In today’s update:
Management of Emergency Admissions to Hospital
Testing of asymptomatic patients for COVID-19:
All patients requiring inpatient admission (i.e. at least admission overnight) require testing for COVID-19 regardless of symptoms or clinical features of COVID-19.
Therefore, even if the patient does not fulfil the case definition, send samples for COVID-19 testing, in addition to usual investigations appropriate to the patient’s clinical condition.
The test must be carried out without delay at the point where decision to admit is made.
For asymptomatic patients, a COVID-19 test can be requested on Medway (under test name COVID-19 Novel Coronavirus PCR and on the ‘Test required’ drop down, select ‘Asymptomatic admission screen’).
Note the Medway request form and specimen must be accompanied by a completed form E28.
Patients who are tested on admission but 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).
Patients with symptoms/signs of COVID-19:
The case definition(updated regularly) now includes any patient requiring admission to hospital with clinical/radiological evidence of pneumonia, acute respiratory distress syndrome, influenza like illness or anosmia (a loss of, or change in, normal sense of taste or smell) or if they develop these after admission.
If a patient fulfils criteria for a possible case, do the following immediately:
- Isolate patient in a single room with respiratory precautions (if no side room is available, patient can be cared for in a bay).
- Minimise number of staff entering the room.
- Wear the appropriate PPE: Click here to see a summary of PPE to be worn [password STHKcovid19]
- Send samples for testing, in addition to usual investigations appropriate to the patient’s clinical condition, as per GOV.UK guidance. COVID-19 test can be requested on Medway (under the test name COVID-19 Novel Coronavirus PCR and on the ‘Test required’ drop down, select ‘SYMPTOMATIC patient test’. Note that the Medway request form and specimen must be accompanied by a completed form E28.
Repeat testing of patients who have a negative admission screen:
For those admitted from 18 May 2020, patients who test negative on their admission screen, a single re-test should be conducted 5-7 days after admission. Using 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).
Requesting COVID-19 tests
These can be requested on Medway under COVID-19 Novel Coronavirus PCR. All requests must be accompanied by a completedform E28.
There is a drop down box to select the test required as shown below:
| Indication | Medway drop down option | Rapid test |
| Any patient (new admission or existing inpatient) with clinical features of COVID-19 | SYMPTOMATIC patient test | 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 | Use Asymptomatic admission screen | No |
| Requesting a repeat screen on any inpatient 5-7 days after admission whose original admission screen was negative | SYMPTOMATIC patient test or Asymptomatic admission screen as appropriate according to clinical condition | No |
| For testing patients prior to discharge to care home or other healthcare setting when indicated | Clearance swab | 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 | No |
| For testing patients other than those being admitted electively for urgent cancer surgery and those who are in the shielded/extremely vulnerable category for screening at pre-op 48-72h in advance of their elective admission for surgery/other procedure | Elective pre-op NON-urgent | No |
| For testing patients prior to urgent elective cancer surgery OR extremely vulnerable patients under shielding who attend for elective surgery/procedures on the day of admission | Elective pre-op URGENT | Yes |
Note that current availability of rapid tests is strictly limited (approximately 20 in total per day) hence these MUST only be used as stated above: Any exceptions MUST be discussed with a Medical Microbiologist on a case by case basis before the test is requested.
Please note guidance related to COVID-19 is updated regularly hence always refer to the most up to date version of the guidance online at https://covid.sthk.nhs.uk/
Symptoms list updated
A loss or changed sense of taste or smell has today been added to the Coronavirus symptoms list.
The Trust’s staff swabbing criteria has also been updated.
Social Distancing
We would like to remind all staff of social distancing measures currently in place across the Trust this includes but is not limited to:
- Distance: Keep yourself at least 2m away from others
- Groups: Do not gather in groups at break or lunchtimes, walk to work or from the car park alone
- Meetings: Don’t arrange to meet with others if you can’t keep your distance
- Busy areas: If an area of the restaurant or retail outlet is busy go to a quieter area
- Lifts: Only 2 people in a lift at one time
Please be kind to each other and give each other space
#HiddenHospitalHeroes
Today we applaud our hard-working team of volunteers who consistently go the extra mile to help staff and support patients. They’ve helped deliver medication to patients who are self-isolating, ensured clothes and treats are delivered safely to inpatients and run countless errands between sites. Their list of jobs is endless but so is their unwavering commitment and genuine kindness. Thank you to each and every volunteer at TeamSTHK
