Staff Monitoring & Return to Work

Ill employees are one of the most common sources of COVID-19 transmission into facilities. Therefore, it is important to screen and manage employees with symptoms of respiratory illness. Staff should promptly report any symptoms of respiratory illness (i.e. cough, fever, sore throat, runny nose, and/or shortness of breath) and stay home from work until cleared to return. The entrance into the facility should be operated with someone to screen staff temperatures and symptoms of respiratory illness prior to each shift. If a staff member experiences symptoms while working, they should immediately apply a mask and go home.

Symptomatic staff do not require COVID-19 testing; however, CDC interim guidance recommends utilizing one of two strategies (Test-Based and Non-Test-Based Strategies) to determine when staff may return to work in healthcare settings. Staff may not return to work until the criteria is met for one of the two strategies. Also, the guidance provides recommended procedures to be followed after returning to work. If the recommended strategies cannot be followed, as determined by appropriate state or local agencies, due to healthcare staffing shortages, the CDC has also established guidance for Crisis Strategies to Mitigate Staffing Shortages.  These CDC strategies and interim guidance can be reviewed here.

Staffing Contingency Plan

Most facilities are already experiencing a staffing crunch and this will worsen once COVID-19 affects employees and residents. It is important to establish a staffing contingency plan to mitigate this possibility before the crisis occurs. Consider these tips when developing the plan:

  • Assign a staff member to evaluate staffing daily
  • Cohort staff and decrease rotation
  • Prioritize essential services based on residents’ status
  • Recruit non-clinical staff to complete non-clinical duties
  • Contact staffing, unemployment agencies and colleges
  • Take advantage of available temporary waivers and flexibilities as well as resources such as AHCA/NCAL’s 8-hour free online Temporary Nurse Aide training course
  • Consider the Dining Assistants’ Waiver Program
  • Communicate with State Department of Health resources


Staff Support

Finally, during this unprecedented time of caregiver stress, consider opportunities to support staff that are going the extra mile to care for residents safely and effectively. Examples of staff support and assistance initiatives include strong employee communication systems, providing meals for staff and take home meals for their families, offering on-site laundry for uniforms and the option to shower and change into a clean uniform at the start of the shift and before leaving work, child care services, employee recognition and bonus/hazard pay.

Resource: Centers for Disease Control and Prevention


Blog by Kristen Walden, MSN, RN, RAC-CT, Proactive Medical Review

Click here to learn more about Kristen and the rest of the Proactive team.