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Infectious Diseases

Simulation study reveals best practices for nursing home outbreak mitigation

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Implementing regular screening and isolation measures along with contact restrictions emerged as highly effective strategies in reducing the spread of infectious diseases among residents in nursing homes, according to a study that highlights the importance of considering the mental and physical well-being of residents when implementing such measures.

Conducted in a simulated environment mimicking a small nursing home, the study utilized detailed data collected from healthcare workers (HCWs) through sensor motes. Researchers employed this information to power simulations of a COVID-19 outbreak, incorporating real-time estimates of infectivity and diagnostic sensitivity.

The study examined various mitigation measures, including regular screening and isolation, inter-resident contact restrictions, reduced HCW presenteeism, and modified HCW scheduling. Results demonstrated that screening every other day and isolating positive cases reduced the attack rate by an average of 27%, resulting in a notable decrease to 0.501 on average.

Moreover, implementing contact restrictions proved highly effective, reducing the attack rate by an average of 35% to a mere 0.240. Combining both screening/isolation and contact restrictions yielded the most impressive outcome, with an attack rate plummeting to 0.029.

Notably, reducing HCW presenteeism by half resulted in an 18% decrease in the attack rate. However, this effect was marginal when paired with less frequent screening. Altering HCW work schedules demonstrated negligible effects on mitigating outbreak spread.
Reference
Li H, Sewell DK, Herman T, Pemmeraju SV, et al; CDC MInD-Healthcare Group. Comparing multiple infection control measures in a nursing home setting: a simulation study. Infect Control Hosp Epidemiol. 2024;1-8. doi: 10.1017/ice.2024.43. Epub ahead of print. PMID: 38487822.

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