Pandemic Influenza Plans in Residential Care Facilities

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Abstract

OBJECTIVES:

To identify characteristics of residential care facilities (RCFs) associated with having a pandemic influenza plan.

DESIGN:

Nationally representative, cross-sectional survey.

SETTING:

RCFs in the United States.

PARTICIPANTS:

Participating facilities in the 2010 National Survey of RCFs (N = 2,294), representing 31,030 assisted living facilities and personal care homes.

MEASUREMENTS:

Facility-level characteristics associated with a pandemic influenza plan, including general organization descriptors, staffing, resident services, and immunization practices.

RESULTS:

Forty-five percent (95% confidence interval (CI) = 43–47%) had a pandemic plan, 14% (95% CI = 13–16%) had a plan in preparation, and 41% (95% CI = 38–43%) had no plan. In the multivariable model, organization characteristics, staffing, and immunization practices were independently associated with the presence of a pandemic preparedness plan. Organization characteristics were larger size (extra large, OR = 3.27, 95% CI = 1.96–5.46; large, OR = 2.60, 95% CI = 1.81–3.75; medium, OR = 1.66, 95% CI = 1.21–2.27 vs small), not-for-profit status (OR = 1.65, 95% CI = 1.31–2.09 vs for profit), and chain affiliation (OR = 1.65, 95% CI = 1.31–2.09 vs nonaffiliated). Staffing characteristics included number of registered nurse hours (<15 minutes, OR = 1.36, 95% CI = 1.07–1.74 vs no hours), any licensed practical nurse hours (OR = 1.47, 95% CI = 1.08–1.99 vs no hours), and at least 75 hours of required training for aides (OR = 1.34, 95% CI = 1.05–1.71 vs <75 hours). RCFs with high staff influenza vaccination rates (81–100%, OR = 2.12, 95% CI = 1.27–3.53 vs 0% vaccinated) were also more likely to have a pandemic plan.

CONCLUSION:

A majority of RCFs lacked a pandemic influenza plan. These facilities were smaller, for-profit, non-chain-affiliated RCFs and had lower staff vaccination rates. These characteristics may help target facilities that need to develop plans to handle a pandemic, or other disasters. J Am Geriatr Soc 62:1310–1316, 2014.

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