Case study: care in nursing homes

Being a nurse during COVID-19

Throughout this week, we have seen the importance of understanding the individual nurse’s experience and how it should be considered in the context of the setting in which they practice.

We have heard from a number of nurses working in a range of settings, many of whom have found themselves propelled into crisis situations. Through these case studies we have learned many valuable lessons. An important lesson we have all learned from the COVID-19 pandemic is that we can never be too prepared.

We have learned the importance of clear and consistent guidelines as well as coordination of care. We have appreciated the importance of digital connectivity and the power of big data to provide analytics. The use of telehealth has accelerated decades in just a few short weeks, with funding bodies relaxing restrictions, healthcare providers upskilling, and patients adapting to remote consultation.

In the midst of technological innovation and advances, we have witnessed a number of system failures. Across the world the deaths in nursing homes is of grave concern. Long-term care facilities, including nursing homes, skilled nursing facilities, and assisted living facilities, provide care for some of the most vulnerable populations in society, including older people and those with chronic medical conditions. These vulnerable populations deserve and require nuanced and targeted models of care.

In the United Kingdom, there are about 17,000 people living in nursing and residential care. In the United States more than 1.3 million individuals live in 15,600 nursing home facilities. In other residential facilities across the world the numbers of positive cases and deaths in nursing homes from COVID-19 continue to rise.

In nursing homes we have seen high transmission rates for infectious diseases for a range of reasons, including:

• staffing models
• crowding
• sharing of bathroom facilities
• gathering in common areas
• low preparedness for infection control
• vulnerability of patients.

Recognizing the high risk associated with these facilities, the Centers for Disease Control in the US has released interim guidance for the prevention and control of COVID-19 in nursing homes.

Share your thoughts

We have heard from Sherry Chen about her challenges working in a nursing home and rising to the challenge of adapting to rapidly changing circumstances.

• Based on your reading, how much do you feel is being done to stop the spread of the virus within these facilities?
• How might these decisions impact on long term care in nursing facilities in the future?

Share your thoughts with other learners in the Comments section.