Clinical Pathway for Inpatient Screening and
Evaluation for COVID-19 Disease

Inpatient SARS-CoV-2 Testing Recommendations
Patients with
New Infectious Symptoms
Exposed Patient Without Symptoms
Pre-Operative Screening for COVID-19
in Asymptomatic Patients
(Excludes exposed pts w/o symptoms)
Discuss w/General ID Consult Team 10467
Consider donning appropriate PPE pending ID recommendations
  • Close contact w/infected person, staff member or travel to/from a High Risk Regions or residing in certain congregate care settings with active transmission in the last 14 days
  • Repeat testing not necessary unless new infectious symptoms develop
  • No Testing Recommended
  • Continue current precautions
Currently Receiving AGP
  • Continue existing Precautions
  • Pt stays on/admitted to standard unit
Currently Receiving AGP
SARS-CoV-2 Results Available
Positive
Negative
Proceed with Surgery
  • Call Charge RT 10504
    Huddle w unit RN/RT/FLOC
    Charge RT to confer w IPC if needed
  • Assess ability to modify respiratory support to mitigate risk
No AGP or AGP successfully mitigated
Unable to hold or
mitigate AGP
  • Call Charge RT 10504
    Huddle w unit RN/RT/FLOC
    Charge RT to confer w IPC if needed
  • Assess ability to modify respiratory support to mitigate risk
No AGP or AGP successfully mitigated
Unable to hold or
mitigate AGP
Modified Expanded Precautions
Pt stays on current unit, single room, door closed
Expanded Precautions
Defend in Place or
Transfer to PSTU or SIU
SARS-CoV-2 Results Available
Negative
Positive
  • Droplet and/or Contact Precautions based on symptoms
  • Transfer out PTSU, SIU as indicated
  • Modified Expanded or Expanded precautions
  • Transfer, remain PSTU or SIU
  • ID Consult
Modified Expanded Precautions
Pt stays on current unit, single room, door closed
Expanded Precautions
Defend in Place or
Transfer to PSTU or SIU
  • Isolate and maintain precautions for 14 days after exposure
  • Monitor Symptoms
Posted: March 2020
Revised: March 30, 2020; April 4, 6, 8, 11, 15, 17, 18, 22, 27; May 1, 5, 22, 23, 2020
Authors: C. Kerman, MD; D, Davis, MD; K, O’Callaghan, MD; K. Chiotos, MD; J. Lavelle, MD; L. Handy, MD; J. Sammons, MD