infection prevention
infection prevention
By Shanina Knighton , PhD , RN , CIC
Considering Health Equity in Infection Prevention & Control Against Contagious Respiratory Viruses for Multigenerational Households in the Post-COVID-19 Era
It is established that race , ethnicity , and socioeconomic status ( SES ) are associated with the incidence or infections of communicable illnesses and or death . Lower access to healthcare , greater exposures through employment , housing situation 1 and a lack of education and understanding how to navigate life before , during and after exposure are contributing factors . However , a factor often overlooked that is intersectional with these challenges is infection prevention and control education for overcrowded households or multigenerational households ( MGHs ).
Overall , it is estimated that 20 percent of the U . S . population lives in a MGHs 2 , 3 which is defined as households that include two or more adult generations , or grandparents and grandchildren younger than 25 living under one roof . Black American and Latino families are more likely to live as part of a multigenerational household than others . In 2016 , compared to 16 percent of Whites , Black families were estimated to have 26 percent of people dwell in multigenerational households and Latino families 27 percent . 2 Dense housing is often driven by economic pressures such as recent unemployment or lack of alternatives for caregiving . 4 Additionally , cultural norms and a sense of shared familial responsibilities for taking care of the young and the old in the family may contribute to these trends . 4 , 5
Individuals living in community-dwelling , low-income MGHs are likely one of the more difficult undeserved and vulnerable populations to reach . For individuals living in multigenerational housing , particularly infants and older adults and those with underlying health conditions , these challenges lead to a disproportionate risk for exposure to communicable respiratory viruses and once exposed , these individuals suffer the most severe consequences of these viruses . 6 MGHs are more likely to have family members with varying viewpoints ( e . g ., vaccine hesitancy ) in the current era of COVID-fatigue and science mistrust that can influence the outcomes of the home .
Unlike congregate living such as assisted living , nursing homes and group homes , multigenerational and overcrowded households do not have organizational advocates or practical informational resources applicable to their living situation . Furthermore , in congregate living settings standardized education and policies are put in place such as regular hand hygiene practice , support with cleaning of linens , environmental cleaning and safe food and medication handling . Thus , alternative , and innovative approaches to support infection prevention and control education for MGHs are critical to maintain interest and promote adherence to fundamental strategies that prevent the transmission of germs that lead to viruses such as influenza and SARS-CoV-2 .
Infection prevention and control utilizing audience-specific messaging and educational resources especially for lower-income MGHs can be effective when tailored to address influential factors such as age , learning styles , and the source of people ’ s trusted information . For example , older adults may traditionally watch the news whereas teenagers and young adults may get their information from social media sources .
Oftentimes , when education is provided to patients upon discharge , the information provided takes into account directions for the patient , but rarely addresses infection prevention and control for where they live , work and play to not only protect themselves from complications and illness but to also protect their families .
Standardized education for households will vary , but it is important that as infection prevention and control move into community settings we start to connect the ‘ why ’ behind the ‘ why ’ for people . For example , explaining why family members should clean the handles to the fridge , light switches , doorknobs etc . that is commonly used by all and especially when someone in the home has a known illness . Furthermore , it is also producing a prevention plan that can minimize waiting too late to seek out care . Below , while there are many topics that can be discussed , I provide some areas that the public health community should focus on for improving the missing gap of multigenerational household infection prevention and control education .
MGHs Need Education About How :
To make an emergency response list of doctor information including phone numbers , putting it in an accessible place like the refrigerator , and alert others where it is . Call the doctor if you or your household member is getting sicker .
Track your symptoms and have someone track your symptoms : take their temperature several times a day , record readings , and note when new symptoms occur .
To not wait to be seen if you have life-threatening symptoms such as chest pain or pressure that does not go away , confusion or cannot be woken up , shortness of breath , trouble breathing , feeling “ off ,” bluish lips , fingers , feet , or face . Call 9-1-1 and seek emergency care .
Prevent spreading viruses from you to your loved ones and vice versa .
Avoid touching face , especially after handling items touched by sick household members . Contagious respiratory viruses transfer by eyes mouth and nose droplets .
Hand Hygiene : Everyone in the home should wash hands often and correctly ( 20 to 25 seconds ). Remember drying is just as important as washing . Clean your hands before and after touching your face and any items touched your or sick person .
Masks : Consider masks in the home for everyone to ensure germs are not being transferred between sick and well household members . Sick member should wear a mask . Always wash or sanitize hands first before and after using a mask , never leave a dirty mask sitting around , apply your mask to a clean face , do not take your mask off from the front , only remove ear to ear . Cough and sneeze into your elbow . Do not wear a mask if you think masks is troubling your anxiety , asthma , allergies , or chronic breathing problems , or under the age of 2 years old , but stay isolated . Wash masks daily , however , if possible , consider disposable ones if sick person cannot clean their mask daily .
Physical distance when possible : Limit contact with others as much as possible . Try to minimize your footprint by having a dedicated space if possible . Do not go within six feet of others in
10 • www . healthcarehygienemagazine . com • may 2024