[Experience of a mid-term care facility in the covid-19 with visit protocols.]

Abstract

Objective: The Hospital Virgen de la Poveda, (Villa del Prado, Spain), assists patients in need of Continuous medical care, Rehabilitation or Palliative care; these patients have many risk-factors of COVID-19 morbility and mortality. With both healthcare humanization and contagion-prevention purposes, in July 2020 two patient visit protocols were implemented. The objective of this study is to describe these measures qualitatively and quantitatively.

Methods: A context is provided regarding COVID-19 measures in this institution. The content and follow-up indicators of visit protocols (number of visits, of outbreaks, inpatients, etc.) and of their context were provided. The empirical outbreak probabilities were calculated, and hypothesis contrast was performed against no-visits (0%) and no visit-control (7-day cumulative incidence/habitant).

Results: Two protocols were created. Accompanying was applied to Palliative Care cases (no appointments required, no time limits), and a short visits protocol was applied to the other patients (appointments for 1 weekly visit for 1-2 persons were given and visits last up to 45 minutes). In both protocols, visitors with symptoms or fever or particularly susceptible were forbidden entrance. Between July and April 2021, 4,759 short-visit appointments were given and 7,544 total visits took place (short visits, accompanying, exceptions). An outbreak was possibly attributed to short visits (probability=0.021% [CI95%: 0.0005-0.1171%]) and two outbreaks were possibly attributed to visits globally (probability=0.0265% [IC95%: 0.0032-0.0958%]).

Conclusions: Elaborating adapted, applicable and prospectively-evaluated protocols with prevention measures at multiple levels might succeed in minimizing the risk of adverse events (in this case, COVID-19 outbreaks).