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. 2021 Jan-Feb;25(1):101039.
doi: 10.1016/j.bjid.2020.11.004. Epub 2020 Dec 5.

COVID-19 among nursing home residents: results of an urgent pre-hospital intervention by a multidisciplinary task force

François Dolveck  1 , Alessio Strazzulla  2 , Coralie Noel  3 , Sylvie Aufaure  4 , Paul Tarteret  5 , Astrid de Pontfarcy  5 , Nicolas Briole  1 , Nicolas Vignier  5 , Sylvain Diamantis  6
Affiliations

COVID-19 among nursing home residents: results of an urgent pre-hospital intervention by a multidisciplinary task force

François Dolveck et al. Braz J Infect Dis. 2021 Jan-Feb.

Abstract

The current coronavirus disease-2019 (COVID-19) pandemic caused 10,541 deaths among nursing home residents in France, by July 17th, 2020. This study reported the results of an urgent pre-hospital intervention in eight French nursing homes. A retrospective study was conducted from March 26th to May 7th, 2020, before and after the intervention of a task force which took action from April 9th to April 11th, 2020. The task force included nurses and specialists of the county general hospital. The intervention had four steps: i) daily notification of deaths; ii) audit by infectious diseases and hygiene specialists focused on nursing team reinforcing, tracking of suspected cases, patients' cohorting, review of preventive and protective measures, hydration, thromboembolism prevention; iii) intervention of an emergency team which urgently performed procedures suggested; iv) relay with a geriatric team. There were a total of 770 residents distributed in eight facilities with capacity varying from 53 to 145 residents. The number of deaths peaked at 139 in week 2 and the trough at 0 occurred in weeks 6-7. Comparison between periods (before vs after intervention) showed a significant decrease in number of new deaths (83/770; 11% vs 35/687; 5%, p = 0.0001) and new COVID-19 cases (348/770; 45% vs 123/422; 29%, p < 0.001). The urgent pre-hospital intervention by a multidisciplinary task force achieved mortality reduction during COVID-19 outbreak in nursing homes. Pre-hospital intervention is a valid alternative to hospitalization in case of hospital saturation.

Keywords: COVID-19; Deaths; Nursing homes; SARS-Cov2.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Evolution of new COVID-19 cases and deaths from March 26th, 2020 to May 7th, 2020. NOTE: task force intervention started in the eight facilities at the end of Week 3. Audit by infectious diseases and hygiene and public prevention specialists took place from April 9th, 2020 to April 11th, 2020. Interventions of emergency and geriatrics teams lasted from few days up to two weeks.
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