COVID19 has especially impacted residents in skilled nursing facilities and long term care (SNF/LTC). Who are at extraordinary risk for infection and mortality. Residents with dementia are at even higher risk because of their need for individual personal care, lack of cognition, and the impact of social distancing and reduced social interaction on their underlying dementia. The staff and family members at SNF/LTCs are facing major challenges in confronting a new infectious disease, imposing visitation and socialization limits, and needing to identify new workflows to provide care to this group of residents who often have significant physical and mental health impairment This Supplement builds on our previous R21 work in SNF/LTCs and partners with 2 Baltimore SNF/LTCF network. We will use two complementary models to inform formative research and to develop a survey instrument which will ultimately guide an intervention: (1) Knowledge, Attitudes and Behavior (KAB) which is individual-focused; and, (2) Systems Engineering Initiative for Patient Safety (SEIPS), a Human Factors and Systems Engineering model, which defines the interactions among humans and other elements in complex sociotechnical work systems. Integrating both models will identify both knowledge gaps for the educational intervention and facilitators and barriers within the work system that may require structural modification. This is an NIA-defined Stage 0 Behavioral Intervention. The formative research phase of Aim 1 will include in-depth qualitative research with resident, family, and staff stakeholders in SNF/LTCFs. This will include 25 in-depth interviews with residents and/or their family members, 15 interviews with facility staff. The interview domains will address both KAB and human factors issues including intervention facilitators and barriers. This will inform development of a survey instrument in Aim 2, which combines the KAB and SEIPs approaches and which will be piloted in 50 residents/family and 20 staff members, to include post-hoc feasibility assessments. Data obtained from the formative research and pilot surveys will support the ultimate objective of developing an interactive intervention in Aim 3 based on behavioral science and human factors engineering principles, which will inform facility workflow redesign and a potential clinical trial intervention.
COVID19 is a major public health challenge and particularly impacts residents in skilled nursing facilities and long term care, and residents with Alzheimers and other dementias. These patients require attentive personal care, and social distancing is impossible. This project will interview patients, family members and staff to help us evaluate their knowledge and attitudes on COVID19 which will help in developing structural and functional alterations to the SNF/LTC environments to benefit residents and staff.
