Recommendations for Welcoming Back Nursing Home Visitors During the COVID-19 Pandemic: Results of a Delphi Panel.
Christian Bergman, Nathan M Stall, Daniel Haimowitz and 4 others
PMID 33256956WHAT IT FOUND
Experts reached consensus on 77 of 119 safety statements for reopening nursing homes to visitors, including universal masking and outdoor visits.
However, they disagreed significantly on testing asymptomatic residents and whether recovered patients are contagious.
Key findings
01The panel reached consensus on 77 of 119 statements, with strong agreement on universal masking, physical distancing, and requiring written isolation and testing plans before welcoming visitors.
02Experts failed to reach consensus on testing asymptomatic residents for surveillance purposes, with only 68% agreeing that residents should be allowed to opt out of such testing.
03There was significant disagreement on immunity, with only 35% of the panel agreeing that a recovered, asymptomatic resident is not contagious, though 88% agreed those recovered for at least 3 weeks are likely not infectious.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The Delphi process was accelerated (30 days), which may have prevented sufficient time for developing consensus on complex or controversial topics. The panel lacked key stakeholders, including nurse leaders, direct care workers, and residents themselves. The process occurred before updated CDC guidance was released, which may have influenced the lack of consensus on retesting recovered residents. There was some self-selection in panel membership, as all members shared a common concern for nursing home residents during the pandemic.
The easy way to misread this
Do not treat these statements as evidence-based clinical guidelines. They represent expert opinion and consensus in a rapidly evolving situation, and the panel explicitly disagreed on major issues like testing and immunity. Furthermore, the panel did not include nurses or direct care workers, limiting the applicability of these recommendations to bedside nursing practice.