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A&E nurses can ease winter pressures with rapid respiratory test

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Giving nurses the tools to rapidly diagnose respiratory illnesses when patients walk into A&E can help ease winter pressures on busy hospitals, researchers say.

A team West Hertfordshire Hospitals Trust has carried out a study on the ‘respiratory point of care testing’ (R-POCT) method.

“The key issue is to rapidly find out what is causing and driving these illnesses”

Dr Kay Roy

They claim it is on average seven times faster than other tests because the results can be obtained by frontline staff in the emergency room rather than needing to be sent to a laboratory.

Nurses and doctors can therefore make critical decisions far earlier on which treatment to give and whether to admit patients to a ward, the researchers add.

Their findings will be presented to delegates at the British Thoracic Society Winter Meeting today.

R-POCT involves genetic analysis of a swab taken from the patient’s nose, mouth or throat which isolates the specific bugs that may be causing their lung illness.

The researchers claim R-POCT is “far more comprehensive” than other tests because it can find 18 viruses and four atypical bacteria.

The results are delivered in an average time of 6.5 hours from when a patient is seen at A&E, compared with 44.4 hours when it needs to be sent to a lab.

The research studied 1,075 patients with respiratory or general influenza-like symptoms who received R-POCT at the hospital between 15 January and 1 May 2018.

Initial in-depth data analysis was undertaken on the outcomes of 387 patients in the study.

Just over 120 of the patients including in the study were identified as being “lower risk” and of those 20% avoided a hospital admission and nearly half did not need to be prescribed antibiotics.

Of 50 flu cases, 22 did not need to move beds after they were admitted as they had already been placed in appropriate wards to minimise any infection risk to vulnerable patients.

Dr Kay Roy, respiratory medicine consultant at West Hertfordshire Hospitals NHS Trust, and member of the British Thoracic Society, said: “During winter, A&E departments have to cope with a surge of patients with lung infections.

“The key issue is to rapidly find out what is causing and driving these illnesses,” she added.

“This comprehensive test is being delivered very quickly and closer to the patient – which allows us to make rapid, informed decisions about treatment and whether admission to hospital is needed,” Dr Roy said. 

At a national level, pneumonia and flu caused 269,313 emergency hospital admissions in the UK in 2016/17, which cost the NHS an estimated £1bn.

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