Stemming the Tide of COVID-19 Infections in Massachusetts Nursing Homes.
Stemming the Tide of COVID-19 Infections in Massachusetts Nursing Homes.
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DOI：
10.1111/jgs.16832
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发表时间：
2020-11
影响因子：
6.3
通讯作者：
Dar M
中科院分区：
文献类型：
--
作者：
Lipsitz LA;Lujan AM;Dufour A;Abrahams G;Magliozzi H;Herndon L;Dar M
2020年4月，马萨诸塞州养老院成为COVID-19感染和相关死亡的热点。作为回应，州长查尔斯·贝克（Charles Baker）拨出了1.3亿美元的额外资金，为期2个月，条件是遵守一套新的护理标准，包括对所有居民和工作人员进行强制性检测，以及28点感染控制清单。我们的目的是描述马萨诸塞州的努力和相关成果。纵向队列研究。总共有360个马萨诸塞州的健康中心。马萨诸塞州老年护理协会和Hebrew SeniorLife迅速组织了一个中央指挥小组，针对123个存在感染控制缺陷的“特别关注”设施进行现场和虚拟咨询，并为所有360个设施提供每周网络研讨会，并回答有关感染控制程序的问题。还向这些设施通报了用于购买个人防护设备（PPE）、后备工作人员和SARS-CoV-2检测的资源。我们使用了两个数据源：（1）所有NH的四个州审计，（2）每周NH报告给马萨诸塞州健康信息和分析中心。主要的独立过程措施是核对表分数和坚持其六个核心能力。主要结果是居民和工作人员的平均每周新发感染率、住院率和死亡率。我们使用了一个针对县COVID-19流行率进行调整的混合效应模型，以估计感染控制过程措施与新发感染率或死亡率之间的关系。在特别重点设施中，居民和工作人员的感染率开始较高，然后迅速下降到两组相同的低水平。遵守感染控制流程，特别是正确佩戴个人防护装备和聚集，与每周感染率和死亡率的下降显着相关。这一全州范围的努力可以作为其他州的全国模式，以防止新冠肺炎等大流行病对体弱的新罕布什尔州居民造成的破坏性影响。
In April 2020, Massachusetts nursing homes (NHs) became a hotspot for COVID‐19 infections and associated deaths. In response, Governor Charles Baker allocated $130 million in additional funding for 2 months contingent on compliance with a new set of care criteria including mandatory testing of all residents and staff, and a 28‐point infection control checklist. We aimed to describe the Massachusetts effort and associated outcomes. Longitudinal cohort study. A total of 360 Massachusetts NHs. The Massachusetts Senior Care Association and Hebrew SeniorLife rapidly organized a Central Command team, targeted 123 “special focus” facilities with infection control deficiencies for on‐site and virtual consultations, and offered all 360 facilities weekly webinars and answers to questions regarding infection control procedures. The facilities were also informed of resources for the acquisition of personal protective equipment (PPE), backup staff, and SARS‐CoV‐2 testing. We used two data sources: (1) four state audits of all NHs, and (2) weekly NH reports to the Massachusetts Center for Health Information and Analysis. Primary independent process measures were the checklist scores and adherence to each of its six core competencies. Primary outcomes were the average weekly rates of new infections, hospitalizations, and deaths in residents and staff. We used a hurdle mixed effects model adjusted for county COVID‐19 prevalence to estimate relationships between infection control process measures and rates of new infections or deaths. Both resident and staff infection rates started higher in special focus facilities, then rapidly declined to the same low level in both groups. Adherence to infection control processes, especially proper wearing of PPE and cohorting, was significantly associated with declines in weekly infection and mortality rates. This statewide effort could serve as a national model for other states to prevent the devastating effects of pandemics such as COVID‐19 in frail NH residents.
影响因子：
158.5
作者：
McMichael, Temet M.;Currie, Dustin W.;Duchin, Jeffrey S.
通讯作者：
Duchin, Jeffrey S.