Long-term care facilities are vulnerable to coronavirus. This team helps them prepare
Long-term care facilities have seen some of the largest, concentrated outbreaks of the coronavirus.
MultiCare, a local health care system, has stepped in to make sure Pierce County nursing homes, skilled nursing facilities and assisted care facilities have what they need to be proactive in curbing the spread of the virus and COVID-19, the disease it causes.
“At lot of them are not in an integrated system. They don’t have the benefit of a large hospital system, with multiple infection control specialists and communicable disease experts,” Dr. Jessica Van Fleet-Green, chief medical officer for Physicians of Southwest Washington said. “This is a community-based approach.”
The health care systems operates hospitals including Tacoma General, Good Samaritan and Mary Bridge Children’s and has partnered with 10 Pierce County long-term care facilities to help them weather the pandemic.
The Tacoma-Pierce County Health Department has not released how many positive cases have been reported at long-term care facilities in Pierce County.
As of Wednesday, 12 of Pierce County’s 40 long-term care facilities have reported at least one COVID-19 positive case.
Van Fleet-Green and Lynn Siedenstrang, vice president of care continuum for MultiCare, spoke to the staff at these facilities recently to help them get a plan in place and needed supplies when a resident tests positive.
MultiCare also created a voluntary “drop team” of five MultiCare doctors and a nurse practitioner to help care facilities as needed.
In one Tacoma facility, MultiCare staff tested all residents and staff after a reported case.
MultiCare would not name the facility for privacy reasons, spokesperson Marce Edwards said.
New policies
During the virtual discussion, Van Fleet-Green helped staff make changes to minimize the risk of infection. She recommended the facilities start using disposable kitchenware, clean surfaces throughout the day and hold residents’ mail for at least 24 hours before distributing.
They have separated those who have tested positive or are under investigation from those who haven’t, Van Fleet-Green said.
Visitors are not allowed in long-term care facilities, per Gov. Jay Inslee’s order. Staff have been handing out iPads so residents can reach out to loved ones.
Some daily tasks had to stop, like handing out non-essential vitamins or using nebulizers, which brings medication directly into the lungs.
Staff at these facilities also have received small amounts of personal protective equipment from MultiCare and lessons on how to safely put on and remove masks, gloves and gowns.
Asked about giving away rationed personal protective equipment, Siedenstrang said sharing PPE wasn’t a question. Providing long-term care facilities with some PPE keeps residents and staff safe, Siedenstrang said.
“It’s important that we support that work of care in place for these patients,” Siedenstrang said.
MultiCare and other health care providers receive large shipments of medical supplies, while long-term care facilities are lower on the priority list.
“They run on tight budgets, and they have not been well-prioritized for PPE unless they have positives,” Van Fleet-Green said.
Care in place
The facilities have been grateful for the help, Van Fleet-Green said.
“People don’t want to feel like they are putting themselves and family at risk,” she said. “These patients are family. It’s hard being a health care worker with people you don’t know, but to have a death with someone you’ve been taking care of for years, it’s really traumatic for them to go through that.”
Being proactive in helping long-term care facilities weather the pandemic is critical because there is not enough space in hospitals to hold all the people at these facilities if they contract the virus, Van Fleet-Green said.
She said it was important that residents stay at the facilities as long as it is safe to do so.
“We want to give them all the tools in the toolbox to care for that patient at that level of need,” Van Fleet-Green said. “There is transfer trauma going back and forth between the hospital. Imagine if you just suffered from a broken hip, it would be physically challenging to be put back on a gurney, going to the emergency room, being exposed to imaging, ambulance rides, and having to be up all night. That really slows recovery.”
