The aim of this article is to describe two interventions carried out during the first wave of the COVID19 pandemic to support healthcare personnel at 60 nursing homes, located within the coverage area of a 613-bed university tertiary care hospital.
In the first intervention, a geriatrician provided telephone support, including help with the clinical management of residents, the administration of intravenous and/or hospital-based treatments, provision of oxygen therapy at the facility, blood and diagnostic tests, and the coordination of disinfection by the Military Emergency Unit. In the second intervention, the multidisciplinary care team also performed on-site visits to the nursing homes.
In the first telephone support intervention 4,553 cases were evaluated. Of these cases, 645 residents (14.2%) were given on-site intravenous therapy; 419 cases (9%) were prescribed oxygen therapy, and 573 nasopharyngeal exudate samples were tested (RT-PCR). In the second intervention, 4,965 residents were assessed on-site. Of these, intravenous treatment was prescribed in 316 patients (6.3% of cases) and oxygen therapy in 634 (12.7%). A total of 2.458 RT-PCR tests were performed on residents and workers. There was a decrease in the mortality rate ten days after the implementation of the second intervention.
Geriatrician-directed telephone support is a highly efficient and essential approach to coordinate long-distance healthcare delivery at nursing homes, but it doesn't seem to reduce mortality. Interventions, including multidisciplinary/Geriatrics visits in nursing homes during pandemics are needed to study if mortality rates can be reduced.