OPERATION OF FEVER CHECK STATIONS
DURING AN INFLUENZA PANDEMIC (DESIGNED BASED ON THE STATE OF CT
DPH 4/18/2008 DRAFT FOR STATE AGENCIES)
Highlighted areas must be customized and the entire plan must fit the organization
Introduction
This guidance document provided information for (insert organization name) decisionmakers, as well as individual workers, regarding the appropriate use of work practice and
engineering controls, administrative controls, and personal protective equipment (PPE),
and was based on the Occupational Safety and Health Administration (OSHA) model of
dividing the facility and work operations into “risk zones”.
This policy/procedure includes the operation of fever check stations. Fever check
stations are only one example of the many controls that should be used to protect
patients/residents, family/responsible party and employees during an influenza pandemic.
First and foremost, all staff should be aware that sick employees are encouraged to stay
home. In conjunction with this message, XYZ organization will also communicate leave
policies (including any emergency provisions that have been implemented during an
influenza pandemic), policies for getting paid, and transportation issues. Equally as
important and where applicable, policies will be in place that encourage appropriate “well
employees” to work from home in the event of an influenza pandemic, and clearly
communicate to these employees what options may be available to them for working
from home. Each of these preventive measures will be much more effective than
screening at fever check stations in keeping sick employees and patient/resident
family/responsible parties from entering the facility.
Purpose
The purpose of operating fever check stations during an influenza pandemic is to screen
employees, new patients and family/visitors/responsible parties for signs and symptoms
associated with influenza, and more specifically to exclude entry to our facility from
those exhibiting influenza signs or symptoms. Fever check stations can and should also
be an important source of information for employees, and should be used in conjunction
with other communication mechanisms to provide ongoing and frequent health and
policy information.
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Fever Check Station Operations
The following guidelines should be used to operationalize fever check stations during an
influenza pandemic.
Access

Employee, families/responsible party and patient/resident points of access to should
be limited and each point of access should have at least one operating fever check
station.
o See attached floorplan designating fever check stations

Employees should be asked to enter and exit through these designated points of
access each day they report to work, except in the case of an emergency (i.e. fire
alarm), where normal evacuation procedures should be used.

All other entrance doors will be locked so that they cannot be accessed from the
outside, however these doors should not be blocked, chained, or otherwise
manipulated to prevent employees, families/responsible parties or patients/residents
from utilizing them in the case of an emergency.

(Insert Facility Name) will operate a sufficient number of fever check stations and
points of access to provide an unhindered flow into the building (based on staff
availability). Fever check stations may do more harm than good if large groups of
employees are gathered at a point of access waiting to be screened at the fever check
station. As a part of the Continuity of Operations Plan, review employee schedules to
anticipate potential peaks and lulls in the number of employees who may be trying to
access the building during any specific time period, and plan to gear up or down the
number of fever check stations available to coincide with these dynamics. In
addition, leadership may wish to temporarily alter employee schedules to facilitate a
more orderly flow of employees accessing the fever check stations.
Staffing

Each fever check station should be staffed by a licensed nurse or other healthcare
professional capable of performing the required screening activities

At least one fever check station should be kept in operation at all times to screen
employees, families/responsible parties who may be accessing the building at a later
time than normally scheduled and to provide a point of contact for anyone who may
begin to feel ill during their work shift (i.e. an “on-call nurse”).

A separate “hotline” phone number (insert number here or that you will provide
notification of this number at the time of the influenza pandemic) for employees to
act as a single point of contact for employees working off-site or for those concerned
about returning to work who may have questions about influenza signs and
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symptoms. Allowing employees to “call-in” with their symptoms and ask questions
about their access status will help to reduce the in-person burden at fever check
stations. This hotline may be operated in conjunction with the fever check stations if
adequate staffing is available at those stations or a collective attempt amongst the
Associations, Corporate and/or other nursing homes / home health agencies / dialysis
centers to share resources.

Each point of access should be staffed by an Emergency Medical Technician (EMT),
Paramedic, or other healthcare professional equipped to provide clinical care in the
event of a medical emergency.

Each point of access should be staffed by a security officer to maintain crowd control
and direct employees to a fever check station

Each point of access should be staffed by at least one support person capable of
performing other necessary duties, such as making copies, retrieving additional
supplies, etc.

Because of the number of face-to-face contacts they will be exposed to daily,
individuals staffing fever check stations should be provided with N95 respirators to
be worn when interacting with employees at the fever check stations. These
respirators should be appropriately fit tested, in accordance with OSHA regulations
(see http://www.osha.gov/SLTC/etools/respiratory/oshafiles/fittesting1.html for
additional information on OSHA fit testing requirements). This respiratory protection
should be provided regardless of whether or not an agency determines that their
facility or work practices constitute a risk category where providing PPE to
employees is appropriate.
Screening
The “Fever Check Station Screening Form” at the end of this document has been
modified off of the Department of Public Health Sample Fever Check Station Screening
Form. The screening form will capture information regarding:

The name of the employee, family/responsible party or patient/resident reporting to
the fever check station.

The date and time the evaluation occurred and the signature of the evaluator.

Any clinical signs or symptoms reported by the employee, family/responsible party or
patient/resident within the last 24 hours.

The employee, family/responsible party or patient/resident body temperature at the
time of the screening.

Whether or not the employee, family/responsible party or patient/resident was granted
access to the building.
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
Any personal protective equipment (PPE) provided to the employee,
family/responsible party or patient/resident (if appropriate).

Any informational or other materials provided to the employee, family/responsible
party or patient/resident. For example, employees who are excluded from on-site
work should be given information about why they were excluded, clinical information
about influenza pandemic, and other information developed for employees during this
emergency period (i.e. leave policies, policies for payroll, contact numbers, etc.).
Employees, family/responsible party or patients/residents who are allowed entry into
the facility should be given clinical information about influenza pandemic and
procedures for reporting the development of any signs or symptoms to the Influenza
Pandemic Coordinator, appropriate hygiene/etiquette practices, and the employees
should be provided with policies for social distancing, holding face-to-face meetings,
patient/resident care interactions, sharing of equipment, and interacting with the
families/responsible parties.
Admittance and Return to Work Criteria
The decision whether to allow or deny access of any employee or family/responsible
party to the facility should be made by the nurse or other health professional performing
the clinical evaluation. These decisions should be based solely on the clinical
information collected at the fever check station and not on any employees perceived need
to be working on-site or family/responsible parties need to support the patient/resident.
Based on current knowledge (2008) of the clinical signs and symptoms of influenza, the
Connecticut DPH recommends the following criteria for exclusion of employees and
families/responsible parties from the facility:

Oral temperature  101.0°F or

Oral temperature > 99.0°F but < 101.0°F and
any one of the following symptoms (or close contact with someone with any of the
following symptoms) in the last 24 hours:
 chills
 persistent cough
 headache
 muscle aches/stiffness
 fatigue (tiredness)
 sore throat
 hoarseness
 stuffy/runny nose
 difficult/painful breathing
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 vomiting
 diarrhea
 abdominal pain
 confusion
Decisions about patients/residents that meet the above criteria will move the facility to
implement appropriate isolation precautions as defined in the infection control plan.
Once an employee or family/responsible party has been denied access to the facility on
the basis of the signs and symptoms listed above, the Connecticut DPH recommends that
the employee not be allowed to return to the facility until:

At least 5 days after the start of their symptoms; AND,

At least 2 days after all symptoms (including fever > 99.0°F) have resolved.
Again, these recommendations are based on current knowledge of the clinical signs and
symptoms of influenza at the time this document was written. As such, the recommended
criteria for exclusion during an influenza pandemic may change however as new
information about the clinical manifestations of any particular influenza pandemic strain
becomes available.
Questions
The information contained in this document is intended to be used as one tool in the
overall planning for protecting employees, family/responsible parties or patients/residents
in the event of an influenza pandemic. Several other documents and data sources have
been referenced in this guidance document and elsewhere, and should be utilized as well
within the scope of planning for a pandemic. For more information about the general
recommendations put forth in this guidance or for specific answers to questions raised by
the recommendations, please contact the Connecticut DPH at (860) 509-8000.
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FEVER CHECK STATION SCREENING FORM
Access Location:
___ Insert Location 1 Here
Date: _____________
___ Insert Location 2 Here (if applicable)
Information
Employee Name: _________________________________________________________
Family/Responsible Party Name: ____________________________________________
Visiting: ____________________________________________________
Patient/Resident Name: ____________________________________________________
Clinical Evaluation
Evaluation Time: ___________
a.m.
p.m.
Temperature: __________ F
Is temperature  101F?
_____ YES (He/She is excluded)
Is the temperature ≤ 99F?
_____ YES (He/She is accepted – Skip to
Disposition)
Is the temperature > 99.0°F but < 101.0°F
_____ YES (continue with questions below
to verify acceptance or
exclusion)
For patients/residents, please utilize the following criteria for isolation (insert criteria or
reference appropriate policy/procedure)
Questions
Indicate which of the following the individual has experienced in the past 24 hours:
___ Persistent Cough
___ Headache
___ Fatigue (Tiredness)
___ Muscle Aches/Stiffness
___ Chills
___ Sore Throat
___ Hoarseness
___ Stuffy/Runny Nose
___ Vomiting
___ Difficult/Painful Breathing
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___ Diarrhea
___ Abdominal Pain
___ Confusion
___ NO SYMPTOMS
Has the individual had close contact with someone with any of these symptoms in the
past 24 hours?
____ Yes
____ No
Did the individual report any of the above symptoms or close contact with someone with
any of the above symptoms in the last 24 hours (with temperature > 99F and <101F)?
____ YES (He/She is excluded)
____ NO (He/She is admitted)
Disposition
Access Granted
Note: Please provide facility access materials packet, if not already received
Access Denied
Note: Please provide exclusion informational packet
Signature Statement
The information on this form is complete and accurate to the best of our knowledge. The
employee/family/responsibly party understands that he/she is being admitted to, or
excluded from, the facility today based on their clinical signs and symptoms. If the
employee/family/responsibly has been denied access today, he/she understands that they
are not to report back to the facility for at least five days after the start of his/her
symptoms AND at least two days after all his/her symptoms have resolved. If the
employee/family/responsibly has been allowed access to the facility today, he/she
understands that he/she is to report each day to the fever check station upon arrival at
the facility for clearance for that day. In addition, he/she understands that if his/her
clinical status changes during the workday (fever increases or symptoms develop), he/she
is to report back to the fever station or contact the Influenza Pandemic Coordinator for
an updated clinical evaluation.
Employee: _________________________________
Date: _____/_____/_______
Evaluator: _________________________________
Date: _____/_____/_______
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