key: cord-0844521-afbdkk3m authors: Wachholz, Patrick Alexander; de Melo, Ruth Caldeira; Jacinto, Alessandro Ferrari; Villas Boas, Paulo José Fortes title: Impact of long-term care facilities’ size on adherence to COVID-19’ infection prevention guidance date: 2022-04-29 journal: Revista latino-americana de enfermagem DOI: 10.1590/1518-8345.5581.3557 sha: 471c3df1ec8c4179f0520df244a2783fdb9e754e doc_id: 844521 cord_uid: afbdkk3m OBJECTIVE: to evaluate the adherence of Brazilian long-term care facilities to the World Health Organization Infection Prevention and Control guidance, and assess the association of their size with the adherence to these recommendations. METHOD: cross-sectional study conducted with facilities’ managers. Authors developed a 20-item questionnaire based on this guidance, and a global score of adherence, based on the adoption of these recommendations. Adherence was classified as (1) excellent for those who attended ≥14 out of 20 recommendations; (2) good for 10 to 13 items; and (3) low for those with less than ten items. Facilities’ sizes were established as small, intermediate, and large according to a two-step cluster analysis. Descriptive statistics and chi-square tests were used at a 5% significance level. RESULTS: among 362 included facilities, 308 (85.1%) adhered to 14 or more recommendations. Regarding its size, adherence to screening COVID-19 symptoms of visitors (p=0.037) and isolating patients until they have had two negative laboratory tests (p=0.032) were lower on larger ones compared to medium and small facilities. CONCLUSION: adherence to COVID-19 mitigation measures in Brazilian facilities was considered excellent for most of the recommendations, regardless of the size of the units. A pandemia sobrecarregou os sistemas de saúde em todo o mundo e realçou as fraquezas (ou a falta) da base de dados nacional e das práticas de prevenção e controle de infecções (PCI) em ILPIs (7) . A prevalência de COVID-19 na comunidade é um forte preditor do número de casos e óbitos em ILPIs (4, 8) . As taxas de mortalidade aumentaram significativamente entre os idosos mais frágeis e entre os que vivem em instituições mais lotadas (9) . Além disso, observou-se que a probabilidade de ocorrência de casos de COVID-19 é maior em instituições grandes, sem fins lucrativos e em regiões metropolitanas. Corroborando esses achados, examinaram-se as características das ILPIs norteamericanas com casos documentados de COVID-19 e descobriram que as infecções estavam relacionadas à localização (urbana) e ao tamanho (maior que 50 leitos) das instituições (1) . Por outro lado, mostrou-se que um alto número de auxiliares de enfermagem e o total de horas de enfermagem contribuem para mitigar as infecções por COVID-19 em ILPIs (4) . Equipes maiores (9) e práticas precoces e robustas de PCI (8) (10) (11) (12) (13) . Contudo, até onde sabemos, a preparação para COVID-19 em ILPIs e a adesão a essas recomendações não foram suficientemente investigadas. Um estudo norte-americano com uma amostra pequena evidenciou que as recomendações do CDC para PCI foram as mais utilizadas (88%), seguidas pelas recomendações das secretarias estaduais ou locais de saúde (84%) e pelas orientações da OMS (48%) (14) . Mais da metade dos gerentes (54%) tinha planos separados para lidar com a COVID- 19 A questão aberta foi analisada a partir da análise temática de conteúdo (22) Characteristics of U.S. Nursing Homes with COVID-19 Mortality associated with COVID-19 in care homes: international evidence American Geriatrics Society Policy Brief: COVID-19 and Nursing Homes Staffing Levels and COVID-19 Cases and Outbreaks in U.S. Nursing Homes COVID-19 and homes for the aged: care or an announced death? Estimates of infection and mortality from COVID-19 in care homes for older people in Brazil Covid-19 and lack of linked datasets for care homes A Comparison of COVID-19 Mortality Rates Among Long-Term Care Residents in 12 OECD Countries Risk Factors Associated With Mortality Among Residents With Coronavirus Disease Long-term Care Facilities in Ontario, Canada World Health Organization. Infection prevention and control guidance for long-term care facilities in the context of COVID-19: interim guidance Center for Disease Control and Prevention. Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes London: British Geriatric Society Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science Encyclopedia of Pharmacy Practice and Clinical Pharmacy Organizational readiness to change assessment (ORCA): Development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework Recommended Common Data Elements for International Research in Long-Term Care Homes: Exploring the Workforce and Staffing Concepts of Staff Retention and Turnover World Health Organization. Instructions for the National Infection Prevention and Control Assessment Tool 2 (IPCAT2) World Health Organization. Assessment tool of the minimum requirements for infection prevention and control programmes at the national level World Health Organization Epidemiology and clinical features of COVID-19 outbreaks in aged care facilities: A systematic review and meta-analysis Copyright © 2022 Revista Latino-Americana de Enfermagem Este é um artigo de acesso aberto distribuído sob os termos da Licença Creative Commons CC BY Esta licença permite que outros distribuam, remixem, adaptem e criem a partir do seu trabalho, mesmo para fins comerciais, desde que lhe atribuam o devido crédito pela criação original. É a licença mais flexível de todas as licenças disponíveis. É recomendada para maximizar a disseminação e uso dos materiais licenciados Rates of COVID-19 Among Residents and Staff Members in Nursing Homes -United States Deaths in Nursing Homes During the COVID-19 Pandemic -Lessons from Japan COVID-19 Infection Prevention and Control Adherence in Long-Term Care Facilities Evolution and effects of COVID-19 European Centre for Disease Prevention and Control. Increase in fatal cases of COVID-19 among long-term care facility residents in the EU/EEA and the UK COVID-19 outbreak in Brazil: adherence to national preventive measures and impact on people's lives, an online survey The COVID-19 syndemic is not global: context matters Report of the Independent Panel for Pandemic Preparedness and Response: making COVID-19 the last pandemic The Impact of COVID-19 Pandemic on Long-Term Care Facilities Worldwide: An Overview on International Issues Special Commission COVID-19, Brazilian Society of Geriatrics and Gerontology Recommendations for the prevention and control of coronavirus infections (SARS-CoV-2) in long term care facilities