Workers In Long-term Care Facilities Research Articles

Profiles in neglect of older adult care workers in a long-term care facility: a latent profile analysis.

Neglect is a common form of abuse, and long-term care facilities record higher incidences of this abuse. Given that older adult care workers are the main workforce in these facilities, their neglectful behavior requires public health attention. Internal individual characteristics can lead to older adult abuse, and managing workers who abuse older adults may require various methods. This study aimed to identify the profiles of neglect among older adult care workers in long-term care facilities and explore the influencing factors of neglect. In this cross-sectional study, a convenience sample of older adult care workers from 15 long-term care facilities in Shandong Province (N = 421) completed a questionnaire on the characteristics associated with neglect. Latent profile analysis was used to identify distinct neglect profiles and promote the understanding of individual characteristics associated with varying levels of neglect. One-way analysis of variance and multivariate logistic regression analyses were used to examine the population characteristic differences. Older adult care workers exhibited three neglect profiles, namely, the "low-risk group," "medium-risk group," and "high-risk group." Males, participants with no employment qualification certificate, and those who did not attend regular training represented the majority of those in the "high-risk group." Participants with a monthly income of more than ¥ 4,000 and nursing 1-2 older adults simultaneously represented the majority of those in the "low-risk group." Long-term care facility administrators should tailor interventions to individual care worker profiles to reduce neglect behaviors and improve care levels.

네트워크 텍스트분석을 통한 치매대상자 인간중심돌봄 연구 경향 분석

The purpose of this study is to explore research trends in person-centered care for people with dementia.To this end, in this study, the papers searched for 'dementia', 'human-centered', 'person-centered', 'patient-centered', and 'care' were selected as research subjects among the papers contained in the domestic academic research information journal. Fifty-two academic papers suitable for this research topic were analyzed, and network analysis was performed on the research subject. As a result of the study, 'long-term care institutions for the elderly', 'behavioral psychological symptoms', 'nursing caregivers', and 'the elderly' were derived as the core main subjects in the human-centered care research related to dementia subjects, and the results of the connection centrality index related to the core main subjects were also high in the order of 'long-term care institutions for the elderly', 'behavioral psychological symptoms', 'nursing care workers', and 'the elderly', similar to the results of the frequency analysis. As a result of grouping the subjects with high conceptual relationships, five cohesive structures (Humanity Tude, adult guardianship system for decision-making of the elderly with dementia, communication skills for the care of dementia patients, ethics, moral anguish, social welfare for the elderly with dementia, working environment of dementia care workers in long-term care facilities for the elderly, and emotional labor) were derived. Based on the results of this study, it is thought that in order to provide human-centered care for dementia patients admitted to long-term care institutions for the elderly, it is necessary to provide educational interventions including communication skills, ethical awareness, and coping with behavioral and psychological symptoms of dementia patients for nursing care workers, who are the main caregivers.

Infection Control Experiences and Educational Needs of Geriatric Care Workers in Long-Term Care Facilities: A Pilot Study

Background: In the post-COVID-19 condition, infection control education is important for geriatric care workers who care for the elderly and are vulnerable to emerging infectious diseases. This study was conducted to enhance the insight into the experiences of geriatric care workers in managing novel infectious diseases (COVID-19) and to identify the newly required educational requirements necessary to effectively implement infectious disease control. Methods: This is a qualitative and pilot study using focus group interviews. Data from 10 participants were collected using a focus group interview. The data were analyzed using Qualitative content analysis. Results: The findings showed that geriatric healthcare workers experienced difficulties following infection control protocols and emotional distress related to visitor restrictions and had an increased workload. The participants requested further education regarding general knowledge of infectious diseases to decrease their fears of infection and reported that visual and practical teaching methods were preferable. Conclusions: Further attention is needed regarding the education of infection control to strengthen infection prevention in long-term care facilities vulnerable to the spread of emerging infectious diseases.

Investigating healthcare workers' technostress when welfare technology is introduced in long-term care facilities

ABSTRACT Welfare technology has recently reached older adults in long-term care facilities (LTCFs). Many Swedish municipalities are introducing emerging technologies such as virtual reality, robotic assistive devices, and social robots in LTCFs as part of everyday care. However, not only older adults are affected by these deployments. Healthcare workers are left to master these technologies – and integrate them into existing care practices. Previous research has identified an increase in work-related stress associated with the introduction of technology for healthcare workers. The literature is, however, sparse on how healthcare workers in LTCFs are affected by the introduction. Therefore, we explored different factors that could affect healthcare workers' technostress through an online survey and semi-structured interviews to get a deeper understanding of how healthcare workers are experiencing deployments of welfare technology. The main findings showed that some of the healthcare workers are finding it difficult to adopt and use welfare technology due to, for example, older age, language difficulties, or a negative attitude toward technology. We conclude that municipalities and LTCFs need to invest in their healthcare workers in order to achieve better on-boarding and reduce technostress.

Health and care workers in long-term care facilities and their role in preventing emerging infectious diseases: A scoping review.

The COVID-19 pandemic has had a tremendous impact on healthcare systems worldwide. In particular, long-term care facilities have proved more susceptible to infection as they care for vulnerable populations at high risk of chronic illness. How this impacts the role and core competencies of health and care workers in these facilities remains less understood. Describe how health and care workers contribute to the prevention of emerging infectious diseases in long-term care facilities. A scoping review. A systematic search of literature dating from 2002 to 2022 was conducted in the following databases: EMBASE, Medline (Ovid), Cochrane Library, CINAHL Plus with Full Text (EBSCOhost), Web of Science, and AgeLine. Studies were selected if they focused on health and care workers in long-term care facilities, offered a perspective on the prevention of emerging infectious diseases or infection prevention and control, and were original qualitative or quantitative studies in English. Data were extracted, cross-checked and analyzed by two researchers, and any difference in views regarding the appropriateness of literature would be resolved by consulting a third researcher. An inductive descriptive approach was applied for the analysis of results, and themes were established via consensus meetings. A total of fourteen studies from Asia, Europe, and the Americas were included. Three themes emerged from the review: "The roles of health and care workers evolve with the times", "The core competencies of health and care workers are essential for preventing emerging infectious diseases in long-term care facilities" and "The key to successful prevention of emerging infectious diseases in long-term care facilities is through a systematic, comprehensive effort that mobilize health and care workers at all levels". Health and care workers had to take on increasingly complex roles and rely on their core competencies to cope with epidemic changes, and facility resources, employee quality and management models were found to have significantly improved infection prevention and control outcomes. The roles of health and care workers are evolving, and effective infection prevention within long-term care facilities depends on their ability to perform core competencies with skill and confidence. Moreover, a systematic, comprehensive framework, for which this paper proposes three guidelines, is urgently needed to ensure consistent policy implementation within the facility as well as support and access to resources for health and care workers. Infection prevention efforts within long-term care facilities must take into account the evolving roles of health and care workers, with a focus on guaranteeing access to resources, training and support that will help them gain the core competencies necessary for juggling those roles. In addition, there is an urgent need for research instruments that will help assess those competencies and identify areas of improvement.

Relationship between Experience of Client Violence and Turnover Intention among Workers in Long-Term Care Facilities for Older Adults: Focusing on Nurses, Social Workers, and Care Workers

To prevent discontinuity of long-term care service and guarantee the quality of care, it is important to clarify the determinants of turnover intentions of long-term care workers. They are at a higher risk of experiencing violence-including physical, emotional, and sexual-from patients or their families, possibly leading to high turnover intention. This study aims to verify how having experienced client violence affect turnover intention of long-term care workers and to suggest implications to prevent frequent turnover in long-term care field. Logistic regression analysis was conducted between groups who have experienced client violence and who have not, using 2019 Korean LTC Survey data. Results revealed that, first, there were differences in determinants of turnover intention depending on groups. Second, having experienced client violence had a different effect on turnover intention based on personal characteristics. Third, gender and occupational differences were found. Based on our results, we highlighted the need for discussions on interventions to address client violence exposure among long-term care workers.

Qualitative Insights into Vaccine Uptake of Nursing Staff in Long-Term Care Facilities in Finland.

Vaccine hesitancy and refusal have undermined COVID-19 vaccination efforts of nursing staff. This study aimed to identify behavioral factors associated with COVID-19 vaccine uptake among unvaccinated nursing staff in long-term care facilities (LTCF) in Finland. Methodology: The study was based on the Theoretical Domains Framework. Data were collected through qualitative in-depth interviews among nursing staff and managers of LTCFs. The analysis was based on thematic analysis. We identified seven behavioral domains, with several themes, that reduced the staff's intention to get vaccinated: knowledge (information overload, inability to identify trustworthy information sources, lack of vaccine-specific and understandable scientific information), beliefs about consequences (incorrect perceptions about the vaccine effectiveness, and lack of trust in the safety of the vaccine), social influences (influence of family and friends), reinforcement (limited abilities of the management to encourage vaccination), beliefs about capabilities (pregnancy or desire to get pregnant), psychological factors (coping with changing opinion), and emotions (confusion, suspicion, disappointment, and fatigue). We also identified three behavioral domains that encouraged vaccine uptake: social influences (trust in health authorities), environmental context and resources (vaccination logistics), and work and professional role (professional pride). The study findings can help authorities to develop tailored vaccine promotion strategies for healthcare workers in LTCFs.

National Weekly SARS-CoV-2 RT-PCR Screening of All Workers in Long-Term Care Facilities Associated with Decrease in Resident Mortality Rate

Introduction: Outbreaks of COVID-19 in long-term care facilities (LTCFs) have resulted mainly from disease transmission by asymptomatic health care workers. This study examines whether routine screening tests carried out on health care workers can help in reducing COVID-19 outbreaks, morbidity, and mortality of LTCF residents. Methods: The study followed a weekly, nationwide, government-funded screening program of LTCF personnel for SARS-CoV-2, by using reverse transcription polymerase chain reaction as the main testing technology. It included all residents and employees in Israeli LTCFs who were screened weekly during the second wave of COVID-19, during the period of time between July 13, 2020, and November 21, 2020. Results: During the study period, 1,107 LTCFs were screened on a weekly basis, including 62,159 HCWs and 100,046 residents. The program screened a median of 55,282 (range 16,249, min 45,910, max 62,159) employees per week, 0.05–1.5% of which were positive for SARS-CoV-2. LTCF mortality in the first wave accounted for 45.3% of all COVID-19 deaths recorded nationally (252 of 556), and in the second wave, this ratio was reduced to 30.3% (709 of 2,337) representing a reduction of 33.8% in expected mortality (p < 0.001). A significant reduction was detected also in hospitalization rate (13.59 vs. 11.41%, p < 0.001) and elder (≥75 years old) mortality rate (52.89 vs. 41.42%, p < 0.001). 214 outbreaks in the second wave were avoided by early identification of SARS-CoV-2 positive HCWs and successful prevention of subsequent infections in the facility. Conclusion: Routine weekly SARS-CoV-2 RT-PCR testing of LTCF employees was associated with reduced national LTCF residents’ hospitalizations and mortality rate.

Factors Related to Mental Health of Foreign Care Workers in Long-Term Care Facilities in Japan during the COVID-19 Pandemic-A Comparative Study.

This study aimed to evaluate the factors related to the mental health of foreign care workers in Japan's long-term care (LTC) facilities and compare their results with those of native care workers. We conducted a cross-sectional survey covering 80 LTC facilities across Japan between August and November 2021. The survey mainly included mental health, workload, reward, sense of coherence, loneliness, COVID-19-specific factors and sociodemographic variables. The results show that workload was a distinct feature associated with the mental health of foreign care workers (n = 172) when compared with those of native care workers (n = 154). In addition, we found that the relationship between cultural adaptation and mental health in a sample of foreign care workers was mediated by loneliness and sense of coherence (SOC). Finally, we found that reward, loneliness, SOC, and COVID-19-specific factors had significant impacts on the mental health of both foreign and native care workers. These findings highlight the importance of support measures from the workplace for foreign care workers. Workplace interventions that focus on workload, reward, and sense of coherence strategies are required to address mental health improvement and may still be of value in dealing with the continuing COVID-19 pandemic.

시설장기요양기관 요양보호사의 직업정체성 관련 경험에 대한 연구

본 연구는 시설장기요양기관 요양보호사 15명과의 심층면담을 통하여 시설요양보호사의 정체성 관련 경험을 탐색해보고자 하였다. 심층면담 내용을 분석한 결과, 시설요양보호사의 정체성 관련 경험으로 정체성의 혼란, 위기, 강화가 드러났다. 첫째, 시설요양보호사는 이론과 실제의 간극에서 괴리감을 느끼거나, 기관장과 돌봄관이 달라 속상함을 느낄 때 정체성 혼란을 경험하고 있었다. 둘째, 시설요양보호사는 시설 내 안전사고 발생에 대해 죄책감과 자괴감을 느끼거나 돌봄 중 발생하는 신체손상으로 업무 수행이 어려울 때 정체성에 위기를 겪고 있었다. 셋째, 시설요양보호사는 입소노인과 보호자의 고마움의 표현에서 오는 보람, 기관장의 자신에 대한 신뢰에서 오는 뿌듯함, 동료들의 칭찬에서 오는 만족감에서 요양보호사로서의 존재감을 확인하고 정체성을 강화시키고 있었다. 이상의 연구결과에 따라 시설요양보호사의 정체성 혼란과 위기를 완화하기 위한 정책적, 실천적 제언을 하였다.

Direct Care Worker Job Dissatisfaction in North Carolina Nursing Homes

Engagement of health care workers has been shown to have a positive impact on job satisfaction and organizational performance, but this relationship is unclear for direct care workers in long-term care facilities. A survey of direct care workers in North Carolina nursing homes was conducted in 2020 to investigate the factors contributing to their job satisfaction using the Benjamin Rose Nurse Assistant Job Satisfaction Survey. Extrinsic factors affecting direct care worker job satisfaction such as compensation, workplace environment and support from management were examined, as well as intrinsic factors of job satisfaction such as communication, recognition at work and training. Survey results indicated that extrinsic factors such as pay and communication with administrators, followed by the intrinsic factor of worker recognition, are the most important factors affecting direct care worker job satisfaction. Management practices related to compensation, engaging and valuing direct care workers must be examined in order to have a lasting impact on direct care worker job satisfaction levels.

The VA’s Long-Term Care Strike Team Supporting Florida’s Nursing Homes Workforce

In coordination with the Florida Department of Health, the VA Sunshine Healthcare Network (VISN 8) established Long-Term Care Strike Teams to provide services to the LTC facilities most affected by the COVID-19 pandemic across the state of Florida. Between April 2020 through September 2020, the Strike Teams provided direct patient care to community residents, infection control/ prevention education, and patient/staff COVID-19 swabbing. We encountered facilities with large numbers of staff infected with COVID-19 and agency staff that were refusing to come to “COVID-infected” facilities. Remaining staff, including the administrators, were under much psychological distress. However, our experience supporting the long-term care facilities also had a major impact on our own perceptions of nursing home care. The bravery, dedication, and caring that we witnessed reinforced that the health care workers in long-term care facilities are true heroes.

Discrimination in Long-Term Care Facilities: Legal Consciousness and Problem-Solving Among Staff

Abstract Over half of direct care workers in long-term care facilities are women of color. Building on legal consciousness theory–which explains how individuals invoke legal principles to define everyday experiences–this study examines how staff understand and resolve discrimination between residents and staff and among staff. This study employs a multi-method qualitative extended comparative case approach. Data includes in-depth semi-structured interviews (n=80) and participant and non-participant observation (n=8 months) at two facilities that vary in staff racial composition. Findings reveal rampant unreported instances of race and sex discrimination toward Black staff by white staff and residents. Black staff at all levels did not invoke rights or discrimination rhetoric when they experienced overt race discrimination by residents but engaged in significant emotional labor to respond to race discrimination by residents. Black staff, however, perceived microaggressions and unequal treatment by white staff as discrimination. At both facilities, floor staff and management adopted diverse team approaches across race and staff hierarchy for responding to race discrimination by residents toward Black female staff. These findings suggest the need for new and targeted policy and practice approaches that recognize extensive emotional labor expended by staff of color when addressing discrimination by residents and challenges from white staff when addressing race discrimination by staff. These findings have theoretical implications by extending legal consciousness theory to multi-level staff understandings of discrimination. Findings also provide useful tools and case examples for policymakers and practitioners interested in racial justice, particularly given how COVID has exacerbated racial inequities in long-term care.

Effectiveness of BNT162b2 mRNA Coronavirus Disease 2019 (COVID-19) Vaccine Against Acquisition of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Among Healthcare Workers in Long-Term Care Facilities: A Prospective Cohort Study.

ObjectiveWe assessed vaccine effectiveness (VE) of BNT162b2 mRNA COVID-19 vaccine against SARS-CoV-2 acquisition among health care workers (HCWs) of long-term care facilities (LTCFs).MethodsThis prospective study, in the framework of "Senior Shield" program in Israel, included routine, weekly nasopharyngeal SARS-CoV-2 RT-PCR testing from all LTCF HCWs since July 2020. All residents and 75% of HCWs were immunized between December 2020 and January 2021. The analysis was limited to HCWs adhering to routine testing. Fully vaccinated (14+ days after second dose; n=6960) and unvaccinated HCWs (n=2202) were simultaneously followed until SARS-CoV-2 acquisition, or end of follow-up, April 11, 2021. Hazard ratios (HRs) for vaccination vs. no vaccination were calculated (Cox proportional hazards regression models, adjusting for socio-demographics and residential-area COVID-19 incidence). VE was calculated as [(1– HR)×100]. RT-PCR cycle threshold values (Cts) were compared between vaccinated and unvaccinated HCWs.ResultsAt >14 days post second dose, 40 vaccinated HCWs acquired SARS-CoV-2 (median follow-up, 66 days; cumulative incidence 0.6%) vs. 84 unvaccinated HCWs (median follow-up 43 days; cumulative incidence, 5.1%); HR=0.11 (95% CI 0.07, 0.17), unadjusted VE=89% (95% CI 83%, 93%). Adjusted VE beyond seven days and >14 days post second dose were similar. The median PCR Cts targeting ORF1ab gene among 20 vaccinated and 40 unvaccinated HCWs was 32.0 vs. 26.7, respectively, p=0.008.ConclusionsVE following two doses of BNT162b2 against SARS-CoV-2 acquisition in LTCF HCWs was high. The lower viral loads among SARS-CoV-2 positive HCWs suggests further reduction in transmission.

Prevalence of SARS-CoV-2 among Belgian workers in long-term care facilities.

BackgroundHealthcare workers (HCWs) can be a source of SARS-CoV-2 within long-term care facilities (LTCFs); therefore, we analysed the data from a testing programme among LTCF employees.AimsThe aim of this study was to investigate the prevalence of SARS-CoV-2 and its determinants among employees of LTCFs and the risk for fellow workers and residents.MethodsTesting started at week 15, the first wave’s peak, using nasopharyngeal swabs for PCR up to week 23. At the start of the second wave (week 32), testing resumed.ResultsA total of 32 457 test results were available from 446 LTCFs: 2% were positive: 1% in men, 2% in women, 2% in HCWs (=having patient contact), 1% in non-HCWs, higher in younger age groups. In total, 30 729 employees were tested once, 823 twice, 66 thrice and 4 four times. Prevalence was 13% during the first week of testing (week 15) and declined to 7% (week 16) to stay at around 1% (from week 17 until week 23). At the start of the second wave (week 31–33), the prevalence was around 3%. In 70% of positive tests, the employee was asymptomatic.ConclusionsOur study confirms the presence of HCWs with SARS-CoV-2 as a possible source of infection in LTCFs even when the incidence in the general population was low; 70% were asymptomatic. To control the spread of SARS-CoV-2 in LTCFs vaccination, infection prevention and control measures are necessary as well as testing of all LTCF HCWs during possible outbreaks, even if asymptomatic.

COVID-19 and Long-Term Care Healthcare Worker Mental Health in Rhode Island

IntroductionHealthcare workers in long-term care settings and group homes for the disabled are at signi?cant risk of contracting COVID-19 and subsequently infecting the residents, fellow co-workers, and their family. In addition, lower paying long-term care healthcare workers maybe working multiple jobs which increases the risk of exposure. In April 2020, 27% of all deaths in the population was among residents in long-term care. The elderly population has the greatest risk for mortality from COVID-19 (Liu et al. 2020) and are disproportionality a?ected by social distance and self-isolation. Most long-term care settings have implemented lockdowns preventing families from visiting and limiting interactions among residents. Social isolation of the elderly is considered a serious public health concern. Social disconnection is a risk factor for increased depression and anxiety among the elderly. It is hypothesized that elderly persons are at high risk for poor mental health outcomes from the COVID-19 pandemic. The Alzheimer's Disease International suggest that those with dementia “may become more anxious, angry, stressed, agitated, and withdrawn during the outbreak”. These factors potentially may increase stress on healthcare workers in long-term care settings beyond the fears of exposure and transmitting COVID-19 to their families. There are few studies to date that examine the mental health impact of COVID-19 on healthcare workers in long-term care. The United Nations has highlighted the mental health risk to workers in long-term care. “First responders and front line workers, particularly workers in health and long-term care play a crucial role in ?ghting the outbreak and saving lives. However, they are under exceptional stress, being faced with extreme workloads, di?cult decisions, risks of becoming infected and spreading infection to families and communities, and witnessing deaths of patients.”MethodsHealthcare workers in long-term care facilities, and assisted living facilities in Rhode Island were given questionnaires to complete that examined mental health and risk factors associated with COVID-19. The questionnaire includes items on the healthcare worker's experience with COVID-19. Resilience is measured using The Brief Resilience Scale assessing the individual's ability to bounce back or recover from stress. Subjective incompetence is de?ned as the perceived incapacity to perform tasks and express feelings deemed appropriate in a stressful situation. Increasing distress and subjective incompetence may convert a normal reaction to stress into mental disorder requiring intervention. Demoralization is measured using the Demoralization Scale-II. Depression and anxiety is measured using two of the most commonly used screens in clinical care, the PHQ-9 for depression and the GAD-7 for generalized anxiety. Family functioning during and before the COVID-19 pandemic is measured using the three-item Brief Assessment of Family Functioning. Social support is measured during and before the COVID-19 pandemic using the emotional-informational support subscale of the Brief Social Support Scale derived from the Medical Outcomes Study Social Support Survey. Coronavirus Anxiety Scale is a mental health screener designed to aid in the identi?cation of probable cases of dysfunctional anxiety associated with the COVID-19 pandemic. The fear of Coronavirus-19 Scale was used to measure this construct. The ?ve-item Primary Care PTSD Screen was adapted to COVID-19 as a traumatic event. Items measuring healthcare worker workplace stress was developed based on a items from a number of existing scales. A 15-item health care workers attitudes toward the management of COVID-19 in the long-term care facility was developed by the research team that focuses on training of sta?, safety, and resident care.ResultsPreliminary data will be presented. Data collection is currently underway. There are 65 assisted living facilities and 85 nursing homes in Rhode Island. Approximately 10% of the facilities are currently participating with the aim to recruit nearly all facilities in the state.ConclusionsThe hypotheses to be tested is that healthcare workers in long-term care settings have mental health issues including demoralization, depression and anxiety due to the COVID-19 pandemic disaster. That those who are in facilities with COVID-19 residents have increased stress. Those facilities that have placed increased demands on healthcare workers will have employees that are having more difficulty in dealing with the COVID-19 pandemic. This study examines how healthcare workers in long-term care facilities have coped during the COVID-19 pandemic and the impact on their mental health; factors that protect or place the healthcare worker at risk for poorer mental health outcomes (depression, anxiety, demoralization, post-traumatic stress); and factors during COVID-19 that place the healthcare worker for poorer mental health outcomes during COVID-19 pandemic.FundingDepartment of Psychiatry of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Lifespan

The Influence of Job Stress, Stress Coping Strategies, Empathy ability on Burnout of Social Workers in Long-term Care Facilities

The Influence of Job Stress, Stress Coping Strategies, Empathy ability on Burnout of Social Workers in Long-term Care Facilities

Ethical Influence of Fall Prevention Sensors on Older Adults, their Families, Nurses and Care Workers in Long-term Care Facilities

Ethical Influence of Fall Prevention Sensors on Older Adults, their Families, Nurses and Care Workers in Long-term Care Facilities

Seroprevalence of SARS-CoV-2 infection among residents and workers of long-term care facilities in Ribeirão Preto, Brazil: an epidemiological survey

OBJECTIVE: Residents and workers in long-term care facilities (LTCF) for older adults share the same space, and residents are more susceptible to COVID-19 complications. The aim of this study was to determine the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies as an indication of previous infection of both residents and workers in LTCFs, as well as associated factors. METHODS: This epidemiological survey was conducted in Ribeirão Preto, Brazil, a medium-sized city. Stratified sampling was performed, with data collected on demographics, health, LTCF protective measures, activities of daily living, and cognition. A serological test was carried out on all selected individuals. RESULTS: The mean resident and worker ages were 80.62 (SD, 9.66) and 37.41 (SD, 12.42) years, respectively. The serological test was positive in 13.33% of the residents, who had 2.91 (SD, 1.28) chronic diseases and used 5.65 (SD, 2.79) medications. Dementia screening was negative in only 11.1%, and only 20% were independent in activities of daily living. The serological test results were positive in 25.93% of the workers, although SARS-CoV-2 had been previously detected in only 6.9%. The LTCF did not perform systematic screening of worker respiratory symptoms. CONCLUSIONS: There was a higher seroprevalence of SARS-CoV-2 among LTCF workers than residents. Systematic screening of worker symptoms before each shift was not regularly performed. The high prevalence of cognitive changes among LTCF residents can impede adherence to personal protection measures.

The Effect of National Weekly COVID-19 Screening Testing of All Workers in Long-Term Care Facilities: A Decrease in Mortality

Background: Outbreaks of Coronavirus 2019 (COVID-19) in Long-Term Care Facilities (LTCFs) have resulted mainly from disease transmission by asymptomatic health care workers (HCW's). It is not known whether routine COVID-19 screening tests carried out on HCW's would reduce mortality of LTCF residents. Since mid-July 2020, the Israeli national LTCF defense program – "Senior Shield" - has used weekly COVID-19 PCR tests on all LTCF employees. Methods: A nationwide, government funded, screening program on all LTCF personnel for four months during the second COVID-19 wave. We evaluated differences between the two waves in the national LTCF's system with regard to hospitalizations and mortality. Estimation of national health system predicted outcomes, in the absence of this weekly screening plan, was calculated. Findings: COVID-19 tests were taken weekly in all 1,107 LTCFs which includes 62,159 HCWs and 100,046 residents. A median of 55,282 (range – 16,249) tests were performed each week. Turnaround time from sampling to result was less than 24 hours in 95% of tests. Compared to the first wave, in which 45.3% of national mortality was attributed to the LTCF's, the second wave saw a 33.8% reduction in this mortality ratio. Estimation of national health system outcomes during the second wave showed that the activation of the screening program reduced hospital load by 35% and prevented 30% of national mortality from COVID-19.Interpretation: Routine weekly COVID-19 PCR testing of all LTCF employees may reduce national hospitalizations and mortality.Funding Statement: None to declare. Declaration of Interests: None to declare.Ethics Approval Statement: The study was determined to be exempt by the Institutional Review Board of Soroka University Medical Center and thus informed consent was not required (0429-20-SOR).