Nursing homes that conduct rapid, on-site testing of residents who exhibit flu-like symptoms can lead to earlier detection of outbreaks and reduce hospitalization rates, according to new research.
Facilities using the rapid tests became more adept at “spotting and halting” outbreaks that flu cases fell from 22% in the first year of the study to 3% in the final year, said the researchers from the University of Wisconsin School and Medicine and Public Health. Emergency room visits at facilities that conducted rapid testing dropped by 22%, hospitalizations fell 21%, and the length of hospital stays plummeted 36%, the research said.
“This study demonstrates the profound effect of early detection of influenza in long-term care facilities,’’ said lead author Jonathan Temte, MD, PhD, professor of family medicine and community health at the UW School of Medicine and Public Health. “Nursing homes are collections of very vulnerable individuals, so anything we can do to protect them is very important.”
The study took place in 20 nursing homes in Wisconsin over the course of three flu seasons from 2016 to 2019. Half of the facilities followed their normal flu protocols of testing patients whose symptoms meet the standard definition of influenza. Nasal swabs were sent to off-site labs for analysis, which could take up to three days to communicate results, resulting in a delay of administering antivirals to residents. The remaining facilities used a broader definition of symptoms — sometimes as minor as a new runny nose without an accompanying fever — and used rapid, on-site tests that could yield results in as fast as 15 minutes. The study noted that fevers and other symptoms tend not to present in older patients.
“The quicker results helped stamp out flu outbreaks,” Temte said. “Time is of the essence for managing influenza because the virus proliferates very quickly.”
Nine of the 10 nursing homes that used the on-site, rapid test wanted to continue with that process after the research ended. The test kits cost approximately $12 each compared to $2,883, which is the cost of an average, per-day hospital stay.
Protecting patients through surveillance could be a critical tool for nursing homes.
While almost all US hospitals mandate flu vaccination for their healthcare workers, comparatively few nursing homes do. Previous studies have shown the long-term care workforce has the lowest share of workers vaccinated against influenza.
Pressure is ratcheting up to ensure coverage, with a new Centers for Medicare & Medicaid Service rule requiring reporting of staff doses received annually between Oct. 1 and March 31. The Influenza Vaccination Coverage among Healthcare Personnel measure was added to the Quality Reporting Program as part of the FY 2023 SNF PPS Final Rule.The study was published in the Journal of the American Medical Directors Association.
