Communication between facilities can reduce patient risk for COVID-19
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Communication between hemodialysis and long-term care facilities can reduce patients’ risks for COVID-19 and adverse outcomes, according to an editorial published in Kidney Medicine.
“Unfortunately, for hemodialysis patients who live in long-term care, even stringent infection control measures are unlikely to fully compensate for the inability to physically distance,” Christine K. Liu, MD, MS, and colleagues wrote. “From our experience, we conclude that such patients are highly likely to contract COVID-19, and that robust communication between the dialysis and long-term care facilities and their clinicians must be a fundamental component of care for this highly vulnerable population.”
The editorial included a qualitative description of the care that one patient received at a hemodialysis facility and at a long-term care facility, as well as data from an ongoing study. Liu and colleagues initially collected data from March to May 2020 in a densely populated area with a high prevalence of COVID-19.
Researchers found the proportion of patients treated with hemodialysis who contracted COVID-19 was greater among those who lived in long-term care facilities compared with those who did not live in such facilities. Two of the authors had been treating the same patient for 5 years and separately discussed advance directive planning with him in early April 2020, although neither practitioner knew the other had because the long-term care facility and hemodialysis facility had separate electronic medical records. The authors wrote that it was not clear whether either facility was aware of the COVID-19 cases at the other. The patient developed a fever in mid-April 2020 and received a COVID-19 test at the hospital per the dialysis facility’s procedure because the long-term care facility’s testing vendor required advance notice. The patient was diagnosed with COVID-19 at the hospital and later died.
“In retrospect, there were missed opportunities on both sides to share key information,” researchers wrote. “Hemodialysis patients who live in long-term care are highly vulnerable to COVID-19, and this risk could be reduced with better communication between dialysis and long-term care facilities.”
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