A Year into a Pandemic: Nursing Homes


We’re a year into this pandemic and taking a look-back to reflect upon where we’ve been and where we’re going. Considering how hard long-term care has been hit we decided to collect perspectives from our teams working directly with the nursing homes across New England.

Marguerite McLaughlin, Senior Program Administrator, spoke at length about her observations in the field based on the online learning collaboratives we’ve been convening using the ECHO model.

Kathy Calandra, Program Director:

Many of the challenges like staffing shortages and staff retention were exacerbated by the pandemic. Unfortunately, COVID-19 shone a bright light on these issues and, for some, put nursing homes in a bad light. The industry has noted what needs to be done to advocate for legislation and changes in reimbursement, so nursing homes who know what they need to do and how to do it can actually make it happen. We hope that we can all learn from what has been revealed by the pandemic and see changes in the field that allow for long-term care to care for some of our most fragile citizens.

Nelia Odom, Program Administrator; Maureen Marsella, Program Administrator:

We noticed a definite transformation over the course of a year amid this pandemic. Although long-term care facilities have a solid, basic foundation of infection prevention, they needed support going beyond the basics. Many felt unprepared for a pandemic and didn’t know where to start. However, through our work as a part of the IPRO QIN-QIO and in collaboration with the Rhode Island Department of Health (RIDOH), we were able to assist with augmenting existing infection prevention programs in a few ways:

We supported long-term care workers through navigating the Centers for Disease Control and Prevention (CDC) by orienting them, guiding them through implementation, and data entry. This support made them increasingly more aware of their own data—allowing them to harness the power of data in their decision-making.

We helped encourage data collection and line listing while curating and distilling the constant flow of information coming from national partners, like the CDC.

Through our work with the Rhode Island Department of Health, we conducted CDC Infection Control Assessment and Response (ICAR) The assessments identified any existing protocol gaps, giving us insights on where to incorporate plans on things like: Personal Protective Equipment (PPE) inventory, cleaning product familiarity, contact time for disinfectants, PPE burn rate, and proper donning and doffing.

We helped frontline, long-term care workers build comprehensive approaches to infection prevention to increase knowledge of the infection prevention process. We worked with RIDOH to help homes develop policies and procedures and make sure that they were being followed. A few initiatives nursing homes put into place to help combat spread of COVID-19: open only one entrance to the facility, then screen everyone upon entry using the RIDOH screening tool. Other examples are creating isolation units for positive COVID-19 patients and changing policies to encourage staff to work at one facility rather than at multiple nursing homes.

And, as always, we made ourselves available for any questions. We always strive to provide clarity through evidence, allowing for a more robust Infection Prevention program, ultimately leading to fewer positive cases.


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