The Effect of Race and Dementia Prevalence on a COVID-19 Infection Control Intervention in Massachusetts Nursing Homes.
The Effect of Race and Dementia Prevalence on a COVID-19 Infection Control Intervention in Massachusetts Nursing Homes.
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DOI：
10.1093/gerona/glab355
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发表时间：
2022-07-05
期刊：
影响因子：
--
通讯作者：
Lipsitz LA
中科院分区：
文献类型：
--
作者：
Dufour AB;Kosar C;Mor V;Lipsitz LA
在COVID-19大流行期间，疗养院（NH）居民，尤其是黑人或痴呆症患者的感染率最高。在360名马萨诸塞州的NH中进行的为期9周的COVID-19感染控制干预显示，遵守感染控制清单，使用适当的个人防护设备（PPE），并与每周感染率下降相关。NHS每周提供网络研讨会，回答感染控制问题，获得PPE的资源，后备人员和SARS-CoV-2测试。我们询问这种干预的效果是否因NHS的种族和痴呆组成而不同。数据来自4个州的审计，使用感染控制检查表、每周感染率以及种族和痴呆症的最小数据集变量，以确定遵守检查表能力是否与每周平均新冠肺炎感染率下降相关。使用混合效应障碍模型，根据县COVID-19患病率进行调整，我们发现干预的总体效果不因种族组成而异，但适当的居民聚集与≥20%非白人的设施中感染率的大幅降低相关（n = 83）。随着检查表评分的提高，痴呆患病率的中（>50%-62%; n = 121）和上（>62%; n = 115）三分位数的设施的感染率下降幅度最大。在痴呆患病率的中、上三分位数的设施中，聚集与感染率的大幅降低相关。坚持适当的感染控制程序，特别是聚集居民，可以减少COVID-19感染，即使是在高风险居民（非白人和痴呆症）比例较高的设施中。
Nursing home (NH) residents, especially those who were Black or with dementia, had the highest infection rates during the COVID-19 pandemic. A 9-week COVID-19 infection control intervention in 360 Massachusetts NHs showed adherence to an infection control checklist with proper personal protective equipment (PPE) use and cohorting was associated with declines in weekly infection rates. NHs were offered weekly webinars, answers to infection control questions, resources to acquire PPE, backup staff, and SARS-CoV-2 testing. We asked whether the effect of this intervention differed by racial and dementia composition of the NHs. Data were obtained from 4 state audits using infection control checklists, weekly infection rates, and Minimum Data Set variables on race and dementia to determine whether adherence to checklist competencies was associated with decline in average weekly rates of new COVID-19 infections. Using a mixed-effects hurdle model, adjusted for county COVID-19 prevalence, we found the overall effect of the intervention did not differ by racial composition, but proper cohorting of residents was associated with a greater reduction in infection rates among facilities with ≥20% non-Whites (n = 83). Facilities in the middle (>50%–62%; n = 121) and upper (>62%; n = 115) tertiles of dementia prevalence had the largest reduction in infection rates as checklist scores improved. Cohorting was associated with greater reductions in infection rates among facilities in the middle and upper tertiles of dementia prevalence. Adherence to proper infection control procedures, particularly cohorting of residents, can reduce COVID-19 infections, even in facilities with high percentages of high-risk residents (non-White and dementia).
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影响因子：
6.3
作者：
Lipsitz LA;Lujan AM;Dufour A;Abrahams G;Magliozzi H;Herndon L;Dar M
通讯作者：
Dar M
影响因子：
6.3
作者：
Li, Yue;Cen, Xi;Temkin-Greener, Helena
通讯作者：
Temkin-Greener, Helena
DOI：
10.1093/gerona/54.11.m546
发表时间：
1999-11-01
影响因子：
5.1
作者：
Morris, JN;Fries, BE;Morris, SA
通讯作者：
Morris, SA
影响因子：
6.6
作者：
Mor, V;Zinn, J;Miller, SC
通讯作者：
Miller, SC
影响因子：
6.3
作者：
White, Elizabeth M.;Kosar, Cyrus M.;Mor, Vincent
通讯作者：
Mor, Vincent