Optimization of COVID-19 testing accuracy with nasal anatomy education()

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.