Impact of long-term care facility size on preparedness and adherence to infection prevention and control guidance for the mitigation of COVID-19

Wachholz, P. A.; Melo, R. C. d.; Jacinto, A. F.; Villas Boas, P. J. F.

Objectives: To evaluate the adherence of Brazilian long-term care facilities(LTCFs) to the World Health Organization(WHO) infection prevention and control(IPC) guidance, and examine its association with LTCF size. Methods: Cross-sectional study of LTCF managers. We classified adherence using a global adherence score as (1)excellent for LTCFs following [≥]14 recommendations, (2)good for those following 10-13, and (3)poor for those following <10 recommendations. LTCF size was established as small, medium, and large according to a 2-step cluster analysis. We used descriptive statistics and chi-square tests at a 5% significance level. Results:308(85.1%) out of 362 facilities adhered to 14 or more recommendations. We found a lower adherence to screening visitors(p=0.037) and isolating patients until they have 2 negative laboratory tests(p=0.032) in larger facilities. Discussion: Preparedness for mitigating COVID-19 in Brazilian LTCFs was considered excellent for most recommendations, regardless of LTCF size. Maintaining a sufficient stock of materials, workforce management, and financial distress were the most prevalent difficulties.