Massachusetts NH Intervention Linked to COVID-19 Infection Control

With the negative impact of COVID-19 infection on nursing homes (NHs) in 2020, Massachusetts implemented a multicomponent infection control intervention.

“The Massachusetts NH intervention was associated with a more rapid reduction in the rate of SARS-CoV-2 infections compared to similarly managed NHs in neighboring states,” wrote researchers.

Researchers compared the weekly risk of PCR-confirmed infections among Massachusetts NH residents to NH residents in neighboring New England states to examine the intervention’s impact.

All NHs included in the study were managed similarly by a single NH provider. The study included 22,985 residents from 20 NHs in Massachusetts and 4493 residents across 45 comparator facilities.

Components included in the intervention included: (1) A 28-item infection control checklist of best practices; (2) incentive payments to NHs contingent on scoring ≥24 on the checklist, meeting 6 core competencies, testing residents and staff for SARS-COV-2 RNA, uploading data, and enabling virtual visits; (3) onsite and virtual infection control consultations for deficient facilities; (4) 6 weekly webinars; (5) continuous communication with the Massachusetts Department of Public Health; and (6) access to personal protective equipment, temporary staff, and SARS-CoV-2 testing.

For county COVID-19 prevalence, researchers adjusted weekly rates of infection. While findings showed adjusted risk of infection was initially higher in Massachusetts, the decline was more rapid when compared to other facilities.

During the early intervention period in Massachusetts, the decline in infection risk was 53% greater than comparator states (state-by-time interaction HR = 0.47; 95% CI 0.37-0.59)

The risk of infection continued to decline in both groups during the late intervention period, however the change from baseline in Massachusetts was marginally greater than that in the comparator states (interaction HR 0.80; 95% CI 0.64-1.00).

“Although several unmeasured factors may have confounded our results, implementation of the Massachusetts model may help rapidly reduce high rates of infection and prevent future COVID-19 surges in NHs,” concluded study authors.

Reference:
Lipsitz LA, Kosar C, Dufour AB, Travison TG, Mor V. Evaluation of a state-wide effort to improve COVID-19 infection control in Massachusetts nursing homes. J Am Geriatr Soc. Published online August 3, 2022. doi:10.1111/jgs.17984