Skip header and navigation

19 records – page 1 of 2.

Document Type
Evidence Search Report
Review Code
LTC042201-01 ESR
Question Submitted
April 22, 2020
Date Completed
24-Apr-2020
Status
3. Completed
Research Team
Long Term Care
QUESTION: What human resources are required in long term care facilities to mitigate or control an ILI
Document Type
Evidence Search Report
Review Code
LTC042201-01 ESR
Question Submitted
April 22, 2020
Date Completed
24-Apr-2020
Status
3. Completed
Research Team
Long Term Care
Category
Administration
Infection Prevention and Control
Subject
Facilities
Health Planning
Long Term Care
Elderly
Population
Aged (80+)
Other
Clinical Setting
Long Term Care
Priority Level
Level 3 completed within 2-3 days
Cite As
Tupper, S; Ward, H; Dalidowicz, M; Boden, C; Ellsworth, C; How can LTC facilities prepare for a pandemic? 2020 Apr 29; Document no.: LTC042201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 27 p. (CEST evidence search report)
Related Documents
Documents
Less detail
Document Type
Rapid Review
Review Code
LTC042201 RR
Question Submitted
April 22, 2020
Date Completed
April 29, 2020
Status
3. Completed
Research Team
Long Term Care
document includes pandemic planning checklists for long-term care homes (LTC) and personal care homes
Document Type
Rapid Review
Review Code
LTC042201 RR
Question Submitted
April 22, 2020
Date Completed
April 29, 2020
Status
3. Completed
Research Team
Long Term Care
Key Findings
· Overall, there is a lack of high quality evidence to support recommended pandemic preparedness strategies (checklist items) to prevent or mitigate respiratory infection outbreaks in LTC. · In the absence of high-quality or mixed evidence to support strategies for pandemic preparedness, it is advisable to follow clinical practice guideline recommendations that have been based on expert opinion (key sources are identified in red). This is particularly the case for infection control interventions that are likely to have no negative impacts on LTC residents (e.g. hand hygiene, cough etiquette). Strategies that have a potential negative impact on LTC residents (e.g. visitor restrictions) must be handled with more flexibility and individual assessment to determine how infection control can be preserved while minimizing negative consequences for residents and families. · Internationally recognized pandemic/outbreak preparedness checklists for LTC (e.g. CDC 2020, Buynder et al. 2017) share many similarities to the current SHA Annex R checklists. · Consideration should be given to converting the checklist into a planner with accountabilities to demonstrate how each item is being addressed (similar to CDC 2020). Links can be embedded in the planner/checklist to more detailed information, such as the PPE burn calculator (CDC 2020), education/training materials (WHO 2020), and communication materials for families (CDC 2020, WHO 2020, Buynder et al. 2017). · Consider the addition of specific detail to the SHA pandemic preparedness checklists on the date of the next pandemic plan/checklist review, contact names for local resource acquisition or assistance with staffing, tracking forms for dates of education/training with staff and residents, tracking of audits/observation of infection control practices, surge capacity planning items, and expanded items for communication (see attached recommendations from family caregivers of the Saskatchewan LTC Network). · Discrepancies exist between reported (77-100%) and observed (25-63%) adherence to infection control practices, indicating a need for independent audits. Adherence rates improve with direct observation, frequent education reminders and prompts. · Even when there is not an outbreak in a home, the pandemic response results in increased workload demands on staff due to infection control practices (e.g. PPE and hand hygiene), loss of family caregiver assistance with resident care, enhanced care needs of residents due to anxiety, increased communication with family caregivers and other members of the care team, monitoring and restricting resident movement in the home, enhanced cleaning, staff absenteeism, and education/training. Consideration is needed for a provincial process for evaluation of needs within individual homes, and allocation of additional human resources, disposable supplies, equipment, or funding to ensure that both infection control and usual care needs of residents are consistently met. · Maintaining public confidence through communication is a defined infection control strategy. Communication strategies include individual communication between family members and staff, public communication strategies by individual facilities and provincially through dedicated pandemic information pertaining to LTC (e.g. dedicated LTC section on provincial websites).
Category
Administration
Infection Prevention and Control
Subject
Facilities
Health Planning
Long Term Care
Elderly
Population
Aged (80+)
Other
Clinical Setting
Long Term Care
Priority Level
Level 3 completed within 2-3 days
Cite As
Tupper, S; Ward, H; Dalidowicz, M; Boden, C; Ellsworth, C; How can LTC facilities prepare for a pandemic? 2020 Apr 29; Document no.: LTC042201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 27 p. (CEST rapid review report)
Related Documents
Documents
Less detail
Document Type
Evidence Search Report
Review Code
LTC042402-01 ESR
Question Submitted
April 24, 2020
Date Completed
April 28, 2020
Status
3. Completed
Research Team
Long Term Care
Recommendations Saskatoon Ministry of Health. Outbreaks in Long Term Care and Integrated Facilities - Generic
Document Type
Evidence Search Report
Review Code
LTC042402-01 ESR
Question Submitted
April 24, 2020
Date Completed
April 28, 2020
Status
3. Completed
Research Team
Long Term Care
Category
Administration
Healthcare Services
Subject
Facilities
Long Term Care
Palliative Care
Infection Prevention and Control
Family
Population
All
Clinical Setting
Cardiac unit
Emergency
ICU
Long Term Care
Medicine Unit
NICU
Oncology
Priority Level
Level 4 completed within 1 week
Cite As
Howell-Spooner, B; Dalidowicz, M; Boden, C. How is "compassionate visit" defined and operationalized in the context of an infectious outbreak or pandemic? 2020 Apr 28; Document no.: LTC042402-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 7 p. (CEST evidence search report)
Related Documents
Documents
Less detail
Document Type
Rapid Review
Review Code
LTC042402 RR
Question Submitted
April 24, 2020
Date Completed
April 30, 2020
Status
3. Completed
Research Team
Long Term Care
restrictions in long-term care (LTC) during an outbreak or pandemic are implemented due to the perceived risk
Document Type
Rapid Review
Review Code
LTC042402 RR
Question Submitted
April 24, 2020
Date Completed
April 30, 2020
Status
3. Completed
Research Team
Long Term Care
Key Findings
Visitor restrictions in long-term care (LTC) during an outbreak or pandemic are implemented due to the perceived risk of transmission between residents or staff and visitors. · Social isolation and possible loss of care resulting from visitor restrictions in LTC may place residents at risk of poorer outcomes in terms of both physical and mental health, as well as distress to families and staff (see Saskatchewan LTC Network Family Perspective). · Visitor restriction policies typically allow visits for compassionate reasons that include end of life, critical care, and support of persons who require assistance beyond that provided by healthcare e.g. support for feeding, mobility, or behaviors, but specific detail on these is not consistent or clear. · Recent changes to visitation policies in Australia are less restrictive and allow brief visitations (end of table 1, noted in red font). · Although the majority of policies describe a need for flexibility and case-by-case assessment of visits deemed “essential”, the majority of policies are not clear in who is to conduct this analysis or the criteria that should be used to make these decisions. Visitation policies differ in detail regarding the number of visitors allowed at one time, total number of visitors allowed, visit duration, mobility within the home and location of the visit. · Remote and technology assisted visits are to be facilitated by LTC staff. · Infection control practices are enforced for visitors, and may include screening (e.g. temperature, symptoms, travel and contact history), prohibiting ill visitors, use of personal protective equipment (PPE), hand and cough hygiene. · Education of visitors and support for proper infection control practices is encouraged in the majority of policies.
Category
Administration
Healthcare Services
Subject
Facilities
Long Term Care
Palliative Care
Infection Prevention and Control
Family
Population
All
Clinical Setting
Cardiac unit
Emergency
ICU
Long Term Care
Medicine Unit
NICU
Oncology
Priority Level
Level 4 completed within 1 week
Cite As
Tupper, S; Ward, H; Howell-Spooner, B; Dalidowicz, M; Boden, C. How is "compassionate visit" defined and operationalized in the context of an infectious outbreak or pandemic in long-term care? 2020 May 1; Document no.: LTC042402 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 17 p. (CEST rapid review report)
Related Documents
Documents
Less detail
Document Type
Evidence Search Report
Review Code
LTC042401-01 ESR
Question Submitted
April 24, 2020
Date Completed
April 30, 2020
Status
3. Completed
Research Team
Long Term Care
for COVID-19: Interim Guidance for Long Term Care Homes https://www.canada.ca/en/public-health/services
Document Type
Evidence Search Report
Review Code
LTC042401-01 ESR
Question Submitted
April 24, 2020
Date Completed
April 30, 2020
Status
3. Completed
Research Team
Long Term Care
Category
Administration
Subject
Facilities
Decision Making
Family
Long Term Care
Population
All
Clinical Setting
ICU
Long Term Care
Medicine Unit
NICU
Oncology
Priority Level
Level 4 completed within 1 week
Cite As
Boden, C; Ellsworth, C. What are best practices for engaging family care providers during a pandemic? 2020 Apr 30; Document no.: LTC042401-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 32 p. (CEST evidence search report)
Related Documents
Documents
Less detail
Document Type
Rapid Review
Review Code
LTC042401 RR
Question Submitted
April 24, 2020
Date Completed
May 7, 2020
Status
3. Completed
Research Team
Long Term Care
health facilities and senior’s care facilities including long-term care homes. Saskatchewan currently
Document Type
Rapid Review
Review Code
LTC042401 RR
Question Submitted
April 24, 2020
Date Completed
May 7, 2020
Status
3. Completed
Research Team
Long Term Care
Key Findings
Core concepts of family engagement include dignity and respect, information sharing, participation in care and decision making, and collaboration (Hart 2020).
A careful balance needs to be maintained between attending to patients’ physical and psychological needs and adhering to infection control guidelines, while offering psychological support to family members (Chan 2006).
The word ‘visitation’ does not adequately describe family members’ involvement. Family presence is a more suitable term as it redefines families as partners in care (Hart 2020). However, it is important to recognize that family presence is not a substitute for adequate staffing levels.
Very little guidance is provided in the literature on innovative or specific approaches engage family care providers during a pandemic. The literature mainly focuses on supporting alternate forms of communication such as telephone calls, or technology assisted communication through social media or video/voice calls.
Enhanced communication strategies that provide regular information to a primary family contact on the patient/resident condition and allow chosen care partners to contribute to decision making as much as possible are recommended (Koller 2006).
The negative impact of visitation restrictions places increased stress on patients/residents and families who are unable to provide or receive non-healthcare specific supportive care. Those with neurocognitive disorders or communication barriers are more significantly impacted.
Staff also report increased stress during family visitation restrictions due to the additional time required to take on a “familial role” for the patient/resident. These roles may include providing a supportive environment, social interaction, information sharing, and opportunities for play (Koller 2006a – pediatric hospital setting).
The search question did not specifically look at impact of visitation on infection rates; therefore, there is insufficient information to determine if visitation policies affect infection rates. However, a systematic review in pediatric hospital setting in Ontario found no connection between liberal visiting hours and increased SARS infection rates (Smith 2009).
When facilitating sibling visitation in the NICU, a pre-visit education process is recommended. Maternity settings may wish to consider a 'combination' policy, where the women's partners and/or significant other would have open visiting (all day), with restricted visiting for others. In other general hospital ward settings, open visiting with a 'quiet hour' is suggested (Smith 2009).
Category
Administration
Subject
Facilities
Decision Making
Family
Long Term Care
Population
All
Clinical Setting
ICU
Long Term Care
Medicine Unit
NICU
Oncology
Priority Level
Level 4 completed within 1 week
Cite As
Tupper, S; Ward, H; Dalidowicz, M; Boden, C; Ellsworth, C; What are best practices for engaging family care providers during a pandemic? 2020 Apr 16; Document no.: LTC042401 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 22 p. (CEST rapid review report)
Related Documents
Documents
Less detail
Document Type
Evidence Search Report
Review Code
LTC020201-01 ESR
Question Submitted
February 2, 2021
Date Completed
February 5, 2021
Status
3. Completed
Research Team
Long Term Care
testing in Long Term care? Context: Point-of-care testing in LTC/residential care [include reports
Document Type
Evidence Search Report
Review Code
LTC020201-01 ESR
Question Submitted
February 2, 2021
Date Completed
February 5, 2021
Status
3. Completed
Research Team
Long Term Care
Category
Infection Prevention and Control
Diagnostics
Subject
Facilities
Antigens
Long Term Care
Testing
Population
Aged (80+)
Clinical Setting
Long Term Care
Priority Level
Level 3 Two weeks (14 days)
Cite As
Dalidowicz, M; Mueller, M. What are the efficacies and outcomes of Point-of-Care/Antigen testing in Long Term care? 2021 Feb 5; Document no.: LTC020201-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 22 p. (CEST evidence search report)
Related Documents
Documents
Less detail
Document Type
Rapid Review
Review Code
LTC020201 RR
Question Submitted
February 2, 2021
Date Completed
February 26, 2021
Status
3. Completed
Research Team
Long Term Care
/Antigen testing in Long Term care? 2021 Feb 26; Document no.: LTC020201 RR. In: COVID-19 Rapid Evidence
Document Type
Rapid Review
Review Code
LTC020201 RR
Question Submitted
February 2, 2021
Date Completed
February 26, 2021
Status
3. Completed
Research Team
Long Term Care
Key Findings
Although rapid antigen point-of-care tests (POCT) to detect SARS-CoV-2 (COVID-19) infection have the advantage of rapid result turn-around time compared to laboratory-based reverse-transcriptase polymerase chain reaction (RT-PCR) test, their sensitivity to correctly detect positive cases is lower (Larremore et al., 2020).
Increased frequency of testing compensates for lower test sensitivity of POCTs (See et al., 2021; Larremore et al., 2020). The majority of policy guidelines and public health directives recommend basing frequency of POCT on rates of community transmission or outbreak status of the setting (Public Health Canada, 2021; Ontario Ministry of Long-term Care [LTC], 2021; CDC, 2021; Arizona Department of Health Services, 2020).
Recommended POCT frequency for screening asymptomatic individuals is 3 times per week of staff, including designated support persons, and residents if the home is in an outbreak situation and once per week of staff and designated support persons in a non-outbreak situation (Ontario Ministry of LTC, 2021; CDC, 2021; Larremore et al., 2020).
Designated support persons (i.e. family caregivers) should be tested at the same frequency as LTC staff (Ontario Ministry of LTC, 2021; Micocci et al., 2020; Vilches et al., 2020; Tennessee Department of Health, 2020).
Recommendations are consistent regarding test interpretation and follow-up actions, with the majority of policies and directives recommending a high degree of caution and follow-up RT-PCR testing after a negative POCT if there is a high pre-test probability for COVID-19 infection (i.e. symptomatic, known contact exposure)(Public Health Canada, 2021; CDC, 2021). All reviewed guidelines recommend confirmatory RT-PCR test following a positive POCT if the individual is asymptomatic in order to avoid unnecessary isolation of residents and work restrictions of staff. Contrary to other guidelines, the Oregon Health Authority (2020) considers all positive antigen tests in a symptomatic individual as a positive test regardless of follow up testing.
Modelling studies consistently show that regular POCT screening of asymptomatic staff and residents in LTC during both outbreak and non-outbreak situations results in significant decreases in projected cases when combined with a multipronged approach to prevent transmission (Larremore et al., 2021; Holmdahl et al., 2020; See et al., 2021; Vilches et al., 2020).
Barriers to frequency of testing are availability of test kits, training of testers, human resources for testing, and a reporting strategy (Micocci et al., 2020).
Prioritization of testing should be given to symptomatic healthcare providers and residents first, then screening for residents and staff during outbreaks (See et al., 2020).
The Saskatchewan Health Authority (SHA) Point of Care COVID Testing: Long Term Care Algorithm contains most of the elements present in other algorithms. Additional information should be added on actions taken for presumptive positive or negative tests in different scenarios. Additional information should be provided on frequency of testing and the context for “high-risk contact”.
Category
Infection Prevention and Control
Diagnostics
Subject
Facilities
Antigens
Long Term Care
Testing
Population
Aged (80+)
Clinical Setting
Long Term Care
Priority Level
Level 3 Two weeks (14 days)
Cite As
Ward, H; Tupper, S; Dalidowicz, M; Mueller, M. What are the efficacies and outcomes of Point-of-Care/Antigen testing in Long Term care? 2021 Feb 26; Document no.: LTC020201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 37 p. (CEST rapid review report)
Related Documents
Documents
Less detail
Document Type
Evidence Search Report
Review Code
LTC042201-03 ESR
Question Submitted
April 22, 2020
Date Completed
April 28, 2020
Status
3. Completed
Research Team
Long Term Care
Document Type
Evidence Search Report
Review Code
LTC042201-03 ESR
Question Submitted
April 22, 2020
Date Completed
April 28, 2020
Status
3. Completed
Research Team
Long Term Care
Category
Administration
Infection Prevention and Control
Subject
Facilities
Health Planning
Elderly
Long Term Care
Population
Aged (80+)
Other
Clinical Setting
Long Term Care
Priority Level
Level 3 completed within 2-3 days
Cite As
Ellsworth, C. What characteristics of residents in LTC homes affect the ability to provide routine care during a COVID-19 or ILI outbreak? 2020 Apr 28; Document no.: LTC042201-03 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 5 p. (CEST evidence search report)
Related Documents
Documents
Less detail
Document Type
Evidence Search Report
Review Code
LTC042201-02 ESR
Question Submitted
April 22, 2020
Date Completed
April 25, 2020
Status
3. Completed
Research Team
Long Term Care
Ellis TEAM: Long-term care CITE AS: Dalidowicz, M; Boden, C. What environmental management
Document Type
Evidence Search Report
Review Code
LTC042201-02 ESR
Question Submitted
April 22, 2020
Date Completed
April 25, 2020
Status
3. Completed
Research Team
Long Term Care
Category
Administration
Infection Prevention and Control
Subject
Infection Prevention and Control
Health Planning
Facilities
Long Term Care
Population
Aged (80+)
Other
Clinical Setting
Long Term Care
Priority Level
Level 3 completed within 2-3 days
Cite As
Dalidowicz, M; Boden, C. What environmental management and built environment factors influence a home’s ability to prevent or manage an ILI outbreak? AND What is the evidence for infection control practices (checklist items) for preventing or managing an ILI outbreak? 2020 Apr 25; Document no.: LTC042201-02 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 24 p. (CEST evidence search report)
Related Documents
Documents
Less detail

19 records – page 1 of 2.