Communicating with Healthcare Workers in Long-Term Care and Dialysis Settings During the COVID-19 Pandemic

Background:

Healthcare workers (HCWs) on the frontlines, including long-term care and dialysis workers, continued to interact frequently with their residents/patients and provide routine care throughout the COVID-19 pandemic. HCWs needed information to prevent the spread of COVID-19 in their facilities and became a primary source of information about COVID-19 vaccines for their residents/patients.

Program background:

Communicators from CDC created products for long-term care facilities, dialysis facilities, and other settings. These products included four short YouTube trainings about core infection prevention and control (IPC) practices such as hand hygiene, environmental disinfection, and personal protective equipment. Communicators also developed fact sheets and fillable letters for long-term care and dialysis facility leadership to share with staff, residents, and patients about IPC recommendations and COVID-19 vaccines. Additional products included webpages and toolkits explaining federal COVID-19 vaccination programs for long-term care and dialysis settings.

Evaluation Methods and Results:

The video trainings received more than 1.8 million views from April 2020-April 2023. Two of the factsheets, “Supporting Your Loved One in a Long-Term Care Facility” and “Sample Notification Letter to Residents and Families: COVID-19 Transmission Identified” had more than 8,800 and 1,110 downloads respectively in 2021.

Resources aimed to build trust and credibility using risk communications principles of “be first,” “be right,” and “be credible.” Providing rapid, accurate information that acknowledged uncertainty and was transparent about the unknowns was essential. Resources expressed empathy for the stress HCW were enduring and the discomfort their patients/residents were experiencing. In addition, they promoted meaningful actions for HCWs to keep themselves and their patients safe.

Healthcare settings employ HCWs of varying education and skill level. We learned that HCWs need resources that are easy-to-find on the web, digestible so they can be viewed on the job in between the care of patients or residents, and delivered in multiple formats (web, multimedia, and print). We also learned that some healthcare facilities did not realize they were considered long-term care settings, and therefore eligible for the federal vaccination program, and many HCWs such as dialysis technicians or certified nursing assistants did not view IPC as their responsibility, so these materials needed to explicitly state that guidance applied to them. Lastly, these HCWs have frequent interaction with their patients/residents and were an important avenue to reach patients/residents with COVID-19 IPC and vaccination messaging.

Conclusions:

These communication products were developed rapidly due to pace of the COVID-19 pandemic, however the lessons learned from HCWs interacting with these products can be strategically applied to future communications work in these settings.

Implications for research and/or practice:

Practice implications include the importance of developing products in multiple formats, understanding institutional and target audience self-recognition, and partnering with HCW professional organizations and other federal agencies (Centers for Medicare & Medicaid Services, Administration for Community Living, etc.) to disseminate messages and gain awareness of challenges in the field.