Open AccessNewly Developed COVID-19 Bundle Greatly Reduces the Infection Fatality Rate for a Highly Vulnerable Nursing Home Population
Author(s) -
Howard J Finger,
Rani N Rao,
Giorgio R. Sansone,
E. Hazel,
Carmentina T Silvestri-Tan
Publication year - 2022
Publication title -
american journal of medical quality
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.592
H-Index - 53
eISSN - 1555-824X
pISSN - 1062-8606
DOI - 10.1097/01.jmq.0000741984.07868.d4
Subject(s) - medicine , covid-19 , case fatality rate , bundle , emergency medicine , vital signs , population , surgery , environmental health , materials science , disease , infectious disease (medical specialty) , composite material
This performance improvement initiative used a bundle designed to reduce the COVID-19 infection fatality rate (IFR) by ≥33% and the new infection rate (IR) to <1% among nursing home (NH) residents over a 3-month period at a large public NH in New York City. Participants were all NH residents, newly testing COVID-19 PCR positive between March 1, 2020 and June 30, 2020. Key bundle components involved close observation of all residents with vital signs taken once/shift, including O2 saturation, frequent clinical team follow-up visits for those symptomatic, and ramped-up COVID-19 PCR testing. From April to June, average IFR was 12.3%, a 49.6% reduction from the March baseline (P < 0.05), and average new IR was 5.4%, a 29.9% reduction from baseline (P < 0.05). In the 2 follow-up months, no deaths occurred with a new IR < 1%, indicating sustained improvement. Because of its simplicity, this bundle or components of it could be readily applied elsewhere after appropriate assessment.