A descriptive Study Evaluating the Impact of COVID-19 on Delivery of Care and Mental Health of Geriatric Nursing Home Staff

Abstract

IntroductionCOVID-19 has had an unprecedented global impact on public health and socio-economic matters. The magnitude of COVID-19 has undoubtedly affected every aspect of daily life and highlighted the need for increased preparedness, coordination, and monitoring. Amongst all social groups, the elderly is by far the most affected age group in morbidity and mortality [1]. Approximately 1.3 million individuals live in 15,600 nursing home facilities in the United States [2]. In fact, the beginning of COVID-19 may be marked by the 25 deaths in a single King County facility in Washington state. Nursing homes have faced the rapid spread of COVID-19 among residents and staff and have been at the center of the public health emergency during the pandemic. Factors that contribute to this rapid spread include crowding, sharing of bathroom facilities, and gathering in common areas that are not set up for infection control. Nursing homes, in particular, provide ideal environments for devastating infections to spread.Nursing homes, in particular, have essentially been in complete lockdown, not unlike inmates, who both deeply lack social interaction and are currently unable to exist outside the walls of their respective institutions. Those who do not have close family or friends, and rely on the support of voluntary services or social workers, could be at additional risk [6]. To lessen the chance of infection among older people in nursing homes, more local authorities are banning visitors to nursing homes and long-term care facilities. Furthermore, restrictions on group activities such as playing board games, watching TV in a common space, and engaging in art therapy, may harm residents’ mental and physical well-being [8]. Nursing home residents are already susceptible to loneliness, and the lack of social interaction due to decreased visitation from family and friends further compounds the traumatization of COVID-19 on daily living.MethodsMETHODS: This is a descriptive study over a period of 1 month conducted among nursing home staff in Lubbock, TX during the COVID-19 pandemic. Agreeable nursing home staff will have access to a survey (Qualtrics) accessing various aspects relating to the consequences of COVID-19. The survey will be open for a period of 1 month until which the participants will have the opportunity to complete the survey. Data from the surveys will then be collected and analyzed.The survey consists of a self-developed questionnaire along with the validated Perceived Stress Scale (PSS). The scale which was originally developed in 1983 by author Sheldon Cohen is one of the most widely used tools to measure the perception of stress. It has been used in studies assessing the stressfulness of situations and is widely available in the public domain [12].Type of study: Descriptive mixed method triangulation design studySubjects: Healthcare staff with direct patient careInclusion criteria:1. Geriatric Nursing home staff in Lubbock, TX2. Staff agreeable to participate in survey regardless of color, creed, age or sex.3. Staff in direct contact with patients (Nursing and Physicians)Exclusion criteria:1. Ancillary staff not involved in direct patient care2. Staff who refuse to give voluntary consent to participate in surveyDesign: This will be a descriptive, mixed method triangulation design studyutilizing an online, self-administered survey tool created using Qualtrics platform. An information sheet explaining the research project will be given to the nursing home staff. It will include: participation is completely voluntary, that participation will not affect their employment in anyway, and their employer will not have access to the results. It will also explain that by submitting an anonymous survey they are agreeing to take part in the research study. The survey questions will gauge mental health impact on staff and their perspectives on the impact on patients and their own mental health. The survey will contain a mix of 10 close- and open-ended questions.ResultsOutcomes: To determine the impact of COVID-19 on nursing home staff mental health and gather information that may be utilized to create measures to better deliver care in nursing homes.Survey will be sent to 40 members with an expected response rate of about 20 percent and possibly higher.Results will be available by March 2020 for further analysis and distribution.ConclusionsUltimately, COVID-19 has taught painful lessons in the difficulties of isolating the elderly. The need for controlling infection may come at a high cost to the mental health and well-being of patients and staff, which is a critical public health issue. We hope that the results of this study will help us better understand the challenges geriatric nursing facilities have faced during the COVID-19 pandemic and help us develop better strategies for similar threats in the future.FundingNo funding was obtained for the purposes of this study