COVID-19 can spread like wildfire. In some facilities, the number of suspected or confirmed cases has surged from zero to fifty or more seemingly overnight. Here are three steps that nurse assessment coordinators (NACs) can take to mitigate the risk of severe COVID-19 spread among residents:
Do COVID-19 surveillance on an independent track
The Centers for Disease Control and Prevention (CDC) recommends that nursing homes that have no suspected COVID-19 residents actively screen all residents upon admission and at least daily for fever and symptoms of COVID-19 in order to immediately isolate symptomatic residents and implement transmission-based precautions. Note: This is consistent with April 2 and March 13 guidance from the Centers for Medicare & Medicaid Services (CMS) and should be done in conjunction with similar recommendations for screening staff, as well as all visitors to the facility, to ensure comprehensive surveillance.
If presumptive or confirmed COVID-19 residents are identified in the facility, the CDC recommends that providers monitor symptomatic residents “(including documentation of temperature and oxygen saturation) at least 3 times daily to … identify and quickly manage serious infection” and also to “consider increasing monitoring of asymptomatic residents from daily to every shift to more rapidly detect any with new symptoms.” Note: This guidance is partially in Key Strategies to Prepare for COVID-19 in Long-term Care Facilities and partially in the Interim Additional Guidance.