Management of COVID-19 in Nursing Home Residents Without Respiratory Symptoms

Isolation Requirements

COVID-19 positive nursing home residents without respiratory symptoms should be isolated in well-ventilated single rooms with restricted activity, monitored for symptom development, and provided appropriate supportive care while following strict infection control measures, as recommended by the Military Medical Research 1, 2
Place residents in well-ventilated single rooms when possible or maintain at least 1 meter bed distance if single rooms are unavailable, according to the Military Medical Research and Praxis Medical Insights 1, 3, 2
Restrict patient activities and limit visits from relatives and friends to minimize contact with others, as suggested by the Military Medical Research and Praxis Medical Insights 1, 3, 2
Ensure the environment is clean and disinfected, using 500 mg/L chlorine-containing disinfectant frequently every day, as recommended by the Military Medical Research 1, 3
Implement proper medical waste management with closed garbage bags that are replaced frequently, according to the Military Medical Research 1, 4

Monitor vital signs regularly including body temperature, heart rate, respiration rate, and oxygen saturation (SpO2), as recommended by Praxis Medical Insights 2, 5
Provide nasal catheter or mask oxygen therapy only if needed, adjusting flow according to the patient's condition, according to the Military Medical Research and Praxis Medical Insights 6, 2
Monitor for symptom development - seek medical attention if temperature exceeds 38°C or if breathing worsens, as suggested by the Military Medical Research and Praxis Medical Insights 3, 2

Patients should wear medical masks when in the presence of others, with N95 masks preferred, as recommended by the Military Medical Research and Praxis Medical Insights 1, 2
Caregivers should wear N95 masks (preferred) or disposable surgical masks (alternative) when in the same room as patients, according to the Military Medical Research and Praxis Medical Insights 1, 2
Avoid sharing personal items such as toothbrushes, towels, tableware, and bed sheets with patients, as suggested by the Military Medical Research 1, 3
Clean and disinfect hands after contact with the patient, before leaving patient's room, before and after eating, and after using the toilet, according to the Military Medical Research 3, 4

Provide information and explanation to persons with dementia if they express concerns about their situation, as recommended by the International Journal of Nursing Studies 7
Use simple reminders and visual instructions to explain the current situation, according to the International Journal of Nursing Studies 7
Interact with persons with dementia frequently, ask how they are doing and take time to listen, as suggested by the International Journal of Nursing Studies 7
Avoid using negative language (words such as 'crisis', 'pandemic', 'lockdown' or 'isolation'), according to the International Journal of Nursing Studies 7
Use old photographs, objects, or songs from the past for distraction, as recommended by the International Journal of Nursing Studies 7
Stimulate movement, exercise, and creative or household activities to maintain routine, according to the International Journal of Nursing Studies 7

Reduce social isolation by encouraging families to drop off letters, drawings, or other packages, as suggested by the International Journal of Nursing Studies 7
Facilitate the use of technology (tablets, smartphones) for online social engagement with relatives, according to the International Journal of Nursing Studies 7
Maintain small group activities when possible while maintaining social distancing, as recommended by the International Journal of Nursing Studies 7
Collaborate with mental health professionals and social workers to deliver adequate mental health care, according to the International Journal of Nursing Studies 7

Persistent high fever despite supportive measures, as recommended by Praxis Medical Insights 2
Development of dyspnea or respiratory distress, according to Praxis Medical Insights 2
Signs of pneumonia development or worsening symptoms, as suggested by Praxis Medical Insights 2
Patients with comorbidities or risk factors for severe disease showing clinical deterioration, according to Praxis Medical Insights 2

Body temperature returned to normal for more than 3 days, as recommended by the Military Medical Research and Praxis Medical Insights 6, 2
Respiratory symptoms (if they develop) have significantly improved, according to the Military Medical Research and Praxis Medical Insights 6, 2
Respiratory nucleic acid tests negative for two consecutive times with at least one-day sampling interval, as suggested by the Military Medical Research and Praxis Medical Insights 6, 2

Caregivers should be healthy individuals without underlying diseases when possible, as recommended by the Military Medical Research and Praxis Medical Insights 1, 2
Wear disposable gloves (double layers) when providing care, handling patient's personal items, or cleaning the patient's room, according to the Military Medical Research 3, 4
Avoid direct contact with patient's secretions or discharges, as suggested by the Military Medical Research 3, 4
Monitor their own body temperature and symptoms closely, according to the Military Medical Research and Praxis Medical Insights 3, 2