Enhancing Public Health Capacity to Prevent and Respond to COVID-19 Outbreaks in Nursing Homes

Our findings highlight strategies for enhancing public health capacity to prevent and respond to COVID-19 outbreaks in nursing homes and provide a possible model to increase public health infection prevention and control capacity for other infectious diseases and other healthcare settings.

Identifying the need to train an expanding public health workforce in COVID-19 IPC for nursing homes

The Coronavirus Disease 2019 (COVID-19) pandemic created a high demand for public health staff with infection prevention and control (IPC) knowledge and skills to prevent and respond to COVID-19 outbreaks in healthcare settings with a high burden of infections, particularly in nursing homes. To support hiring and other COVID-19 prevention and response activities, the Centers for Disease Control and Prevention (CDC) provided funding to state, territorial, and local public health agencies across the nation, including Healthcare-associated Infection and Antibiotic Resistance (HAI/AR) Programs.

Despite emergency funding for hiring and prevention and response activities, public health agencies faced challenges scaling up workforce capacity, and HAI/AR Programs reported needing CDC’s support to train their new and less experienced staff in COVID-19 IPC for nursing homes. To address this training need, CDC developed the COVID-19 IPC 101 for HAI/AR Programs course. In our recent report, we describe impacts and key takeaways from the course.

Development, Implementation, and Evaluation of CDC’s COVID-19 IPC 101 for HAI/AR Programs Course

Using feedback from HAI/AR Programs, we rapidly developed and implemented a virtual training course in October 2020 that covered the basics of COVID-19 IPC in nursing homes for new and less experienced public health staff. The course curriculum included sessions focused on applying CDC’s interim COVID-19 healthcare IPC guidance for nursing homes and on performing IPC assessments and consultations to prevent and respond to COVID-19 outbreaks.

To evaluate the course curriculum, format, and changes in learners’ knowledge and confidence, we distributed electronic pre- and post-course assessments to learners at regular intervals. We also collected feedback from HAI/AR Program managers to measure the impact of the course for public health programs. By the end of August 2021, we had trained 171 learners from state and local health departments across the nation.

Key capacity-building takeaways for the broader public health workforce

Our findings highlight effective strategies for increasing knowledge and confidence for COVID-19 IPC in nursing homes among new and less experienced public health staff. As both learners and HAI/AR Program managers reported benefiting from our course, this approach is now serving as a model for developing public health workforce trainings to increase IPC capacity for other infectious diseases and other healthcare settings.

We identified the following key capacity-building takeaways for the broader public health workforce:

  • Consider virtual training approaches to increase capacity among public health learners.
  • Use multiple training formats (eg, pre-training reading materials, didactic presentations, case-based scenarios, peer-learning opportunities, and subject matter expert-led discussion) to promote the translation of knowledge to practice.
  • Tailor training materials to meet jurisdiction-specific needs and provide opportunities for learners to gain real-world experience through applied learning.
  • Identify mechanisms to retain experienced staff over time to sustain public health capacity and to support train-the-trainer opportunities.

Want to learn more about CDC’s COVID-19 IPC 101 for HAI/AR Programs course? Read our report here:

Suggested Further Reading:


Austin R. Penna, MPH, CIC, is an Epidemiologist in the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention (CDC). He is currently focused on the development and implementation of initiatives to enhance public health workforce capacity among CDC-funded Healthcare-associated Infection and Antibiotic Resistance Programs.