Table 2.

GIROT interventions provided in each nursing home during the outbreak

At the beginning of the outbreak

Environmental interventions to limit transmission: cleaning procedures, room changes and setup of “COVID-19 bubbles” including with donning and doffing stations

Residents’ and staff testing to identify all SARS-CoV-2 cases

Use of ID bracelets to favor residents’ identification (particularly in presence of external staff)

Comprehensive geriatric assessment of SARS-CoV-2-positive residents and risk stratification according to symptoms severity (Green/Yellow/Red code); medical therapy review and optimization (including COVID-19 protocol-based therapy), blood testing

Direct provision of oxygen and first-line medications (Table 2) within 24 h of outbreak

Supply of caloric nutritional supports including specific diets for dysphagia

Identification of staff shortage and supply of nurses and other healthcare workers from local hospitals as appropriate

Provision of PPE and staff training on appropriate PPE use and other transmission control procedures

During the course of the outbreak

Regular medical assessment according to color coding, including interventions for prevention and management of geriatric syndromes

Activation of palliative comfort-based care services, when deemed appropriate based on comprehensive geriatric assessment

Regular residents’ and staff SARS-CoV-2 testing for infection monitoring

Daily clinical report to GPs and regular update to families

Discontinuation of residents’ isolation at the end of the infection, according to a symptom-based approacha

PPE personal protective equipment

^aThe symptom-based approach [26] allowed patients to be released from isolation also in presence of a positive virus test, provided that they were asymptomatic for at least 21 days