COVID‐19 Infection Prevention and Control Adherence in Long‐Term Care Facilities, Atlanta, Georgia

Abstract

Background/Objective Recommendations for infection prevention and control (IPC) of COVID‐19 in long‐term care settings were developed based on limited understanding of COVID‐19 and should be evaluated to determine their efficacy in reducing transmission among high‐risk populations. Design and Setting Site visits to 24 long‐term care facilities (LTCFs) in Fulton County, Georgia, were conducted between June and July 2020 to assess adherence to current guidelines, provide real‐time feedback on potential weaknesses, and identify specific indicators whose implementation or lack thereof was associated with higher or lower prevalence of COVID‐19. Participants Twenty‐four LTCFs were visited, representing 2,580 LTCF residents, among whom 1,004 (39%) were infected with COVID‐19. Measurements Overall IPC adherence in LTCFs was analyzed for 33 key indicators across five categories: Hand Hygiene, Disinfection, Social Distancing, PPE, and Symptom Screening. Facilities were divided into Higher‐ and Lower‐prevalence groups based on cumulative COVID‐19 infection prevalence to determine differences in IPC implementation. Results IPC implementation was lowest in the Disinfection category (32%) and highest in the Symptom Screening category (74%). Significant differences in IPC implementation between the Higher‐ and Lower‐prevalence groups were observed in the Social Distancing category (Higher‐prevalence group 54% vs Lower‐prevalence group 74%, P < .01) and the PPE category (Higher‐prevalence group 41% vs Lower‐prevalence group 72%, P < .01). Conclusion LTCFs with lower COVID‐19 prevalence among residents had significantly greater implementation of IPC recommendations compared to those with higher COVID‐19 prevalence, suggesting the utility in adhering to current guidelines to reduce transmission in this vulnerable population.