'4C' Intervention to Reduce SARS-CoV-2 (Covid-19) Transmission
Nursing homes have long faced special challenges in implementing effective infection prevention programs, including limited resources and diagnostic challenges in a frail functionally disabled long-stay population. Advancing our understanding of the transmission of SARS-CoV-2 within these facilities for vulnerable populations deserves urgent and further investigation. Environmental contamination with SARS-CoV-2 that is reported in limited studies highlights the potential importance of transmission between patients, their environment, and healthcare providers via direct and indirect contact.
This study seeks to characterize the epidemiology of SARS-CoV- 2 in the NH patient room environment over time and the risk of transmission to near and far environments, with the explicit intent of developing integrated, simple COVID-19 infection prevention strategies that can be reported to and implemented throughout other nursing homes and long-term care facilities.
|Condition or Disease||Intervention/Treatment||Phase|
In order to achieve these goals the study is being performed at four different nursing homes and will include patients with active or with recent COVID-19 infection, as well as nursing home staff members. The study will test a multimodal aging-friendly intervention including four components and hypothesizes that the implementation of this organizational, educational, quality improvement program will be associated with lower odds of SARS-CoV-2 transmission to the environment.
Arms and Interventions
|No Intervention: Control|
Two facilities will follow their local protocols for infection prevention, including COVID-19 precautions. We will swab environmental surfaces at these sites to compare outcomes.
Using a cluster-randomized design, we will test a multimodal aging-friendly intervention including four components (4Cs): Coaching staff Cleaning protocols, standardized Communication with staff and leadership Collaboration with local expertise We hypothesize that the implementation of this organizational QI educational program will be associated with lower odds of SARS-CoV-2 transmission to the environment.
Behavioral: Coaching, Cleaning, Communication, Collaboration
Coaching staff Cleaning protocols, standardized Communication with staff and leadership Collaboration with local expertise
Primary Outcome Measures
- Surface contamination with SARS-CoV-2 [3 months, depending on COVID-19 epidemiology]
Prevalence of SARS-CoV-2 on surfaces in COVID-19 positive patient rooms
Inclusion criteria for nursing home patients:
18 years of age or older
Residing in a participating nursing home facility
Active or recent (last 14 days) COVID-19 infection
Exclusion criteria for nursing home patients:
- Not located in a participating nursing home facility
Inclusion criteria for healthcare workers:
- Healthcare worker at a participating nursing home facility
Exclusion criteria for healthcare workers:
Contacts and Locations
LocationsNo locations specified.
Sponsors and Collaborators
- University of Michigan
- National Institute on Aging (NIA)
Study Documents (Full-Text)None provided.