Optimization of COVID-19 testing accuracy with nasal anatomy education

Abstract

Importance: Adequate sampling of the nasopharynx is crucial to performing accurate SARS-CoV-2 (COVID) testing. Formalized education of nasal anatomy may improve provider testing technique and reduce false-negative test results.

Objective: To assess the effect of nasal anatomy education on medical providers' comfort level and knowledge base in performing accurate SARS-CoV-2 (COVID) testing.

Study design: Pre-post survey.

Settings: Tertiary care academic hospital.

Participants: 17 nurses performing COVID testing were enrolled.

Intervention: An educational session on COVID nasopharyngeal testing technique and nasal anatomy was presented by an otolaryngologist.

Main outcomes and measures: A pre-session survey assessed providers' prior nasal testing training and COVID testing challenges. Provider comfort level with COVID testing was surveyed pre-and post-session. A 6-question nasal anatomy test was administered pre- and post-session.

Results: 16 out of 17 nurses performed fewer than 10 COVID tests prior to the educational session (94%). Reported challenges with COVID testing included patient discomfort (79.6%), inability to pass the test swab (23.5%) and nasal bleeding (11.8%). The number of providers comfortable with independently performing COVID testing increased from pre- to post-session (5 and 14, p = 0.013). The average number of correct responses to the 6-question nasal anatomy test increased following the session (3.2 ± 1.2 to 5.1 ± 1.1, p = 0.003). Specifically, the number of providers able to localize the nasopharynx increased from 8 providers pre-session to 14 providers post-session (p = 0.04).

Conclusion: Early implementation of nasal anatomy and nasopharyngeal swab technique education can help improve provider comfort and knowledge in performing accurate COVID testing.

Keywords: COVID; COVID testing; Education; Nasal anatomy.

Fig. 1

Provider nasal anatomy test. The 6-question test administered before and after the educational session to evaluate the provider's knowledge base of nasal anatomy related to COVID testing.

Fig. 2

Number of providers who correctly answered nasal anatomy test questions The number of providers who correctly answered each individual nasal anatomy question increased following the educational session, with statistical significance achieved for identification of the nasopharynx and which nare to swab in the presence of inferior turbinate hypertrophy.