Differences in Nursing Home Staff COVID-19 Testing Rates and Odds of Vaccination Across Work Shifts
February 6, 2023
Investigators from the Improved Vaccine Uptake in Skilled Nursing Facilities: IMPACT-C supplement study, Elizabeth White, APRN, PhD, Jasmine L Travers, PhD, MHS, RN, Natalia Gouskova, PhD, Vincent Mor, PhD, and Sarah Berry, MD, PhD, published an article in Health Affairs exploring nursing home staff testing and vaccination rates. The investigators analyzed nursing home staff COVID-19 testing and immunization data from 294 facilities between April 2020-March 2021. They found that day-shift staff had the highest testing rates and odds of primary vaccination, while night-shift staff had the lowest.
Abstract
COVID-19 vaccination and regular testing of nursing
home staff have been critical interventions for mitigating disease outbreaks in US nursing homes. Although implementation of testing has largely been left to nursing home organizations to coordinate, vaccination occurred through a combination of state, federal, and organization efforts. Little research has focused on structural variation in these processes. We examined whether one structural factor, the primary shift worked by staff, was associated with differences in COVID-19 testing rates and odds of vaccination, using staff-level data from a multistate sample of 294 nursing homes. In facility fixed effects analyses, we found that night-shift staff had the lowest testing rates and lowest odds of vaccination, whereas day-shift staff had the highest testing rates and odds of vaccination. These findings highlight the need to coordinate resources and communication evenly across shifts when implementing large-scale processes in nursing homes and other organizations with shift-based workforces.