Today’s cabinet update is below:
Testing of asymptomatic patients for COVID-19:
As of 27 April 2020, 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, 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). Pre-existing inpatients do not need testing for COVID-19 unless they have relevant clinical features.
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 or influenza like illness (or 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
- 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.
Rapid COVID-19 tests (performed at the Whiston Microbiology Laboratory) are now available for:
1. Patients that are to be discharged to care homes.
2. Pre-operative patients having urgent elective surgery for cancer.
These can be requested on Medway under COVID-19 Novel Coronavirus PCR.
There is now a drop down box to select the test required as shown below;
Use SYMPTOMATIC patient test (COVIDS) to request a test for any patient (new admission or existing inpatient) with clinical features of COVID-19.
Use Asymptomatic admission screen (COVA) to request an 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 Clearance swab (COVIDX) to request a rapid test for patients prior to discharge to care home.
Use Pre-op cancer swab (COVIDP) to request a rapid test for patients prior to urgent elective cancer surgery.
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.
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Bronze Command – May Bank Holiday
Please note that the Bronze Command Centre will be closed on Bank Holiday Friday 8th May 2020 and will resume on Monday 11th May 2020.
Any operational issues should be raised through the usual weekend/Bank Holiday protocol of contacting the on call Directorate Manager via switchboard.
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#NHSCovidHero
Today’s Covid Queen is Diane Stafford, Assistant Director of Operations, Medical Care.
Diane works tirelessly at the best of times, but throughout the pandemic she has been instrumental to the smooth running of the hospitals, reconfiguring medical wards and services, problem solving and supporting her staff through the many rapid changes required over the last few weeks. Diane always has a smile on her face and is much deserving of a special mention for her energy and drive to make our hospitals the very best for patients and staff.
