Another study examined COVID risks to outpatient care of residents.
At a time when nursing homes continue to be among the institutions hardest hit in the coronavirus pandemic, new studies are beginning to provide insight into why some facilities see more cases than others – and, according to one, how important nursing home staff themselves are at work.
A study released Monday by The Journal of the American Medical Association (JAMA) found that in eight states, those facilities that were able to have more staff in homes had fewer COVID-19 cases than staff in homes who rated the study as low-performance.
The study, by Harvard researchers, looked at coronavirus outbreaks in California, Connecticut, Florida, Illinois, Maryland, Massachusetts, New Jersey, and Pennsylvania. Researchers used federal reviews based on health inspections, quality measures, and nursing staff to see if facilities with poor performance management in those categories had more viral infections than fatalities.
When it came to health inspections or ratings for quality measurements, the study found no significant difference in the burden of COVID-19 cases between homes. But the data suggested one interesting data point: Facilities with a shortage of nursing staff may be more susceptible to the spread of the virus.
The report published by JAMA acknowledged the importance of infection control practices, but pointed out that policies that provide direct support to staff members “may be more effective in limiting the spread of COVID-19.”
The study used “average person-hours per capita by qualified nurses” as the metric rating for nurses.
Eric Carlson, a long-term expert with the advocacy group Justice in Aging, told ABC News that if facilities do not have enough staff, people will suffer residents from a lower quality of care.
“If nurses are responsible for too many residents, they do not have the time to follow the proper infection prevention procedures,” Carlson said. “It is penny wise and pounds foolish to provide facilities for short-term staff, because this research shows that over-staffing leads to infections and deaths. ”
Toby Edelman, a senior policy advocate for the Center for Medicare Advocacy, a nonprofit organization that provides education, advocacy and legal assistance to help seniors and people with disabilities get health care, told ABC News that nursing homes have struggled to meet federal standards at staff levels even before the coronavirus pandemic.
“Nurses with more registered nurses and higher levels for nurses in general are more effective at containing the coronavirus than facilities with fewer nurses,” Edelman said.
Meanwhile, a study released on Tuesday by the Centers for Disease Control and Prevention, centered on the need for long-term care facilities to more closely monitor residents who regularly leave the outpatient health care facility.
The study, which followed an outbreak at a nursing home in Maryland, found that patients requiring dialysis had a treatment for kidney failure, more likely to have COVID-19, possibly because of their frequent out-of-nursing exposures to both dialysis community patients. and staff at dialysis centers.
According to the report of the study, the hospital level for residents who received dialysis was higher than among residents who did not receive dialysis.
The CDC report emphasizes that residents of nursing homes undergoing dialysis are a particularly vulnerable population because they often have more underlying medical conditions such as diabetes mellitus, hypertension and heart disease.
“The problem in Maryland is another wake-up call to the challenges of spreading COVID-19 in nursing homes,” said Dr. Jay Bhatt, an intern in Chicago and an ABC News contributor. “The report highlights the serious risk that COVID-19 poses to people who have chronic illness, are immunocompromised or on dialysis. COVID-19 made no secret of the fact that nursing homes are at high risk for spread, infection and poor outcomes. ”
The report advised that clear communication between nursing homes and dialysis centers, and coordination of testing practices between the sites are key to preventing outbreaks of COVID-19.
“It is critical that healthcare facilities and nursing homes have protocols in place to ensure that preventive measures we know are working to keep patients and their families safe,” Bhatt said.
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