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COVID-19 testing in English care homes and implications for staff and residents.
Micocci, Massimo; Gordon, Adam L; Allen, A Joy; Hicks, Timothy; Kierkegaard, Patrick; McLister, Anna; Walne, Simon; Hayward, Gail; Buckle, Peter.
  • Micocci M; NIHR London In Vitro Diagnostics Co-operative, London, UK.
  • Gordon AL; Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, UK.
  • Allen AJ; NIHR Applied Research Collaboration East Midlands (ARC-EM), Nottingham UK.
  • Hicks T; NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, UK.
  • Kierkegaard P; NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, UK.
  • McLister A; Newcastle upon Tyne Hospitals NHS Foundation Trust, UK.
  • Walne S; NIHR London In Vitro Diagnostics Co-operative, London, UK.
  • Hayward G; NIHR London In Vitro Diagnostics Co-operative, London, UK.
  • Buckle P; NIHR London In Vitro Diagnostics Co-operative, London, UK.
Age Ageing ; 50(3): 668-672, 2021 05 05.
Article in English | MEDLINE | ID: covidwho-1043239
Semantic information from SemMedBD (by NLM)
1. Toxic Epidermal Necrolysis PROCESS_OF Staff
Subject
Toxic Epidermal Necrolysis
Predicate
PROCESS_OF
Object
Staff
2. Toxic Epidermal Necrolysis PROCESS_OF Staff
Subject
Toxic Epidermal Necrolysis
Predicate
PROCESS_OF
Object
Staff
ABSTRACT

INTRODUCTION:

Care home residents are at high risk of dying from coronavirus disease 2019 (COVID-19). Regular testing, producing rapid and reliable results is important in this population because infections spread quickly, and presentations are often atypical or asymptomatic. This study evaluated current testing pathways in care homes to explore the role of point-of-care tests (POCTs).

METHODS:

A total of 10 staff from eight care homes, purposively sampled to reflect care organisational attributes that influence outbreak severity, underwent a semi-structured remote videoconference interview. Transcripts were analysed using process mapping tools and framework analysis focussing on perceptions about, gaps within and needs arising from current pathways.

RESULTS:

Four main steps were identified in testing infection prevention, preparatory steps, swabbing procedure and management of residents. Infection prevention was particularly challenging for mobile residents with cognitive impairment. Swabbing and preparatory steps were resource-intensive, requiring additional staff resource. Swabbing required flexibility and staff who were familiar to the resident. Frequent approaches to residents were needed to ensure they would participate at a suitable time. After-test management varied between sites. Several homes reported deviating from government guidance to take more cautious approaches, which they perceived to be more robust.

CONCLUSION:

Swab-based testing is organisationally complex and resource-intensive in care homes. It needs to be flexible to meet the needs of residents and provide care homes with rapid information to support care decisions. POCT could help address gaps but the complexity of the setting means that each technology must be evaluated in context before widespread adoption in care homes.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Point-of-Care Testing / COVID-19 Testing / COVID-19 / Nursing Homes Type of study: Diagnostic study / Prognostic study / Qualitative research Limits: Humans Language: English Journal: Age Ageing Year: 2021 Document Type: Article Affiliation country: Ageing

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Point-of-Care Testing / COVID-19 Testing / COVID-19 / Nursing Homes Type of study: Diagnostic study / Prognostic study / Qualitative research Limits: Humans Language: English Journal: Age Ageing Year: 2021 Document Type: Article Affiliation country: Ageing