When COVID-19 Patients Return

When appropriate, patients who have tested positive for the virus and need to return for follow-up care in the outpatient setting should have a telehealth visit instead of an in-person consultation. If an in-person visit is necessary, please refer to this guidance to determine what personal protective equipment to use. 

Approach to follow-up outpatient visits for persons with confirmed COVID-19

Purpose: To provide guidance on the handling of necessary, in-person follow-up clinic visit for patients with confirmed COVID-19 

 Scope: All outpatient clinic areas which may see patients in follow-up have been diagnosed with COVID-19 

Approved: ICC Operations, ICC Safety, ICC Med-Tech, ICC Commander

Date: May 11, 2020

Process: 

All patients requiring outpatient follow-up with either confirmed or suspected COVID-19 should be evaluated using the following criteria to determine appropriate precautions for protection of staff and other patients during follow-up visits. 

1. Evaluate patient/situation for telehealth visit if possible.

2. If an in-person visit is deemed necessary, determine the time since symptom onset and period for which the patient has been afebrile with other symptoms improving.

  • This determination should be performed (if possible) the day prior to the scheduled visit
  • If the patient cannot reliably provide the time since symptoms onset use the date of positive SARS-CoV-2 test

3. Use the following guidance to determine precautions/PPE use during visit:

  • Symptoms onset ≥10 days ago and afebrile for 72 hrs (without fever-reducing medication) with other symptoms improving

           a. Standard precautions/PPE
           b. Room can be safely cleaned immediately upon patient discharge from clinic

  • Less than 10 days since symptom onset or fever/worsening symptoms within the last 72 hours

           a. Precautions/PPE for COVID-19+/PUI
           b. After the patient leaves the room, the room should be left empty with the door closed for 2 hours, and then can be safely cleaned

Definitions:

Confirmed COVID-19: positive results for SARS-CoV-2 by PCR

Suspected COVID-19: compatible clinical symptoms with no test done for SARS-CoV-2 and no clear alternative etiology

Standard PPE- includes mask for all patients, surgical mask for all providers

COVID-19/PUI precautions/PPE- patient placed in exam room immediately with surgical mask. Provider N95 masks, gown, eye protection, and gloves.

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