Immediately:
- Keep the door to the room closed, wear a fit-tested N95 respirator, gloves, gown, and eye protection (face shield), and place a medical mask on the resident when anyone is in the room, unless the resident is unable to tolerate the mask. In a semi-private room, keep the privacy curtain closed and the residents separated as much as possible until one of the residents can be moved.
- Notify the resident and the resident’s representative of the COVID-19 related illness.
Within 24 Hours (confirmed case or presumed case only):
- Review the patient’s history to determine if the patient had COVID-19 in the prior 3 months and may have a persistent positive SARS-CoV2 PCR test.
- If available, place and operate a portable HEPA/UV filtration device in the room unless the room is an Airborne Infection Isolation Room.
- Complete the outbreak investigation & contact tracing and plan to meet testing requirements.
- Relocate the resident with confirmed COVID-19 to a room in a designated COVID-19 area if such an area is already in use, or relocate the roommate. If a roommate needs to be relocated, do not move the roommate to another semi-private room.
- Offer any available and appropriate testing and treatment for COVID-19 as per the NIH treatment guidelines.
Ongoing:
- Residents with confirmed COVID-19 may be cohorted in a room or unit with other residents with confirmed COVID-19 as long as no other contraindications to cohorting exist as per usual infection prevention procedures. Avoid cohorting patients with confirmed COVID-19 with patients who have presumed COVID-19 or previously recovered from COVID-19.
- If there is a confirmed outbreak of COVID-19 on the resident’s unit, newly-ill residents should be managed as presumptive-positive COVID-19 cases and have COVID-19 PCR testing.
- Only staff fitted for an N95 respirator will perform aerosol-generating procedures, including suctioning (if not using an inline catheter), nebulizer administration, manipulation of BiPAP/CPAP mask, chest physiotherapy, and CPR. A portable UV/HEPA filtration device must be used in the room during the aerosol-generating procedure.
- Actively monitor the resident once per shift for at least two weeks.
- Interview for new symptoms, when the resident is able.
- Measure and document body temperature and oxygen saturation.
- Additional observations to consider: Vital signs, lung auscultation.
- Residents with suspected or confirmed COVID-19 should be cared for by the same clinical staff, dedicated to the care of the COVID-19 patients whenever possible. Minimize the number of persons entering the resident’s room, including clinicians performing non-clinical work or work of other clinicians as long as the work is within their scope of practice.
- The resident should only leave the room for medically-necessary procedures.
- Resident to perform hand hygiene (with assistance, if needed) & don a medical mask before leaving the room.
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