Long Term Care Facility Resident Monitoring Protocol

Long-Term Care Facility Residents/Patients

All Patients

Obtain vitals (temperature, heart rate, respirations) AND pulse oximetry every eight hours (Q8 hours). Blood pressure can be taken once a day.

Symptom screening to be performed every shift (Q8H) and should include questions about and/or observations of the following:

  • Fever 
  • Shortness of breath (SOB) 
  • Cough 
  • Sore throat
  • Chills or shaking w/chills
  • Muscle pains
  • Headache
  • New loss of taste or smell

Contact the clinical supervisor for any of the following: new-onset fever, SOB, cough, sore throat, or for any decrease in pulse oximetry from resident baseline level or any pulse oximetry reading < 92%. If these symptoms are present, providers should strongly consider transfer to a higher level of care. Monitoring every four hours is appropriate for patients with evidence of clinical deterioration.

If patients have been screened and their testing is NEGATIVE for COVID-19:

  1. Avoid placing with COVID-19 or symptomatic1 patients.
  2. Consider discharge to home of post-acute/rehabilitation patients who can be home quarantined.

If patients have been screened and their testing is POSITIVE for COVID-19 OR if patients have signs/symptoms of a respiratory viral infection:

  1. Vitals (temperature, heart rate, respirations) AND pulse oximetry every four hours (Q4hours). Blood pressure every eight hours.
  2. Locate in a private room or cohort with another symptomatic/positive patient.
  3. Maintain standard contact and droplet precautions (including eye protection).
  4. Consider that staff caring for positive or symptomatic patients do NOT care for negative or asymptomatic patients.
  5. Positive or symptomatic patients should be given a surgical mask and encouraged to wear it at all times, especially  when close contact with others is anticipated.

1Signs/symptoms consistent with respiratory viral infection

*Interim guidance developed by the Illinois Department of Public Health and DuPage County Health Department based on the Illinois long-term care COVID-19 experience and in consultation with the University of Washington.

Last Updated:  7/2/2020