Clinical Information
The American Nurses Association supports your ongoing efforts centered on education, prevention, and treatment to mitigate the spread of SARS CoV-2. Continue reading to learn more about the basics of SARS CoV-2 and its associated illness, COVID-19, and find an overview of preparedness and infection control measures.
What is Coronavirus Disease (COVID-19)?
Coronavirus Disease (COVID-19) is the illness that is caused by the coronavirus SARS CoV-2 that was first identified in December 2019 in Wuhan, China. In February 2020, the World Health Organization (WHO) formally named it COVID-19. CO stands for corona, VI for virus, and D for disease. We do know that SARS CoV-2 easily spreads from person to person via respiratory droplets produced from coughs, sneezes, and even while speaking. When a person is within six feet of someone with SARS CoV-2, these droplets may land in the eyes, mouths or noses of individuals, or be breathed into the mouth or nose. It is also possible to contract SARS CoV-2 if the virus is on your hands by touching your eyes, nose, or mouth. SARS CoV-2 can spread in the absence of symptoms.
Click here to learn more about the association between SARS CoV-2 and COVID-19 from Project Firstline.
According to the CDC, symptoms may appear 2-14 days after exposure to the virus. Although, it is also possible for people to have no symptoms. People with these symptoms or combinations of symptoms may have COVID-19:
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
Preparedness, Early Identification, and Notification
All nurses and the health care team must receive the highest level of protection to provide care for the individuals and communities in which they serve. It is essential to develop and educate ALL staff on preparedness plans that provide infection control procedures and protocols used within the health care facility for the early identification, containment, and care of patients with symptoms associated with COVID-19 to prevent spread within the facility.
- Obtain updated inventory of all resources needed for response. This includes staffing resources, space, equipment, and PPE.
- Develop inpatient, ambulatory, and home care policies and procedures that are in line with current CDC guidelines for COVID-19
- Provide training to all personnel on screening, isolation and transport procedures
- Provide updated training and guidelines on the use of PPE and infection control measures to prevent the spread within the facility and amongst patients and staff
- Display clear signage with instructions for access and use of PPE
- Ensure consistent use of proper hand hygiene, standard precautions, contact precautions, and airborne precautions, along with the proper use of a National Institute for Occupational Safety and Health (NIOSH)-Approved N-95 respirator or higher (refer to Infection Control and Prevention Section)
- Clearly display signage for patients that lists symptoms and instructions to wear a face mask before entering the health care facility
- To address asymptomatic and pre-symptomatic transmission, update the policy to require everyone (e.g., healthcare personnel, patients, visitors) entering a healthcare facility wear a cloth face mask, regardless of symptoms. This helps prevent transmission from infected individuals who may or may not have symptoms of COVID-19.
- Cloth face coverings are not considered PPE and do not replace the use of PPE for health care personnel. All staff must have access to the appropriate PPE to safely provide care.
- Create a designated point of entry for all patients
- Eliminate visiting hours to protect hospitalized patients from further exposure
- Incorporate assessment questions to document a detailed exposure history
- Identify, in advance, rooms designated, for quarantine and screening
- Plan for patient surge. Cohort patients with respiratory symptoms during triage. Identify a designated unit or wing to cohort patients with confirmed positive COVID-19 tests
- Outline staffing protocols to facilitate care of patients with COVID-19 to minimize patient-to-patient and patient to health care worker transmission. Learn more about staffing and crisis standards of care here.
- Develop a telephone triage protocol for patients to access from home to minimize community-based transmission
- Maintain and communication with the local and state department for updated guidelines and to best assist with contact tracing measures.
OSHA COVID-19 Emergency Temporary Standard
The U.S. Department of Labor's OSHA has issued an Emergency Temporary Standard (ETS) to protect healthcare workers from contracting the Coronavirus Covid-19. This ETS establishes new requirements for settings where employees provide health care or health support services, including hospitals, skilled nursing homes and home health. To find out more, see the OSHA Covid-19 ETS Webpage, and watch this OSHA YouTube video: COVID-19 Emergency Temporary Standard (ETS) for Healthcare.
Isolation, Quarantine, Monitoring, and Hospitalization
The CDC recommends several steps to identify and care for persons with suspected or confirmed COVID-19.
- Have masks available for patients to don before entering the health care facility
- Once identified, place a patient in a private room with the door closed for assessment. Limit the number of staff entering the room. All staff entering the room must don a N95 respirator (or surgical/medical mask if the N95 respirator is not available), gown, gloves, face shield or goggles for eye protection
- Health care personnel entering the room should use standard precautions, contact precautions, droplet precautions, airborne precautions, and eye protection (goggles or a face shield)
- Have guidelines for the proper use of PPE displayed throughout the health care facility. For printable donning and doffing instructions, click here.
- Have infection control personnel available to provide just-in-time training on proper PPE use
- Notify your infection control personnel and the local and state health department of suspected and confirmed positive cases to assist with contact tracing.
