Did You Know That Sharing Staff Between Nursing Homes Can Exacerbate the Spread of COVID-19 in Nursing Homes?
Nursing Homes are comprised of multiple departments such as Nursing, Environmental, Dietary, Recreation, etc. The Nursing department is the largest, having on average, 59% of all Nursing Home employees. In U.S. Nursing Homes, 37% of Nursing Home employees are Nursing Assistants, 13% are Licensed Practical and Licensed Vocational Nurses, and 9% are Registered Nurses (U.S Bureau of Labour Statistics, 2018).
Nurses Assistants are hands-on employees who provide direct care to patients 24/7, while Nurses are more involved with medication administration, treatments, and documentation.
Despite the hard work of the nursing assistants, their median pay is only about $13.73/hr ($28,558.40 per year) (U.S Beaure of Labour Statistic, 2018). Because of their low-income status, 50% of these Nursing Assistants have a second full-time or part-time job to help them sustain a living. As a result, Nursing Assistants may go from one job to the next, on the same day without having the opportunity to go home, take a shower, and change their uniforms before going to their next job.
With this practice, there are higher chances that a Nursing Assistant can work in a facility that has COVID-19 and go straight to another facility that does not have COVID-19, thereby increasing the chances of spreading COVID-19 into that facility.
In addition to Nursing Assistants working in multiple facilities to make ends meet, most facilities use nurses from agency staff pools to complement their employee ratio. Most of the agency staff, work in multiple facilities and can go from one facility straight to the next, on the same day, also without the opportunity to change their uniforms. As a result, they can also unintentionally contribute to the spread of COVID-19.
Nurses in nursing homes are responsible for administering medications to patients. Sometimes these nurses may give nebulizing breathing treatments (bronchodilator) to patients with COVID-19. These treatments generate an aerosol that increases the risk of droplets that remain in the air and on surfaces (Institute for Safe Medication Practice, 2020). This risk includes infected droplets remaining on the nurse’s uniform. Therefore, when nurses (i.e. Agency Nurses) travel from one facility to the next, without changing their uniforms, there is a possibility of them spreading COVID-19.
To effectively monitor the spread of COVID-19 in nursing homes, Administrators and Directors of Nurses should:
Identify the nursing assistants and nurses who work in other nursing homes.
Identify the nursing homes where they work.
Find out the COVID-19 status in those homes.
Encourage those staff members to change their uniforms and/or provide uniforms for staff to change into upon arrival to work.
Bargain with staff to rearrange their work schedules to only work their other job on their days off from your facility.
Explore the possibility of financial compensation to staff to avoid going to the second job.
It is critical that nursing home Operators; Administrators; Directors of Nursing; Local, State, and Federal Governments, and all stakeholders, work cohesively to minimize the spread of COVID-19 in the nursing homes, where the COVID-19’s most vulnerable population resides.
References
Institute for Safe Medication Practice (2020). Revisiting the need for MDI common canister protocols during covid19 pandemic. Retrieved from:https://ismp.org/resources/revisiting-need-
mdi-common-canister-protocols-during-covid-19-pandemic.
U.S Beaure of Labour Statistics (2018).Occupational and Employment Wages: Nursing Assistants. Retrieved from:https://www.bls.gov/oes/2018/may/oes311014.