A leading physicians group has compiled best practice recommendations for reducing the spread of COVID-19 in skilled nursing facilities, based on lessons learned in New York State.
The guidance, from American Medical Directors Association, comes from a group of certified medical directors experienced in managing the disease.
“The time has come to consolidate our learnings as a field in terms of caring for at-risk elderly … especially as we prepare for a potential second wave of infections in the coming months, as well as for future pandemics,” writes Paula Lester, M.D., FACP, a geriatrician at NYU Winthrop Hospital and corresponding author.
Among the recommendations (further detailed in the report):
- Creating COVID-specific units
- Twice-daily residents screenings
- Discontinuation of drug delivery modes that might spread the virus (such as nebulizers)
- Reviewing do-not-intubate and do-not-hospitalize advance directives with patients and families
Protocols for staff include:
- Serial COVID-19 testing (three tests, one week apart) to enable identification of newly infected staff
- Assignments to specific units to permit easier contact tracing
- Staff assigned to COVID-19 should not work elsewhere in the facility
Other guidance covered includes management of COVID-19 positive and presumed-positive cases, communication during an outbreak, management of admissions and readmissions, and providing emotional support for staff.
The report is available online in JAMDA.