Exploring Concurrent Approach for Respiratory Epidemiological Surveillance and Symptom Screening (CARES): a new strategy for preventing respiratory infection outbreaks in long-term care facilities

Abstract

Abstract Objective: The Concurrent Approach for Respiratory Epidemiological Surveillance and Symptom Screening (CARES) combines symptom screening to prevent external respiratory infections by managing staff and visitor health and surveillance to monitor the infection rates within the facility and take timely decisions on activity programs based on outbreak prevalence. This study examines the efficacy of the CARES strategy in preventing respiratory infection outbreaks in long-term care facilities. Design: Prospective cohort study utilizing historical controls including an intervention and control group. Setting: This study was conducted in two long-term care facility wards (total: 110 beds) in Japan. Patients: We enrolled patients aged 1–72 years from the target ward with severe intellectual and physical disabilities from October 1, 2018, to March 31, 2019, and from October 1, 2017, to March 31, 2018, for the intervention (n = 104) and control (n = 98) groups, respectively. The study included all admitted patients and excluded those hospitalized or discharged during the study period. Intervention: The total number of days that activity programs, new admissions, and visitations were cancelled in the two groups was compared before and after the introduction of CARES. Results: CARES reduced the duration of new admission cancellations and visitation cancellations by 16 and 23 days, respectively (α = 0.1, P value < 0.001). Additionally, the maximum duration of activity program cancellations was reduced by 2 days. Furthermore, five cases of presenteeism were prevented. Conclusions: CARES improves patients’ quality of life by continuation of activity programs, new patient admission, and ongoing visitations.