Yau Fiona, Ferreira Rosalina, Kamali Rima, Bird Paul W, Halliwell Richard, Patel Hemu, Nicoara Daniela C, Woltmann Gerrit, Tang Julian W
Clinical Microbiology, University Hospitals of Leicester NHS Trust, Leicester, UK.
Clinical Decisions Unit, University Hospitals of Leicester NHS Trust, Leicester, UK.
Clin Infect Pract. 2021 Nov;12:100086. doi: 10.1016/j.clinpr.2021.100086. Epub 2021 Jul 23.
With the onset of the COVID-19 pandemic in 2020, hospital clinical teams have realised that there is a need for a rapid, accurate testing facility that will allow them to move patients quickly into isolation rooms or specific COVID-19 cohort wards as soon as possible after admission.
Starting from July 2020, PCR-based test platforms, which could test 4-8 samples in parallel with turnaround (sample-to-result) times of 50-80 min, were placed in a satellite laboratory. This laboratory was on the same floor and within walking distance to the acute respiratory admissions ward. It was staffed by a team of three mid-Band 4 staff that split a 0700-2200 h-work day, 7 days a week, with 2 senior supervisors. Urgent sample testing was decided upon by the clinical teams and requested by phone. The test results were entered manually in real-time as they became available, and sent electronically to the requesting ward teams.
The daily/monthly PCR positive test numbers approximately followed the local and national UK trend in COVID-19 case numbers, with the daily case numbers being reflective of the November and December 2020 surges. Test results were used to rapidly segregate positive patients into dedicated COVID-19 ward areas to minimise risk of potential nosocomial transmission in crowded waiting areas. Testing capacity was sufficient to include cases with uncertain diagnosis likely to require hospital admission. Following completion of other admission processes, based on these rapid test results, patients were allocated to dedicated COVID-19 positive or negative cohort wards.
This rapid testing facility reduced unnecessary 'length-of-stay' in a busy acute respiratory ward. In the current absence of a treatment for mild-to-moderate COVID-19, on which patients could be discharged home to complete, the rapid test facility has become a successful aid to patient flow and reduced exposure and nosocomial transmission.
随着2020年新冠疫情的爆发，医院临床团队意识到需要一个快速、准确的检测设施，以便在患者入院后尽快将他们迅速转移到隔离病房或特定的新冠病房。
从2020年7月开始，基于聚合酶链反应（PCR）的检测平台被安置在一个卫星实验室中，该平台能够同时检测4 - 8个样本，周转（从样本到结果）时间为50 - 80分钟。这个实验室与急性呼吸道入院病房在同一楼层，步行即可到达。实验室由三名中级4级工作人员组成的团队负责，他们每周工作7天，每天工作时间为07:00 - 22:00，并有2名高级主管。临床团队决定进行紧急样本检测并通过电话进行申请。检测结果在获得后实时手动录入，并以电子方式发送给申请病房团队。
每日/每月的PCR阳性检测数量大致遵循英国当地和全国的新冠病例数趋势，每日病例数反映了2020年11月和12月的激增情况。检测结果被用于迅速将阳性患者隔离到专门的新冠病房区域，以降低拥挤候诊区域潜在医院内传播的风险。检测能力足以涵盖可能需要住院治疗的诊断不确定病例。在完成其他入院流程后，根据这些快速检测结果，患者被分配到专门的新冠阳性或阴性病房。
这个快速检测设施减少了繁忙的急性呼吸道病房中不必要的“住院时间”。在目前缺乏针对轻至中度新冠的治疗方法、患者可居家完成治疗的情况下，快速检测设施已成为患者流动的成功辅助手段，并减少了暴露和医院内传播。
