COVID-19 in Nursing Homes: Calming the Perfect Storm
COVID-19 in Nursing Homes: Calming the Perfect Storm
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DOI：
10.1111/jgs.16784
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发表时间：
2020-09-02
影响因子：
6.3
通讯作者：
Grabowski, David C.
中科院分区：
文献类型：
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作者：
Ouslander, Joseph G.;Grabowski, David C.
导致COVID-19疾病的严重急性呼吸系统综合征冠状病毒2的病毒感染大流行使养老院行业陷入危机。表现出COVID-19非特异性和非典型表现的弱势人群，由于病毒感染导致的人员短缺，快速，准确的检测和个人防护设备的资源不足和可用性不足，以及养老院居民中缺乏有效的COVID-19治疗方法，这些因素结合在一起，在我国的养老院中形成了一场“完美风暴”。随着社会开始重新开放，这场完美风暴将继续下去，导致更多的养老院工作人员和临床医生感染，他们在工作之外获得病毒，保持无症状，并在不知不觉中使病毒在工作场所传播。由于完美风暴的因素，养老院就像一个火绒箱，只需要一个人就可以在一个设施中引发火灾，造成许多人死亡。一些公共卫生干预措施和卫生政策战略、充足的资源和有重点的临床质量改进举措可以帮助平息风暴。这场完美风暴最可悲的部分是，政策制定者多年来的无所作为助长了其影响。我们现在有机会改善养老院，以保护居民和他们的照顾者在下一场风暴之前。现在是时候重新想象我们如何支付和规范养老院护理，以实现这一目标。
The pandemic of viral infection with the severe acute respiratory syndrome coronavirus-2 that causes COVID-19 disease has put the nursing home industry in crisis. The combination of a vulnerable population that manifests nonspecific and atypical presentations of COVID-19, staffing shortages due to viral infection, inadequate resources for and availability of rapid, accurate testing and personal protective equipment, and lack of effective treatments for COVID-19 among nursing home residents have created a "perfect storm" in our country & apos;s nursing homes. This perfect storm will continue as society begins to reopen, resulting in more infections among nursing home staff and clinicians who acquire the virus outside of work, remain asymptomatic, and unknowingly perpetuate the spread of the virus in their workplaces. Because of the elements of the perfect storm, nursing homes are like a tinderbox, and it only takes one person to start a fire that could cause many deaths in a single facility. Several public health interventions and health policy strategies, adequate resources, and focused clinical quality improvement initiatives can help calm the storm. The saddest part of this perfect storm is that many years of inaction on the part of policy makers contributed to its impact. We now have an opportunity to improve nursing homes to protect residents and their caregivers ahead of the next storm. It is time to reimagine how we pay for and regulate nursing home care to achieve this goal.