for Disease Control and Prevention (CDC) advises that people get the flu shot to try to minimize the number of flu cases that could be mistaken for the novel coronavirus.
Compliance Perspective
Faced with the possible outbreak of a virus like Covid-19 that is highly transmittable and considered particularly lethal to elderly and ill residents, a nursing home should be proactive in its efforts to have its Infection Prevention and Control Program in place and operating to protect the residents in its care. Failure to implement adequate infection prevention and control practices could be considered substandard quality of care, in violation of state and federal regulations.
Discussion Points
- Review policies and procedures for the facility’s Infection Prevention and Control Program related to infectious organisms and transmission precautions.
- Train staff in the protocols involved with the Infection Prevention and Control Program, the use of protective equipment when treating persons with infectious illnesses, and hand sanitizing protocols for all staff and residents.
- Periodically audit to ensure that Infection Prevention and Control protocols, including hand hygiene, transmission precautions, and use of personal protective equipment, are being followed in all areas and departments of the facility.
