Last updated on January 4th, 2022 at 03:37 pm
Today’s update is below:
- Important reminder – Uniform procedures
- Important PPE and social distancing guidance reminder
- Discharge of patients who have had a positive COVID-19 test result and are within 90 days from their initial illness onset or test result to care home setting
- Repeat testing of patients who have a negative admission screen
- SARS-CoV-2/COVID-19, Flu and RSV Testing
Important reminder – Uniform procedures
Please remember it is vital that staff follow uniform procedures at all times to protect themselves, their families and our patients.
- Staff must not wear hospital uniform/scrubs outside of the hospital – you must travel to and from work in your own clothes and change into your uniform or scrubs at work.
- Uniforms must be removed before leaving the hospital and transported in a separate disposable plastic bag and laundered at home as per the Trust laundry policy:
- Launder daily on a separate wash at the highest temperature available on a domestic washing machine (minimum 60˚C). DO NOT add other clothing items to the load
- For staff working in a high risk area, you must ONLY wear scrubs. Please wear one set of scrubs per shift, change if they become soiled.
- Scrubs are to be left at the hospitals and cleaned by our laundry service The process is as follows:
- Place used scrubs in white linen bag
- Put this in disposal hold
- The scrubs are then collected, cleaned and put back into circulation
- Do not leave scrubs on the floor or anywhere else
Patient facing community staff
- All staff undertaking work in community settings must wear hospital uniform when on duty (unless otherwise agreed for safety reasons)
- This includes in patients’ homes, when travelling between patients’ homes and when in a clinical setting
- Uniforms must be removed and laundered as soon as you arrive home after work
- Staff are only allowed to wear uniform when on Trust business and not in any other areas e.g. local shops or school grounds etc.
Important PPE and social distancing guidance reminder
Staff are reminded, that they MUST adhere to the current PPE guidance AT ALL TIMES, even if there are no COVID positive patients in their area.
Please also remember it is essential that ALL staff wear surgical masks when moving around our buildings, including non-clinical buildings such as Alex Park, and continue to observe social distancing when not providing direct clinical care.
All patients must wear surgical masks when moving around the ward (away from bedside) and around our buildings.
For the latest PPE guidance for your area, visit the COVID website: https://covid.sthk.nhs.uk/what-to-wear-and-when/ (password: STHKcovid19)
The number of COVID positive patients in hospital is once again increasing and the risk of transmission of COVID within the Trust still remains very high.
Adhering to appropriate PPE and social distancing guidance will help keep our staff and patients safe. Also note, should you have had the vaccine, you are still required to comply fully with PPE guidelines.
Staff are also reminded of the importance of following social distancing guidance outside of work.
ALL STAFF should follow the local guidance, should not be mixing in large groups, have visitors to their home or visit anyone outside of their household or support bubble.
Discharge of patients who have had a positive COVID-19 test result and are within 90 days from their initial illness onset or test result to care home setting
If a patient who has previously tested positive for COVID-19, and are within 90 days from their illness onset or first positive test date, they may be discharged straight to a care home without having to enter and isolate in a designated care setting if they fulfil all the following criteria
- The patient has nonew COVID-19 symptoms or new exposure to COVID-19
- The patient has completed the appropriate self-isolation period of 14 days (from the first positive test within the last 90 days or if a COVID contact, 14 days from the last exposure to COVID). Note: While the patient is an inpatient, isolation precautions MUST be continued until 14 days after the date of the last positive test (even if this is a repeat positive within the preceding 90 days)
- The patient is not severely immunocompromised
If all 3 criteria above are fulfilled, the patient does not require a further COVID-19 test in the 48 hours prior to discharge.
The clinical team discharging the patient must ensure that the COVID-19 status of the patient as well as the details of the 3 points above are documented in the discharge summary and that this information is communicated to the care home.
This does not alter the discharge policy and approach for those people who are being discharged within 14 days of their first positive test, and therefore still within an isolation period for COVID-19 infection. These people should still be discharged to a designated setting, where they should complete their remaining isolation period.
Repeat testing of patients who have a negative admission screen
Any inpatients who test negative on their admission screen should be retested on day 3 of admission (day of admission is taken as day 1). Then, unless the patient is found to be positive, repeat screening should be undertaken on day 5 of admission and continued every 5 days thereafter until discharge. Use the appropriate drop down selection on Medway (see below). Patients who are awaiting this repeat test result but who do not have clinical features of COVID-19 do NOT need isolation in side rooms (unless they also have another reason to require this e.g. another infectious disease requiring isolation precautions or infection alert such as MRSA/VRE/CPE).
SARS-CoV-2/COVID-19, Flu and RSV Testing
From 4 January 2021, for the winter/influenza season, as per PHE guidelines, the laboratory will be providing PCR testing for influenza A/B and RSV (respiratory syncytial virus) in addition to SARS CoV-2/COVID-19 for patients with symptoms of COVID-19/influenza.
The tests done will be determined by clinical details provided on the request form hence it is important that the correct details are selected on Medway under COVID-19 Novel Coronavirus PCR:
- Patients with symptoms/clinical features of flu/COVID requiring admission will routinely be tested for SARS-CoV-2, Influenza A/B and RSV: for these patients select ‘SYMPTOMATIC patient test [COVIDS]’ on the Medway dropdown menu. There is no need to request testing for influenza/RSV separately.
All the above tests will be performed on a single sample (i.e. either viral nose swab and a viral throat swab combined into one pot of viral transport medium; single viral swab used for throat then nose into one pot of viral transport medium or nasopharyngeal aspirate in a universal transport pot). - Patients with no clinical features/symptoms of flu/COVID will be tested for SARS-CoV-2 only: select the other appropriate option from the drop down menu as below:
| Indication | Medway drop down option | Flu/RSV test included | Rapid test |
| Any patient (new admission or existing inpatient) with clinical features of COVID-19/flu | SYMPTOMATIC patient test COVIDS | Yes | No |
| An emergency admission screen for COVID-19 on any patient who requires at least overnight admission to the Trust who has no clinical features of COVID-19/flu | Asymptomatic admission screen COVA | No | No |
| Requesting a repeat screen on any asymptomatic inpatient whose previous screens were negative (for routine repeat screening on days 3 and 5 post admission and then every 5 days thereafter) | Asymptomatic admission screen COVA | No | No |
| For testing patients prior to discharge to care home or other healthcare setting when indicated | Clearance swab COVIDX | No | No |
| For testing previously COVID-19 positive severely immunocompromised inpatients or inpatients who have received ICU care during the current admission prior to stepping down infection prevention precautions | Clearance swab COVIDX | No | No |
| For testing patient electively admitted for surgery or other procedures at pre-op 48 to 72h in advance of their elective admission for surgery/other procedure | Elective pre-op NON-urgent COVP | No | No |
All hand written requests must also clearly state clinical details i.e. COVIDS if symptomatic or if asymptomatic, COVA, to ensure the correct tests are performed.
Please note: the current availability of the combination PCR tests for influenza A/B, SARS-CoV-2 and RSV are limited hence the ‘SYMPTOMATIC patient test [COVIDS]’ must only be used for patients with clinical features (symptoms/signs) of COVID-19 and/or flu.
The turnaround times for results is within 24 hours of the specimen arriving in the laboratory at Whiston Hospital. Note that for symptomatic patients, results of all 3 tests (i.e. SARS CoV-2, flu A/B and RSV) will be reported under a single investigation ‘COVID-19 Novel Coronavirus PCR’ on Medway rather than separately.