[Evidence summary:] Is visiting [in the social context] associated with increased incidence of COVID-19 in long-term residential care facilities? [v1.1]
| dc.contributor.author | National Health Library & Knowledge Service (NHLKS) | |
| dc.contributor.author | White, Gethin | |
| dc.contributor.author | Leen, Brendan | |
| dc.contributor.author | Cole, Natalie | |
| dc.date.accessioned | 2020-10-23T15:10:40Z | |
| dc.date.available | 2020-10-23T15:10:40Z | |
| dc.date.issued | 2020-10-05 | |
| dc.identifier.uri | http://hdl.handle.net/10147/628428 | |
| dc.description | In response to the COVID-19 pandemic many nursing homes and long-term care facilities have introduced restrictions on visitors to minimize the risk of spreading the infection to their residents. Public Health and government advice globally has attempted to reconcile the separate concerns of limiting the potential transmission of SARS-CoV-2 on the one hand; and, on the other hand, the psychological wellbeing of residents1, 2. A rapid review by the University of Oxford Centre for Evidence Based Medicine did not find any evidence on the effectiveness of limiting visitors to facilities. However they did state that as staff movement is a risk factor for outbreaks, similarly visitors may be a potential source of infection during a pandemic with widespread community transmission.6Although there is little evidence to date investigating visitation as a means of spreading COVID-19, there is evidence that families play a significant role in the community transmission of the infection15 . Another study from McMichael et al16 points out the prevalence of asymptomatic transmission of SARS-CoV-2 in nursing homes, reinforcing the need for particular caution around any potential relaxation of restrictions. Visitor access to nursing homes should be dependent on a risk assessment of both the local epidemiological situation and of the nursing home itself.1 Communicating the relative risk of visiting to nursing homes is identified as a key step in re-building trust in long-term care facilities1. Krones and Lee-Fay point out that restricting visitor access to nursing homes has not inhibited transmission of the virus. Increasingly, as the duration of the COVID-19 pandemic extends, organizations representing older people are questioning the benefits of implementing visitor restrictions on the grounds that protection against the virus has to be weighed against the risk of damage to an older person’s mental health17. Dichter also suggests: “In spite of current restrictive infection control measures, the principle of person-centred care must be implemented”8. Ethical considerations regarding long-term isolation and restriction of visits should be balanced against the potential impact of infection on residents and staff6. Several studies identified under-resourcing of nursing homes combined with inadequate decontamination and poor hand hygiene as the most frequently cited factors propagating transmission13. Staff working across different care homes have a higher risk of SARS-CoV-2 positivity than staff working in single care homes12. Another study by Belbin et al recorded far lower rates of COVID-19 transmission in nursing homes that were able to implement staff confinement with residents4. He et al10 assessed cross-sectional data from 1,223 Californian skilled nursing facilities with reported quality and longitudinal data of COVID-19 cases and found that homes with 5-star ratings were less likely to have COVID-19 cases and deaths after adjusting for nursing home size and patient population. A national study by Verbeek et al which looked at the results of allowing visitors back into nursing homes in the Netherlands during COVID-19 pandemic found that of the 26 nursing homes surveyed, none reported any new COVID-19 infections. The authors also comment on the value to resident wellbeing achieved by allowing visitors to return. There have been efforts in several countries to facilitate visits to nursing homes even when tighter restrictions have been implemented: eg garden and window visits. Technology has also played an important role in maintaining social connectedness between families and residents. | en_US |
| dc.language.iso | en | en_US |
| dc.publisher | Health Service Executive | en_US |
| dc.relation.ispartofseries | Evidence summaries | en_US |
| dc.subject | CORONAVIRUS | en_US |
| dc.subject | COVID-19 | en_US |
| dc.subject | RESIDENTIAL CARE | en_US |
| dc.subject | INFECTION PREVENTION AND CONTROL | en_US |
| dc.subject | VISITORS | en_US |
| dc.subject | VULNERABLE POPULATIONS | en_US |
| dc.title | [Evidence summary:] Is visiting [in the social context] associated with increased incidence of COVID-19 in long-term residential care facilities? [v1.1] | en_US |
| dc.type | Other | en_US |
| refterms.dateFOA | 2020-10-23T15:10:48Z |
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HSE Library Summaries of Evidence
Evidence summaries and reviews on the management and treatment of Novel Coronavirus Covid-19 and other clinical topics