Protecting Nursing Homes and Long-Term Care Facilities From COVID-19: A Rapid Review of International Evidence.
Sally Hall Dykgraaf, Sethunya Matenge, Jane Desborough and 5 others
PMID 34428466WHAT IT FOUND
No robust evidence showed which long-term care strategies worked.
Repeated testing of residents and staff was the strategy most often identified as useful, while symptom or temperature screening missed many asymptomatic cases.
Key findings
01The review found little evidence linking interventions or strategies to robust data on effectiveness, and the evidence base had no randomized or controlled trials.
02Thirty-six articles described universal testing protocols, and testing was usually paired with isolation, cohorting, or other infection control measures.
03Routine temperature screening, symptom-based testing, and single point-prevalence testing demonstrated limited effectiveness.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The evidence base was immature, mainly observational, and had no randomized or controlled trials. Risk of bias was not examined in detail, and screening and extraction relied on single reviewers. Most studies were done during facility outbreaks or high community transmission, so results may not apply in other settings. Facility types and terms varied across countries, making comparisons difficult. Many responses were multicomponent, so the contribution of any single measure cannot be separated. Few studies came from low- or middle-income countries, and none examined vaccination programs.
The easy way to misread this
Do not read repeated universal testing as proven on its own. The review found no randomized or controlled trials, and testing was usually combined with isolation, cohorting, PPE, or other infection control measures. Also, most studies were done during outbreaks or high community transmission, so the results may not apply elsewhere.