Asymptomatic Cases and Limited Transmission of SARS-CoV-2 in Residents and Healthcare Workers in Three Dutch Nursing Homes.
Ontology highlight
ABSTRACT:
SUBMITTER: van Buul LW
PROVIDER: S-EPMC7756037 | biostudies-literature | 2020 Jan-Dec
REPOSITORIES: biostudies-literature
Publications
Asymptomatic Cases and Limited Transmission of SARS-CoV-2 in Residents and Healthcare Workers in Three Dutch Nursing Homes.
van Buul Laura W LW van den Besselaar Judith H JH Koene Fleur M H P H FMHPH Buurman Bianca M BM Hertogh Cees M P M CMPM
Gerontology & geriatric medicine 20200101
We aimed to assess the contribution of a- and presymptomatic residents and healthcare workers in transmission of SARS-CoV-2 in nursing homes. We conducted two serial point-prevalence surveys, including standardized symptom assessment and nasopharyngeal and oropharyngeal testing for SARS-CoV-2, among 297 residents and 542 healthcare workers of three Dutch nursing homes (NHs) with recent SARS-CoV-2 introduction. At the first point-prevalence survey, 15 residents tested positive of which one was pr ...[more]
Similar Datasets
Project description:BackgroundDuring the COVID-19 outbreak in 2020, national governments took restrictive measures, such as a visitors ban, prohibition of group activities and quarantine, to protect nursing home residents against infections. As 'safety' prevailed, residents and close relatives had no choice but to accept the restrictions. Their perspectives are relevant because the policies had a major impact on them, but they were excluded from the policy decisions. In this study we looked into the moral attitudes of residents, close relatives and volunteers regarding the restrictions in retrospect, and what moral lessons they considered important.MethodsWe conducted 30 semi-structured interviews with residents and close relatives and one focus group meeting with volunteers working in nursing homes. Data were transcribed verbatim and analyzed inductively. Subsequently, three Socratic dialogue meetings with residents, close relatives and volunteers were organized in which first analysis outcomes were discussed and dialogues were fostered into moral lessons for future pandemics. Outcomes were combined with moral theory following an empirical bioethics design.ResultsCritical perspectives regarding the COVID-19 restrictions grew in time. Various moral values were compromised and steered moral lessons for our future. The participants recognized three moral lessons as most important. First, constructing tailored (well-balanced) solutions in practice is desirable. Second, proper recognition is needed for the caring role that close relatives fulfill in practice. Third, a responsive power distribution should be in place that includes all stakeholder perspectives who are affected by the restrictions.DiscussionComparing the results with moral theory strengthens the plea for inclusion of all stakeholder groups in decision-making processes. To further concretize the moral lessons, tailored solutions can be realized with the use of moral case deliberations. Proper recognition includes actions addressing moral repair and including counter-stories in the debate. Responsive power distribution starts with providing clear and trustworthy information and including all perspectives.
| S-EPMC10481572 | biostudies-literature
Project description:Background52% of all deaths in Norway occur in nursing homes. Still advance care planning (ACP) is scarce and heterogeneous. To improve the implementation and practice of ACP in nursing homes, knowledge about health care professionals' views on ACP is vital. The objective of this study is to explore nurses and physicians' aims and experiences with carrying out ACP in nursing homes.MethodsSemi-structured group interviews were conducted with 20 health care professionals, recruited from nursing homes where ACP was performed regularly. Qualitative content analysis was used to analyse the data.ResultsThe primary aim of the nursing home professionals when doing ACP in nursing homes were to build alliances with next of kin to avoid misunderstandings and future conflicts. Two main experiences with ACP were described: i) due to the sensitivity of ACP issues, it was important to balance directness with being sensitive, and ii) when the physicians raised questions concerning future medical treatment, the answers from residents as well as next of kin were often hesitant and unclear.ConclusionOur study add insights into how ACP is practiced in nursing homes and the professionals' agenda. A focus on medical issues and achieving consensus with next of kin may result in lack of involvement of the residents and limited awareness of the residents' needs. Interdisciplinary approaches, ACP-training and tailored guidelines may improve the implementation and practice of ACP.
| S-EPMC6929496 | biostudies-literature
Project description:Background: Malnutrition is a widespread issue among older people, significantly impacting health outcomes. Nutritional interventions can improve health, but their success often depends on the attitudes and knowledge of healthcare workers. Aim: This study assesses healthcare workers' attitudes toward older people's nutrition using the validated Italian version of the Staff Attitudes to Nutritional Nursing Geriatric care scale (SANN-G), focusing on staff in nursing homes in Northern Italy. Methods: A cross-sectional study was conducted with 1789 healthcare workers from 41 facilities. The SANN-G questionnaire measured attitudes across five dimensions: nutritional norms, habits, assessment, intervention, and individualization. Data were collected online and on paper, with descriptive and inferential statistical analyses (chi-square and ANOVA) performed using R software (R-4.4.2 for Windows). Results: Most healthcare workers were female (68.59%) and aged 41-50 (33.31%), with nursing assistants comprising 35.83%. Only 23.48% scored positively on the SANN-G scale, with most exhibiting neutral or negative attitudes. Healthcare workers who attended a malnutrition course were more likely to exhibit positive attitudes toward nutrition, particularly in the dimension of norms, assessment, intervention, and individualization. Younger healthcare workers, with the role of nurses and who attended a course on malnutrition, were more likely to have positive attitudes, while older healthcare workers and with the role of physicians tended to show neutral or negative attitudes. Conclusions: Education on malnutrition improves healthcare workers' attitudes toward older adults' nutrition, especially among younger nurses. The low percentage of positive attitudes (23.48%) underscores the need for broader education programs to enhance nutritional care quality.
| S-EPMC11755615 | biostudies-literature
Project description:BackgroundOral health problems are common among care-dependent older adults living in nursing homes. Developing strategies to prevent the deterioration of oral health is therefore crucial to avoid pain and tooth loss. A standardized work widely used in nursing homes in Sweden is the quality register Senior Alert (SA), which assesses age-related risks concerning e.g. pressure sores, falls, malnutrition and oral health. The oral health assessment is performed with the Revised Oral Assessment Guide-Jönköping (ROAG-J), which also includes planning and implementation of preventive oral care interventions with the goal of achieving good quality care. However, what facilitates and hinders healthcare workers in working with oral health in SA remains unexplored. The aim of this study was to describe healthcare workers' experiences of assessing oral health with the ROAG-J, planning and performing preventive oral health care actions in accordance with SA in nursing homes.MethodsHealthcare workers (n = 28) in nursing homes in two Swedish municipalities participated and data was collected through six focus group interviews. Reflexive thematic analysis was used to identify patterns of meaning in the data.ResultsThemes generated in the analysis were: (1) A structured process promotes communication and awareness and stresses the importance of oral health; (2) Oral care for frail older adults is challenging and triggers ethical dilemmas; (3) Unclear responsibilities, roles and routines in the organization put oral health at risk; (4) Differences in experience and competence among healthcare staff call for educational efforts.ConclusionsThe structured way of working increases staff awareness and prioritization of oral health in nursing homes. The main challenges for the healthcare workers were residents' reluctance to participate in oral care activities and oral care being more complicated since most older adults today are dentate. Organizational challenges lay in creating good routines and clarifying staff roles and responsibilities, which will require continuous staff training and increased management involvement.
| S-EPMC11443800 | biostudies-literature
Project description:BackgroundInformal carers (ICs) of residents living in nursing homes (NH) have a key role in the care of residents, including making decisions about and providing care. As radiology has a role in decision making about care, it is important to understand IC's perspectives about resident's use of mobile X-ray services (MXS). The aim was to explore the perspectives of ICs of residents living in nursing homes about the use of MXS.MethodsFrom November 2020 to February 2021, twenty ICs of residents living in four nursing homes in different areas of one Australian city participated. Their perspectives of MXS, including benefits and barriers, were explored in semi-structured interviews. Data were analysed using thematic analysis.ResultsICs were resident's children (80%) and spouses (20%). One resident had received a MXS. Four themes were developed: (1) a priority for resident well-being, where ICs were positive about using MXS, because residents could receive healthcare without transfer; (2) MXS could reduce carer burden; (3) economic considerations, where MXS could reduce health system burden but the MXS call-out fee could result in health inequities; and (4) pathways to translation, including the need to improve consumer awareness of MXS, ensure effective processes to using MXS,, consider nursing home staff levels to manage MXS and ICs expectations about quality and availability of MXS.ConclusionsICs consider MXS can benefit resident well-being by potentially reducing transfers to hospital or radiology facilities and advocated equitable access. ICs cautioned that the quality and safety of healthcare delivered in nursing homes should equal what they would receive in hospitals.
| S-EPMC10369836 | biostudies-literature
Project description:Aims Psychological First Aid is a brief intervention based on international guidance from the World Health Organisation. Free to access online training in the intervention was introduced during the COVID-19 pandemic in UK. We aimed to determine the uptake of Psychological First Aid training among healthcare workers in care homes in the UK and to assess its effects on their wellbeing. Design This was a sequential mixed methods design. Methods Healthcare workers (nurses and carers) working in care homes in the UK were surveyed about their uptake of Psychological First Aid, their stress, coping efficacy and the key concepts of Psychological First Aid (safety, calmness, hopefulness, connectedness, and accomplishment). Those that completed the Psychological First Aid training were asked to share their experiences via qualitative survey. Data collection was conducted between June and October 2021. Analyses included descriptive statistics and regression analysis. A six step thematic analysis was used to interpret the qualitative data. Results 388 participants responded to the survey. The uptake of Psychological First Aid training was 37 (9.5%). Psychological first aid was a significant predictor for coping efficacy (β = 17.54, p = .001). Participants with a physical or mental health condition experienced higher stress and lower coping regardless of PFA training. Four themes were identified from the qualitative analysis: self-awareness and growth, relationships with others, overcoming stress and accessibility. Conclusion While this study suggests some benefits to healthcare workers in care home settings undergoing PFA the poor uptake of the training warrants further investigation. Impact Care home staff need psychological support. This gap remains as few completed PFA training. This is the first study in UK and worldwide to look at the effects of psychological first aid on stress and coping in this population and it warrants further investigation.
| S-EPMC9632887 | biostudies-literature
Project description:ObjectiveNursing homes (NHs) are serving an increasing proportion of residents with cognitive issues (e.g., dementia) and mental health conditions. This study aims to: (1) implement unsupervised machine learning to cluster NHs based on residents' dementia and mental health conditions; (2) examine NH staffing related to the clusters; and (3) investigate the association of staffing and NH quality (measured by the number of deficiencies and deficiency scores) in each cluster.Data sources2009-2017 Certification and Survey Provider Enhanced Reporting (CASPER) were merged with LTCFocUS.org data on NHs in the United States.Study designUnsupervised machine learning algorithm (K-means) clustered NHs based on percent residents with dementia, depression, and serious mental illness (SMI, e.g., schizophrenia, anxiety). Panel fixed-effects regressions on deficiency outcomes with staffing-cluster interactions were conducted to examine the effects of staffing on deficiency outcomes in each cluster.Data extraction methodsWe identified 110,463 NH-year observations from 14,671 unique NHs using CASPER data.Principal findingsThree clusters were identified: low dementia and mental illnesses (Postacute Cluster); high dementia and depression, but low SMI (Long-stay Cluster); and high dementia and mental illnesses (Cognitive-mental Cluster). From 2009 to 2017, the number of Postacute Cluster NHs increased from 3074 to 5719, while the number of Long-stay Cluster NHs decreased from 6745 to 3058. NHs in Long-stay/Cognitive-mental Clusters reported slightly lower nursing staff hours in 2017. Regressions suggested the effect of increasing staffing on reducing deficiencies is statistically similar across NH clusters. For example, 1 hour increase in registered nurse hours per resident day was associated with -0.67 (standard error [SE] = 0.11), -0.88 (SE = 0.12), and -0.97 (SE = 0.15) deficiencies in Postacute Cluster, Long-stay Cluster, and Cognitive-mental Cluster, respectively.ConclusionsUnsupervised machine learning detected a changing landscape of NH serving residents with dementia and mental illnesses, which requires assuring staffing levels and trainings are suited to residents' needs.
| S-EPMC9108080 | biostudies-literature
Project description:ObjectivesTo compare the standardized incidence rates (IRs) of hip fracture for Native Americans versus other racial groups in U.S. nursing homes (NHs).MethodsWe studied Medicare fee-for-service NH residents aged ≥65 years who became long-stay (index date) between 1/1/2008 and 12/31/2009 (n = 1,136,544). Residents were followed from the index date until occurrence of hip fracture, death, Medicare disenrollment, or study end (12/31/2013). We calculated hip fracture IRs by race and used inverse probability weighting to standardize the rates for baseline demographic and clinical characteristics collected from the Minimum Data Set and Medicare claims data. We compared characteristics of NHs used by residents of different races using Online Survey, Certification and Reporting (OSCAR) data.ResultsAmong long-stay U.S. NH residents, the standardized IR of hip fracture per 100 person-years was highest in Native Americans [2.16; 95% confidence interval (CI) 1.91-2.44] and white residents (2.05; 2.03-2.06), and lowest in black residents (0.82; 0.79-0.85). NHs caring for Native American residents were more likely to be rurally located as compared to other racial group.ConclusionsIn U.S. NHs, Native Americans and whites have the highest standardized IR of hip fracture and should receive particular attention in fracture prevention efforts.
| S-EPMC6527125 | biostudies-literature
Project description:BackgroundHealthcare workers are at increased risk of exposure to respiratory pathogens including Streptococcus pneumoniae (pneumococcus). While little asymptomatic carriage has been reported in young-to-middle-aged adults, this may be due to nonsensitive diagnostic methods. The aim of the current study was to investigate the rates of pneumococcal carriage in a large cohort of healthcare workers, using saliva as a respiratory specimen.MethodsWe evaluated pneumococcal carriage in convenience samples of saliva, self-collected from asymptomatic healthcare workers (Connecticut, USA) who were testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from 30 March to 11 June 2020. DNA extracted from the culture-enriched saliva was later tested using quantitative polymerase chain reaction for piaB, lytA, and serotype. Saliva samples were considered positive for pneumococcus when the piaB cycle threshold value was <40.ResultsStudy participants were 22-74 years old (mean age, 38.5 years), 75% female, 75% white, and with occupations including registered nurses (48%), medical doctors (23%), and patient care assistants (5%). Overall, 138 of 1241 samples (11%) from 86 of 392 individuals (21%) tested piaB positive at some point during the 4-month study period, with 28 (33%) colonized individuals positive at multiple time points. Carriers reflected the overall study population. No significant demographic characteristics were associated with detection of pneumococcus. Colonized individuals primarily carried serotypes 19F (25.6%) and 3 (12.8%).ConclusionsDuring a period of mandatory masking, we identified a cumulative pneumococcal carriage prevalence of 21% among healthcare workers. This study highlights that healthcare workers may act as unrecognized reservoirs of pneumococcus in the population. Despite long-standing pediatric immunization programs, vaccine-targeted serotypes continue to be prevalent among the adult population.
| S-EPMC11800483 | biostudies-literature
Project description:BackgroundThis was an observational study designed to estimate the frequency of methicillin-resistant Staphylococcus aureus (MRSA) transmission to gowns and gloves worn by health care workers (HCWs) interacting with Veterans Affairs Community Living Center (VA nursing home) residents to inform MRSA prevention policies.MethodsParticipants included residents and HCWs from 7 VA nursing homes in 4 states and Washington, DC. Residents were cultured for MRSA at the anterior nares, perianal skin, and wound (if present). HCWs wore gowns and gloves during usual care activities. After each activity, a research coordinator swabbed the HCW's gown and gloves. Swabs were cultured for MRSA.ResultsThere were 200 residents enrolled; 94 (46%) were MRSA colonized. Glove contamination was higher than gown contamination (20% vs 11%, respectively; P < .01). Transmission varied greatly by type of care from 0%-19% for gowns and 7%-37% for gloves. High-risk care activities (odds ratio [OR] > 1.0, P < .05) for gown contamination included changing dressings (eg, wound), dressing, providing hygiene (eg, brushing teeth), and bathing. Low-risk care activities (OR < 1.0, P < .05 or no transmission) for gown contamination included glucose monitoring, giving medications, and feeding.ConclusionsMRSA transmission from colonized residents to gloves was higher than transmission to gowns. Transmission to gloves varies by type of care, but all care had a risk of contamination, demonstrating the importance of hand hygiene after all care. Transmission to gowns was significantly higher with certain types of care. Optimizing gown and glove use by targeting high-risk care activities could improve resident-centered care for MRSA-colonized residents by promoting a home-like environment.
| S-EPMC6453115 | biostudies-literature