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Article ; Online: Value of a confidential COVID-19 helpline for nursing home staff.

Gussin, Gabrielle M / Singh, Raveena D / Nguyen, Kristine P / Huang, Susan S

2022 Volume 51, Issue 7, Page(s) 841–843

Abstract: We hosted a confidential helpline to address concerns about COVID-19 prevention among staff in 12 nursing homes in Orange County, California. We fielded 301 inquiries from April 2021-April 2022, most commonly involving questions about vaccines (40%), ... ...

Abstract	We hosted a confidential helpline to address concerns about COVID-19 prevention among staff in 12 nursing homes in Orange County, California. We fielded 301 inquiries from April 2021-April 2022, most commonly involving questions about vaccines (40%), nursing home COVID-19 prevention (28%), SARS-CoV-2 variants (18%), symptom reporting (10%), and home and community COVID-19 prevention (5%). During COVID-19 surges, staff dominantly expressed fear, anger, and exhaustion. During nadirs, sentiment shifted towards optimism and acceptance.
MeSH term(s)	Humans ; COVID-19/prevention & control ; SARS-CoV-2 ; Nursing Homes ; Skilled Nursing Facilities
Language	English
Publishing date	2022-11-18
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2022.11.004
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Article ; Online: Impact of Alzheimer's disease and related dementias (ADRD) on the quality of room cleaning in nursing homes.

Hsi, Joshua B / Singh, Raveena D / Pedroza, Robert / Gussin, Gabrielle M / Tjoa, Thomas T / Gohil, Shruti K

Infection control and hospital epidemiology

2023 Volume 44, Issue 9, Page(s) 1508–1510

Abstract: Persons with Alzheimer's disease and related dementias (ADRD) are prone to receiving reduced quality of care. We compared the quality of room cleaning of rooms with ADRD residents and rooms with non-ADRD residents in nursing homes using an ultraviolet ( ... ...

Abstract	Persons with Alzheimer's disease and related dementias (ADRD) are prone to receiving reduced quality of care. We compared the quality of room cleaning of rooms with ADRD residents and rooms with non-ADRD residents in nursing homes using an ultraviolet (UV) marker. ADRD status was associated with greater failure of UV marker removal (odds ratio, 1.68; 95% confidence interval, 1.04-2.71;
MeSH term(s)	Humans ; Alzheimer Disease ; Nursing Homes
Language	English
Publishing date	2023-02-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.7
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Article ; Online: Evaluating barriers and potential solutions to speaking up about coronavirus disease 2019 (COVID-19) symptoms: A survey among nursing home workers.

Gussin, Gabrielle M / Singh, Raveena D / Tjoa, Thomas T / Saavedra, Raheeb / Kaplan, Sherrie H / Huang, Susan S

Infection control and hospital epidemiology

2023 Volume 44, Issue 11, Page(s) 1834–1839

Abstract: Objective: Quantify the frequency and drivers of unreported coronavirus disease 2019 (COVID-19) symptoms among nursing home (NH) staff.: Design: Confidential telephone survey.: Setting: The study was conducted in 70 NHs in Orange County, ... ...

Abstract	Objective: Quantify the frequency and drivers of unreported coronavirus disease 2019 (COVID-19) symptoms among nursing home (NH) staff. Design: Confidential telephone survey. Setting: The study was conducted in 70 NHs in Orange County, California, December 2020-February 2022. Participants: The study included 120 NH staff with COVID-19. Methods: We designed a 40-item telephone survey of NH staff to assess COVID-19 symptom reporting behavior and types of barriers [monetary, logistic, and emotional (fear or stigma)] and facilitators of symptom reporting using 5-point Likert scales. Summary statistics, reliability of survey constructs, and construct and discriminant validity were assessed. Results: Overall, 49% of surveys were completed during the 2020-2021 COVID-19 winter wave and 51% were completed during severe acute respiratory coronavirus virus 2 (SARS-CoV-2) δ (delta)/ (omicron) waves, with a relatively even distribution of certified nursing assistants, licensed vocational or registered nurses, and nonfrontline staff. Most COVID-19 cases (71%) were detected during mandated weekly NH surveillance testing and most staff (67%) had ≥1 symptom prior to their test. Only 34% of those with symptoms disclosed their symptom to a supervisor. Responses were consistent across 8 discrete survey constructs with Cronbach α > 0.70. In the first wave of the pandemic, fear and lack of knowledge were drivers of symptom reporting. In later waves, adequate staffing and sick days were drivers of symptom reporting. COVID-19 help lines and encouragement from supervisors facilitated symptom reporting and testing. Conclusions: Mandatory COVID-19 testing for NH staff is key to identifying staff COVID-19 cases due to reluctance to speak up about existing symptoms. Active encouragement from supervisors to report symptoms and stay home when ill was a major driver of symptom reporting and resultant infection prevention and worker safety measures.
MeSH term(s)	Humans ; COVID-19/diagnosis ; COVID-19/epidemiology ; COVID-19 Testing ; SARS-CoV-2 ; Reproducibility of Results ; Nursing Homes
Language	English
Publishing date	2023-04-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.51
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Article ; Online: Beyond Costs: Pragmatic Considerations for Pooling of SARS-CoV-2 Test Samples for Nursing Home Surveillance.

Gussin, Gabrielle M / Singh, Raveena D / Tifrea, Delia F / Tjoa, Thomas / Bittencourt, Cassiana E / Edwards, Robert A / Monuki, Edwin S / Huang, Susan S

Microbiology spectrum

2023 , Page(s) e0388022

Abstract: Pooling of samples can increase throughput and reduce costs for large-scale SARS-CoV-2 testing when incidence is low. In a cross-sectional study of serial SARS-CoV-2 sampling of staff and residents at three nursing homes, laboratory labor constraints ... ...

Abstract	Pooling of samples can increase throughput and reduce costs for large-scale SARS-CoV-2 testing when incidence is low. In a cross-sectional study of serial SARS-CoV-2 sampling of staff and residents at three nursing homes, laboratory labor constraints limited the feasibility of pooling prior to the maximal incidence that favored cost savings.
Language	English
Publishing date	2023-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2807133-5
ISSN	2165-0497 ; 2165-0497
ISSN (online)	2165-0497
ISSN	2165-0497
DOI	10.1128/spectrum.03880-22
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Cost-effectiveness of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) testing and isolation strategies in nursing homes.

Bartsch, Sarah M / Weatherwax, Colleen / Martinez, Marie F / Chin, Kevin L / Wasserman, Michael R / Singh, Raveena D / Heneghan, Jessie L / Gussin, Gabrielle M / Scannell, Sheryl A / White, Cameron / Leff, Bruce / Huang, Susan S / Lee, Bruce Y

Infection control and hospital epidemiology

2024 , Page(s) 1–8

Abstract: Objective: Nursing home residents may be particularly vulnerable to coronavirus disease 2019 (COVID-19). Therefore, a question is when and how often nursing homes should test staff for COVID-19 and how this may change as severe acute respiratory ... ...

Abstract	Objective: Nursing home residents may be particularly vulnerable to coronavirus disease 2019 (COVID-19). Therefore, a question is when and how often nursing homes should test staff for COVID-19 and how this may change as severe acute respiratory coronavirus virus 2 (SARS-CoV-2) evolves. Design: We developed an agent-based model representing a typical nursing home, COVID-19 spread, and its health and economic outcomes to determine the clinical and economic value of various screening and isolation strategies and how it may change under various circumstances. Results: Under winter 2023-2024 SARS-CoV-2 omicron variant conditions, symptom-based antigen testing averted 4.5 COVID-19 cases compared to no testing, saving $191 in direct medical costs. Testing implementation costs far outweighed these savings, resulting in net costs of $990 from the Centers for Medicare & Medicaid Services perspective, $1,545 from the third-party payer perspective, and $57,155 from the societal perspective. Testing did not return sufficient positive health effects to make it cost-effective [$50,000 per quality-adjusted life-year (QALY) threshold], but it exceeded this threshold in ≥59% of simulation trials. Testing remained cost-ineffective when routinely testing staff and varying face mask compliance, vaccine efficacy, and booster coverage. However, all antigen testing strategies became cost-effective (≤$31,906 per QALY) or cost saving (saving ≤$18,372) when the severe outcome risk was ≥3 times higher than that of current omicron variants. Conclusions: SARS-CoV-2 testing costs outweighed benefits under winter 2023-2024 conditions; however, testing became cost-effective with increasingly severe clinical outcomes. Cost-effectiveness can change as the epidemic evolves because it depends on clinical severity and other intervention use. Thus, nursing home administrators and policy makers should monitor and evaluate viral virulence and other interventions over time.
Language	English
Publishing date	2024-02-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2024.9
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Article ; Online: Impact of universal chlorhexidine bathing with or without COVID-19 intensive training on staff and resident COVID-19 case rates in nursing homes.

Gussin, Gabrielle M / Singh, Raveena D / Gohil, Shruti K / Saavedra, Raheeb / Tjoa, Thomas T / Nguyen, Kristine P / Pedroza, Robert / Hsi, Joshua B / O'Brien, Kevin / Berman, Chase / Park, Jessica / Hsi, Emily A / Ghasemian, Kimia / Osalvo, Avy / Chun, Stephanie / Fonda, Emily / Huang, Susan S

Infection control and hospital epidemiology

2024 , Page(s) 1–4

Abstract: We evaluated whether universal chlorhexidine bathing (decolonization) with or without COVID-19 intensive training impacted COVID-19 rates in 63 nursing homes (NHs) during the 2020-2021 Fall/Winter surge. Decolonization was associated with a 43% lesser ... ...

Abstract	We evaluated whether universal chlorhexidine bathing (decolonization) with or without COVID-19 intensive training impacted COVID-19 rates in 63 nursing homes (NHs) during the 2020-2021 Fall/Winter surge. Decolonization was associated with a 43% lesser rise in staff case-rates (
Language	English
Publishing date	2024-03-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2024.30
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Zs.A 1714: Show issues

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Article ; Online: Central-line team effort: Recognizing insertion-site concerns in nursing homes.

Nguyen, Kristine P / Singh, Raveena D / Saavedra, Raheeb / Gohil, Shruti K / Billimek, John T / Tam, Steven P / Steinberg, Karl E / Porter, Lori / Huang, Susan S

Infection control and hospital epidemiology

2023 Volume 44, Issue 11, Page(s) 1887–1889

MeSH term(s)	Humans ; Nursing Homes ; Catheterization
Language	English
Publishing date	2023-08-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.165
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Article ; Online: Not as simple as it seems: extensive facility and training gaps in nursing home bathing.

Nguyen, Kristine P / Singh, Raveena D / Saavedra, Raheeb / Billimek, John T / Tam, Steven P / Steinberg, Karl E / Porter, Lori / Mitchell, John / Huang, Susan S

Infection control and hospital epidemiology

2023 Volume 44, Issue 9, Page(s) 1490–1493

Abstract: Standardized observation of bed baths and showers for 100 residents in 8 nursing homes revealed inadequate cleansing of body sites (88%-100% failure) and >90% process failure involving lather, firm massage, changing dirty wipes or cloths, and following ... ...

Abstract	Standardized observation of bed baths and showers for 100 residents in 8 nursing homes revealed inadequate cleansing of body sites (88%-100% failure) and >90% process failure involving lather, firm massage, changing dirty wipes or cloths, and following clean-to-dirty sequence. Insufficient water warmth affected 86% of bathing opportunities. Bathing training and adequate resources are needed.
MeSH term(s)	Humans ; Baths ; Nursing Homes ; Skilled Nursing Facilities
Language	English
Publishing date	2023-06-16
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.109
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Article ; Online: How the Timing of Annual COVID-19 Vaccination of Nursing Home Residents and Staff Affects Its Value.

Bartsch, Sarah M / Weatherwax, Colleen / Wasserman, Michael R / Chin, Kevin L / Martinez, Marie F / Velmurugan, Kavya / Singh, Raveena D / John, Danielle C / Heneghan, Jessie L / Gussin, Gabrielle M / Scannell, Sheryl A / Tsintsifas, Alexandra C / O'Shea, Kelly J / Dibbs, Alexis M / Leff, Bruce / Huang, Susan S / Lee, Bruce Y

Journal of the American Medical Directors Association

2024 Volume 25, Issue 4, Page(s) 639–646.e5

Abstract: Objectives: To evaluate the epidemiologic, clinical, and economic value of an annual nursing home (NH) COVID-19 vaccine campaign and the impact of when vaccination starts.: Design: Agent-based model representing a typical NH.: Setting and ... ...

Abstract	Objectives: To evaluate the epidemiologic, clinical, and economic value of an annual nursing home (NH) COVID-19 vaccine campaign and the impact of when vaccination starts. Design: Agent-based model representing a typical NH. Setting and participants: NH residents and staff. Methods: We used the model representing an NH with 100 residents, its staff, their interactions, COVID-19 spread, and its health and economic outcomes to evaluate the epidemiologic, clinical, and economic value of varying schedules of annual COVID-19 vaccine campaigns. Results: Across a range of scenarios with a 60% vaccine efficacy that wanes starting 4 months after protection onset, vaccination was cost saving or cost-effective when initiated in the late summer or early fall. Annual vaccination averted 102 to 105 COVID-19 cases when 30-day vaccination campaigns began between July and October (varying with vaccination start), decreasing to 97 and 85 cases when starting in November and December, respectively. Starting vaccination between July and December saved $3340 to $4363 and $64,375 to $77,548 from the Centers for Medicare & Medicaid Services and societal perspectives, respectively (varying with vaccination start). Vaccination's value did not change when varying the COVID-19 peak between December and February. The ideal vaccine campaign timing was not affected by reducing COVID-19 levels in the community, or varying transmission probability, preexisting immunity, or COVID-19 severity. However, if vaccine efficacy wanes more quickly (over 1 month), earlier vaccination in July resulted in more cases compared with vaccinating later in October. Conclusions and implications: Annual vaccination of NH staff and residents averted the most cases when initiated in the late summer through early fall, at least 2 months before the COVID-19 winter peak but remained cost saving or cost-effective when it starts in the same month as the peak. This supports tethering COVID vaccination to seasonal influenza campaigns (typically in September-October) for providing protection against SARS-CoV-2 winter surges in NHs.
MeSH term(s)	Aged ; Humans ; United States/epidemiology ; COVID-19 Vaccines ; COVID-19/epidemiology ; COVID-19/prevention & control ; SARS-CoV-2 ; Medicare ; Vaccination ; Nursing Homes
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2024-03-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2024.02.005
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Article ; Online: Can testing the environment for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) be a signal for coronavirus disease 2019 (COVID-19) cases among nursing home staff?

Gussin, Gabrielle M / Singh, Raveena D / Coimbra Ibraim, Izabela / Saavedra, Raheeb / Tjoa, Thomas T / Curtis, Micaila / Nguyen, Kristine P / Messaoudi, Ilhem / Huang, Susan S

Infection control and hospital epidemiology

2022 Volume 44, Issue 5, Page(s) 847–848

MeSH term(s)	Humans ; COVID-19 ; SARS-CoV-2 ; Nursing Homes ; Virus Diseases ; Skilled Nursing Facilities
Language	English
Publishing date	2022-12-27
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2022.303
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