These are facilities that care for people who suffer from physical or mental disability, some of who are of advanced age. The people living in LTCF are vulnerable populations who are at a higher risk for adverse outcome and for infection due to living in close proximity to others. So, LTCFs must take special precautions to protect their residents, employees and visitors.

Long-term care facilities are expected to maintain high standards of hygiene and sanitation during the COVID-19 crisis [Image: Freepik/master1305].

IPC focal points

LTCFs should ensure that there is an Infection Prevention and Control (IPC) focal point at the facility to lead and coordinate IPC activities, ideally supported by an IPC team with delegated responsibilities and advised by a multidisciplinary committee.

At a minimum, the IPC focal point should:

  • Provide COVID-19 IPC training to all employees, including:

– An overview of COVID-19

– Hand hygiene and respiratory etiquette

– Standard precautions

– COVID-19 transmission-based precautions

  • Provide information sessions for residents on COVID-19 to inform them about the virus, the disease it causes and how to protect themselves from infection
  • Regularly audit IPC practices (hand hygiene compliance) and provide feedback to employees
  • Increase emphasis on hand hygiene and respiratory etiquette:

– Ensure adequate supplies of alcohol-based hand rub (ABHR) [containing at least 60% alcohol] and availability of soap and clean water. Place them at all entrances, exits and points of care

– Post reminders, posters, flyers around the facility, targeting employees, residents and visitors to regularly use ABHR or wash hands

– Encourage hand washing with soap and water for a minimum of 40 seconds or with ABHR for a minimum of 20 seconds

– Require employees to perform hand hygiene frequently, in particular at the beginning of the workday, before and after touching residents, after using the toilet, before and after preparing food, and before eating.

  • Encourage and support residents and visitors to perform hand hygiene frequently, in particular when hands are soiled, before and after touching other people (although this should be avoided as much as possible), after using the toilet, before eating, and after coughing or sneezing.

– Ensure adequate supplies of tissues and appropriate waste disposal (in a bin with a lid).

– Post reminders, posters, flyers around the facility, targeting employees, residents, and visitors to sneeze or cough into the elbow or to use a tissue and dispose of the tissue immediately in a bin with a lid.

  • Maintain high standards of hygiene and sanitation practice. Guidance on water, sanitation, laundry, and waste management for COVID-19 is available.
  • Provide annual influenza vaccination and pneumococcal conjugate vaccines to employees and staff, according to local policies, as these infections are important contributors to respiratory mortality in older people.

 

Source: Infection Prevention and Control guidance for Long-Term Care Facilities in the context of COVID-19. WHO Interim guidance 21 March 2020.