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Given the high risk of spread after COVID-19 enters a nursing home, facilities must act immediately to protect residents, families, and staff from serious illness and death, the Centers for Disease Control and Prevention (CDC) emphasizes.
Subtle signs and changes in nursing home residents may signal the early onset of COVID-19 infections, said Kara Jacobs Slifka, MD, a member of the CDC COVID-19 response team.
“You know your residents best,” she said in a CDC training video. “Noting even small changes in their appearance and behavior may indicate a new COVID-19 infection. Alerting staff and a supervisor may prevent many others from infection.”
New symptoms of dizziness, headaches, diarrhea — any changes could be a sign of an infection, the CDC advises.
With asymptomatic transmission and environmental contamination, it may be possible to get COVID-19 by touching surfaces or objects that the virus is on, “such as the resident’s bed or bedside table or things like doorknobs or blood pressure machines, and then touch your mouth, nose, and eyes,” Slifka said. “The earlier you can recognize sick residents, the faster you can prevent COVID-19 from spreading throughout the building.”
The most likely mode of entry of the coronavirus is through healthcare personnel and other staff, “some of which may not have symptoms,” she said. “It is for this reason that you wear your surgical mask at all times and not work when sick.”
The resident’s temperature should be taken every day, and even more often if you are concerned about an outbreak. “A temp of equal or more than 100 [degrees Fahrenheit], or multiple temps of 99 should trigger a warning that this resident may have COVID-19,” Slifka said.
Since sick residents can rapidly progress to severe illness, they should have vital signs monitored three times a day, including use of a blood oxygen oximeter.
Ask them to tell you if they feel ill and monitor for symptoms, such as new and different coughs and sore throat, she said. CDC recommendations to prevent COVID-19 spread in nursing homes include the following:1
Keep COVID-19 from entering your facility:
Prevent spread of COVID-19:
Financial Disclosure: Peer Reviewer Patrick Joseph, MD, reports that he is a consultant for Genomic Health, Siemens, and CareDx. Senior Writer Gary Evans, Editor Jason Schneider, Executive Editor Shelly Morrow Mark, Nurse Planner Patti Grant, RN, BSN, MS, CIC, Editorial Group Manager Leslie Coplin, and Accreditations Director Amy M. Johnson, MSN, RN, CPN, report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.