The association of nursing home infection preventionists’ training and credentialing with resident COVID 19 deaths.

The association of nursing home infection preventionists’ training and credentialing with resident COVID 19 deaths.

Publication date: Jan 19, 2024

Nursing home (NH) residents’ vulnerability to COVID-19 underscores the importance of infection preventionists (IPs) within NHs. Our study aimed to determine whether training and credentialing of NH IPs were associated with resident COVID-19 deaths. This retrospective observational study utilized data from the Centers for Disease Control and Prevention’s National Healthcare Safety Network NH COVID-19 Module and USAFacts, from May 2020 to February 2021, linked to a 2018 national NH survey. We categorized IP personnel training and credentialing into four groups: (1) LPN without training; (2) RN/advanced clinician without training; (3) LPN with training; and (4) RN/advanced clinician with training. Multivariable linear regression models of facility-level weekly deaths per 1000 residents as a function of facility characteristics, and county-level COVID-19 burden (i. e., weekly cases or deaths per 10,000 population) were estimated. Our study included 857 NHs (weighted nā€‰=ā€‰14,840) across 489 counties and 50 states. Most NHs had over 100 beds, were for profit, part of chain organizations, and located in urban areas. Approximately 53% of NH IPs had infection control training and 82% were RNs/advanced clinicians. Compared with NHs employing IPs who were LPNs without training, NHs employing IPs who were RNs/advanced clinicians without training had lower weekly COVID-19 death rates (-1. 04 deaths per 1000 residents; 95% CI -1. 90, -0. 18), and NHs employing IPs who were LPNs with training had lower COVID-19 death rates (-1. 09 deaths per 1000 residents; 95% CI -2. 07, -0. 11) in adjusted models. NHs with LPN IPs without training in infection control had higher death rates than NHs with LPN IPs with training in infection control, or NHs with RN/advanced clinicians in the IP role, regardless of IP training. IP training of RN/advanced clinician IPs was not associated with death rates. These findings suggest that efforts to standardize and improve IP training may be warranted.

Concepts Keywords
Death COVID-19
Nursing credentialing
Usafacts infection preventionists
Weekly nursing homes
staffing
training

Semantics

Type Source Name
disease MESH infection
disease MESH COVID 19
disease IDO facility
disease VO population
disease MESH death
disease MESH Long Covid

Original Article

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