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COVID-19 Bulletin: Friday 27 November

November 30, 2020

Following the announcement yesterday of the tier system that is coming in following the end of the second lockdown, we have received notice from the government that colleagues who have been shielding during this time will no longer be required to, so will return to work if they are unable to work from home.

 Many patient facing colleagues will by now have received their lateral flow testing kit, but if you haven’t, don’t worry, approximately 500 kits are being delivered every day, up until 3 December. If you were expecting a kit and haven’t received one by then please call the contact centre Monday to Friday, 8am – 6pm on 0121 507 2664, option 6.      

Our daily COVID bulletin is produced for the purpose of sharing news and decisions made by our Trust. If you have a question you would like answered or if you would like to nominate a PPE hero for demonstrating best practice, please let us know by emailing swbh.comms@nhs.net. All the latest information about our COVID response is published on Connect here. Please take the time to keep yourself updated and safe.

  1. Updated message: Staff Swabbing Testing Process

Swabbing for colleagues who have COVID symptoms and/or a positive Lateral Flow test remains available through our drive-through at City Hospital and Little Lane car park at Sandwell Hospital. If you have been experiencing COVID symptoms (high temperature, new continuous cough or loss/change in taste or smell) or have tested positive on your Lateral Flow test you can book an appointment for a swab by calling the community contact centre on 0121 507 2664 option 6 Monday – Friday 8am – 6pm. On weekends call 07816 992873. Please do not just turn up!

Test results will be available within 72 hours from the Occupational Health and Wellbeing Service which has been running its result service over 7 days to facilitate the need to communicate results to staff as soon as possible. If you have not received your results within 72 hours then please email swbh.occyhealthcovid19@nhs.net. Please avoid calling Microbiology or Occupational Health before 72 hours of your test as results are unlikely to be ready if they have not been sent out. If you have had a Rapid Swab Test then you may call Microbiology to enquire about the result if it has not been sent out by 7pm on the day your swab was taken.

If you have a positive result the occupational health team will text and email your result to let you know. They will also call you over the same day or the next day to discuss your result, offer support and will work closely with infection prevention and control and your manager in situations where there is a significant breach in PPE in order to contact trace and manage the situation locally. If your test result is negative then you will receive a text message and/or email to inform you of your result. On occasions, you may receive a message regarding your result from the National Test and Trace service before Occupational Health. You can read the staff swabbing and results process by clicking here. All staff swabbing enquires can be made via swbh.occyhealthcovid19@nhs.net. Staff members are advised to inform their line manager of their result particularly if a positive test result is received and a period of self-isolation required. No results will be communicated in the late hours or overnight but results will be sent over the weekends.

2. New message: Clinical coding and mortality statistics

We are currently showing the highest mortality figures in the region, due to the way patient diagnoses are being incorrectly recorded – as our COVID deaths are being included in our normal expected death in hospital figures. All other Trusts have their COVID death figures taken out of their total. We must improve accuracy in our clinical coding, as it is essential that diagnoses are documented in patient records as clearly as possible, reducing ambiguity and using approved terminology. This will help improve coding accuracy, which in turn impacts on the Trusts Mortality statistics.  Clinicians should note that when documenting a diagnosis, or probable diagnosis, the following terms are accepted in accordance with the National Clinical Coding Standards:

  • Definite Diagnoses
  • Treated As
  • Probably/probable
  • Presumed

 Consider the above alternatives in place of or in addition to terms which you might normally use such as:

  • Differential Diagnosis
  • Possible
  • Maybe
  • Suspected
  • Impression
  • Diagnosis follow by a ‘?’

 Ensure you state the main diagnosis rather symptom for example, Anaemia probably due to Gastric Carcinoma, or Hyponatremia  probably due to Metastatic Lung Carcinoma. Avoid interchangeable terms and ensure you list all co-morbidities. For example, instead of LRTI/Chest Infection, state ‘treated as Pneumonia’, if this is the presumed diagnosis which is being addressed in the current episode. This is as pneumonia has a greater impact on the Charlson Co-morbidity Index (CCI). Ensure all co-morbidities are documented on admission (which is listed as “problems” (active or resolved) on Unity), as this contributes to the patient’s mortality risk profile. Ensure you are specific when recording the co-morbidities: e.g. Recording creatinine levels does not permit a clinical coder to record CKD, this must be documented explicitly. Congestive Cardiac Failure or Congestive Heart Failure needs to be stated as CCF and not CHF.

 Please see useful materials regarding the above:

  1. Reminder: Hand Hygiene – Do you know your 5 moments?

We all know why we should wash our hands regularly and even how to wash our hands properly (we should, we invented the protocol) but are you clear on the when? Here’s a reminder for colleagues that not only should you be washing your hands for 20 seconds or more, and as many times as possible, it’s key to make sure you wash your hands at key moments.

Remember to clean your hands:

  1. Before touching a patient
  2. Before clean/aseptic procedure
  3. After body fluid exposure/risk
  4. After touching a patient
  5. After touching surroundings

The expert infection prevention and control team can be reached on ext. 5900

Did you know?

The hand hygiene technique used all over the world today was actually developed back in the 1970s at the Hospital Infection Research Laboratory which was based on the City Hospital site at the time.