Providing Point of Care Testing (POCT) – where a patient receives the results of a COVID-19 test in just minutes - has been a goal the Saskatchewan Health Authority has been working towards since the pandemic was first declared last March.
Recently, Abbott ID NOW machines that provide this type of testing arrived in the province and hospitals in both Saskatoon and Regina adopted the new technology to move patients through the system more efficiently. Swabbing a patient, running a point-of-care test and obtaining a results takes an average of only 22 minutes. This saves significant time and helps patients receive the care they need in the right place.
St. Paul’s Hospital (SPH) in Saskatoon dedicated five Licensed Practical Nurses (LPNs) to lead the work of implementing this technology within the hospital as a pilot project. The team has set up mini labs in the Emergency Department (ED), on the fifth floor and on unit 4B. LPNs deliver the test kits to the various units, the unit nurse does two swabs on the patient, and the LPNs return to the mini labs to do the analysis. A second swab was also sent to the lab at Royal University Hospital (RUH) for a second analysis and confirmation for the duration of the pilot. Once the result is back, a paper copy is delivered to the unit and placed in the patient’s chart. The team is also working to develop a way to include the result electronically in the patient record.
“It’s not just St. Paul’s Hospital doing this great work,” said Graham Blue, the Saskatoon Integrated Health Incident Command Centre Defensive Strategy Chief. “Royal University Hospital is also running a pilot project for POCT. The two processes will be compared and a final adoption will be made. We also have plans to expand this to Saskatoon City Hospital in the near future.”
Regina General and Pasqua Hospitals have also taken on POCT to assist with patient movement and investigation of patients who have screened as either high or low probability to be COVID-19 positive. Similar to Saskatoon, the use of the POCT confirms a patient’s COVID-19 status before they are moved onto a hospital unit. This testing has reduced the time to move patients to less than 60 minutes, from the previous 12 to 24 hours.
“The POCT has been going to inpatient units with high numbers of patients isolated or patients under investigation for COVID-19,” said Tom Stewart, the Regina Integrated Health Incident Command Centre Defensive Strategy Chief. “By completing a POCT along with a physician review and alternate diagnosis, the team is able to remove select patients from isolation. This improves overall patient flow and reduces the amount of time ED patients who need to be admitted have to wait for a bed.”
The screening tools are very sensitive and the POCT devices can detect COVID-19 in patients with various symptoms, whether they are presenting as COVID or other illnesses. A team assesses a patient with their physician, an Infectious Disease physician and Medical Microbiologist to assess their clinical status, conduct a rapid POCT swab, and safely remove precautions if indicated. It also allows for confirmation of a negative test before transferring patients back to long-term care or personal care homes, prior to receiving urgent or emergent surgery, and for reassurance before patients undergo procedures, such as MRIs.
POCT is one tool the SHA is using to make significant improvements to the COVID-19 response in acute care facilities. It is still imperative that everyone follows all current public health orders, maintains physical distancing, wears a mask and practices good hand hygiene so, together, we can slow the spread of COVID-19.
Members of the Point-of-Care testing team await analysis of a swab during the Abbott ID NOW pilot project. From left: Licenced Practical Nurses Annabelle Desalisa, Stephanie Balaski and Lianne Itterman.