As the novel coronavirus began to take hold in the United States, disproportionately affecting residents of nursing homes, Luther Woods in Hatboro began utilizing data analytics combined with best medical practices to help reduce the spread of COVID-19.
The nursing home had started using Megadata Health Systems, a data analytics platform based in Lakewood, N.J., more than a year ago, initially for its financial reports, but then began utilizing it for clinical information as well, said Terri L. Costa, RN, Luther Woods administrator.
“We started getting daily reports,” said Costa, on residents’ temperatures and oxygen saturation levels.
The 140-resident nursing home was monitoring patient temperatures during every shift, looking for any over 99.4 degrees. In March, they incorporated oxygen saturation levels, looking for any patients with levels 1% below their normal, or baseline, levels, or for any patient whose level was below 95 %. Low oxygen saturation levels can mean a patient is developing a virus or bacterial infection, including pneumonia and/or COVID-19, Costa said.
“We’re doing vitals every shift,” she said, more often than normal, to keep track of shifts in temperature, and oxygen saturation levels, potential indicators of COVID-19. “Megadata accesses our data and issues a report. ... I can go into their website anytime. … This puts it all together; it’s right there for you to see.”
According to Shalom Reinman, a partner at Megadata Health Systems, the company provides dashboards, reports and other analytics that “help nursing homes achieve excellent clinical and operational outcomes.”
“For COVID-19,” Reinman said, “we developed special data tools to detect patterns across a facility and alert for the earliest possible indicators of COVID outbreaks. This allows our clients to act as early as possible to mitigate the spread of COVID in their buildings.”
In accordance with guidelines from the PA Department of Health via the Centers for Disease Control and Prevention, Luther Woods was monitoring workers’ temperatures upon entry and exit.
In line with Abington Hospital, the nursing home had begun requiring staff and independent contractors to wear surgical masks beginning March 14, and it made the switch to N95 masks on April 6.
“I am such a huge advocate of the protection the mask has to offer,” Costa said.
Coincidently, she said, on April 6, the nursing home learned one of its Certified Nursing Assistants had tested positive for COVID-19. Thirteen days after she was last at Luther Woods, and 10 days after she had tested positive, the first of the CNA’s patients also tested positive, and within 48 hours the majority of her patients had tested positive, Costa said.
“O2 alerts spiked,” Costa said. “Within 48 hours we had 12 more.”
A second worker who tested positive for COVID-19, and who also worked at another facility, did not transmit the virus to any residents at Luther Woods, Costa said. After that, however, Luther Woods did not permit anyone who worked there to also work at another facility.
“We told our employees they couldn’t come to our facility if they were working at other facilities,” Costa said. “We said, ‘You have to make a choice.’ They all decided to stay with us.” Anyone working at the facility through an outside agency worked at Luther Woods full time through their agency, rather than working at multiple facilities.
“We have had no new positives since the original exposure,” Costa said.
In all, 17 residents at Luther Woods, tested positive for COVID-19; five of them died. Both of the health-care providers survived.
“It was really hard for the staff,” Costa said of the deaths of the patients. “It was really emotional. I don’t think people understand we’re in this because we care.”
The symptoms of Luther Woods residents who tested positive were varied, Costa said, and in some cases, nonexistent.
“You had one symptom, we tested,” she said. “We’ve been COVID-testing from the very beginning.”
Symptoms of those testing positive included nine with very mild symptoms such as a cough and/or headache, at least one with a gastrointestinal issue and some with more severe respiratory problems. However, there were several who were asymptomatic.
“There was not one symptom that stood out,” Costa said. “Some people we were very concerned about got through with no problem,” she added.
Costa said Luther Woods wanted to thank the community for its support, including those who made and dropped off masks, shields and gowns, as well as Luther Woods’ parent corporation, Vida, and the state Department of Health.