Tight facilities increase the risk of rapid spread of infection – VG

Villa Skaar Valstad, where nine residents have lost their lives, has small living rooms without their own bathroom and is therefore not suitable for quarantine and isolation.

According to FHI, the nursing home, which was built in Eidsvoll Verk in 1965, has a design that makes it difficult to gather sick residents in a secluded part.

The 23 residents and a dozen employees of the private nursing home Villa Skaar Valstad have been infected with corona.

The virus was first detected in three employees on November 4. Nine of the residents are dead.

READ ALSO: Infection in the nursing home on Eidsvoll: the messages that reveal the nightmare

FHI writes in its report after Wednesday’s inspection of Villa Skaar Valstad that the period of undetected infection has probably been relatively long.

Close contact all day

– The nursing home has narrow living rooms and common rooms, so residents and employees are in close contact with each other during working hours. This increases the risk of rapid spread of the infection, writes the National Institute of Public Health.

The report indicates that Villa Skaar Valstad does not have sufficient measures to guarantee compliance with isolation and quarantine, for residents who cannot stay in their own room.

– During the outbreak, it was decided to isolate residents in their rooms, but because many residents with dementia, who were unable to stay in the room, this became difficult to implement, writes FHI.

An alternate who reported on conditions at the nursing home told VG:

– The infected people walked as they wanted and the doors were wide open. They use the same toilets as the uninfected and the staff had no control over where it was infected and where it was not infected.

Recommend fewer workplaces

FHI notes in the report that the nursing home during the pandemic does not systematically map if and where employees have other workplaces.

– We recommend that employees have as few workplaces as possible, preferably one, and that they are organized into work cohorts that track defined residents.

Nearly 100 cases of infection in Eidsvoll are linked to the outbreak in the nursing home.

In addition, the infection was detected in two municipal institutions, after the employees worked both there and at Villa Skaar Valstad.

In one of these institutions, one of the crown-infected residents died.

NIPH considers it likely that some employees will be infected after infection control routines and measures were implemented as a result of the outbreak.

– It is not known how they were infected. But it has been difficult for employees to maintain a good enough distance, especially in situations where they are not wearing protective gear, such as during meal breaks, writes FHI.

Improvement points

For Villa Skaar Valstad, FHI has identified other areas for improvement:

• The infection control program is not designed for this nursing home. Procedures for, for example, insulation are not adapted to the premises of the residence.
• No employees with dedicated work hours and specific job duties within infection control in general and COVID-19 in particular (infection control contact).
• Organization of work cohorts that follow defined residents in only one of the two districts.
• There is no systematic review of compliance with infection control routines among employees, with feedback to the individual.
• Lack of clean and dirty zone marking, and insufficient routines for undressing and putting on protective equipment inside and outside the zones.
• Lack of feedback to the municipality about the difficulties in isolating residents in their rooms.
• Potential for improvement regarding the acquisition of experience in infection control and training in the correct use of personal protective equipment.

– No serious bug was revealed

Eidsvoll Township will begin work on Monday to improve practice in nursing homes.

– We are pleased that no serious failures have been identified that imply the need for immediate action, says Eidsvoll municipal chief physician Carl Magnus Jensen.

Remember that FHI is not a control authority, but was called as professional support to guide the municipality to overcome the outbreaks as quickly as possible.

– We look forward to the inspections of the county governor, who will clarify if there are other issues worthy of criticism than those pointed out by FHI, says the municipal chief.

For the municipality of Eidsvoll, FHI has identified the following areas for improvement:

• The municipal chief lacks sufficient support from people with good experience in infection control in the municipality, there is no agreement on external experience in infection control.
• Uncoordinated infection tracking / evaluation of possible infection route at the beginning of the outbreak between the nursing home and the municipal superior. (The coordinated infection tracking team is already in place.)

The owner of the private nursing home Skaar Omsorg AS notes that no discrepancies have been identified that could have prevented the infection from entering the nursing home.

– Moving difficult

Skaar notes that the report claims that the challenge with many people infected at an early stage made isolation or relocation measures difficult.

– Due to the widespread spread of infection in the nursing home before symptoms develop, there is a high probability that rapid relocation of residents will not lead to a limitation of the outbreak. Residents who had possibly been transferred were likely already infected, writes FHI.

Skaar Omsorg AS is a private actor who has provided care for over 60 years. The chain runs nursing homes in five locations in eastern Norway.

Villa Skaar Bøn and Villa Skaar Valstad are located in the Eidsvoll municipality, between Oslo and Hamar. Valstad has 28 rooms in two apartments.