Clinical Advisory: Management of LAU Patient with Positive COVID-19 Result

Overview

This document outlines the standard operating procedures following the identification of a COVID-19 positive result within the Local Assessment Unit (LAU). Ensuring the safety of both the patient and the healthcare environment is the primary objective of these measures.

Immediate Clinical Response

Upon receipt of a positive PCR or rapid antigen result, the following steps must be initiated by the attending nurse or physician:

• Isolation: If not already in an isolation room, the patient must be transferred to a negative-pressure room or a designated cohort area specifically for COVID-19 positive patients.
• Personal Protective Equipment (PPE): All staff entering the room must don FFP3/N95 respirators, eye protection, fluid-resistant gowns, and gloves.
• Staff Notification: The infection control lead must be notified immediately to commence contact tracing for the surrounding clinical area.

Patient Care and Monitoring

The patient should be assessed for clinical stability. Vital signs, including oxygen saturation, respiratory rate, and temperature, should be recorded every four hours unless the patient's condition necessitates more frequent observations. Any signs of respiratory distress, such as increased work of breathing or a drop in SpO2 below 94%, should be escalated to the senior medical team immediately.

Infection Prevention and Control (IPC) Measures

Strict adherence to IPC protocols is mandatory to prevent horizontal transmission within the unit:

• Hand Hygiene: Strict "Bare Below the Elbows" policy and hand sanitization before and after every patient interaction.
• Equipment Dedication: Wherever possible, medical equipment (such as stethoscopes and blood pressure cuffs) should remain within the isolation room and be sanitized between uses.
• Aerosol-Generating Procedures (AGPs): Staff should minimize AGPs. If an AGP is clinically necessary, it must be performed in a controlled environment with specialized ventilation.

Communication and Documentation

Documentation is critical. Ensure that the positive result is clearly flagged in the electronic patient record (EPR) to alert any staff member accessing the file. Family members or primary caregivers should be updated by the medical lead, keeping in line with data protection policies and patient consent.

Discharge and Transfer

The decision to transfer the patient from the LAU to a specialized ward or to discharge home depends on their clinical status. Patients who are asymptomatic or have mild symptoms may be suitable for home isolation, provided they meet the local criteria for self-care and have adequate support structures in place.

Staff Wellbeing

It is understood that managing positive COVID-19 cases can be stressful. Staff members who have been in close contact with the patient without appropriate PPE should report to Occupational Health for a risk assessment. Please ensure that all staff members remain vigilant regarding their own health and report any new respiratory symptoms immediately.