Optimising clinical and infection prevention management of influenza in a high risk obstetric population utilising the CepheidTM rapid influenza/RSV test and a multidisciplinary approach.

Dr Michelle Porter1, Ms Jane  Bew1, Ms Brittany Brennan1, Ms Tamara Lebedevs2, Mrs Danielle Engelbrecht2, Ms Lisa Nicalou2, Mrs Cathy Jones2, Leanne Sammels1

1Pathwest Laboratory Services, Nedlands, Australia,
2KIng Edward Memorial Hospital, Subiaco, Australia

Background:

King Edward Memorial Hospital (KEMH) has a patient population of  complex obstetric patients at high risk for severe complications of influenza.

Actions:

In the 2018 influenza season, with the support of the hospital executive, a trial of the Cepheid flu/RSV rapid test on site at KEMH was initiated. A multidisciplinary team of Infection Prevention, microbiology, pharmacy and medical and nursing/midwifery educators co-ordinated the launch of the test, which was integrated into an influenza  patient management plan. The cost of oseltamivir, a non- PBS medication, was identified as a significant barrier to early intervention in pregnant women with influenza who were not yet unwell enough to be admitted.   A process for dispensing of oseltamivir directly from the emergency centre to discharged patients infected with influenza was put in place. Inpatients were assessed promptly for appropriateness of prescribing antiviral medication. Education regarding infection prevention, selecting patients for the rapid test, appropriate taking of samples and use of test results in clinical decision making was undertaken in medical and midwifery forums and on line learning. Effectiveness of the pilot was audited after 6 months.

Results:

Use of the rapid test reduced turn- around time from sample collection to result down to less than 2h during office hours in 17/18 cases. The test resulted in earlier treatment of affected patients and avoidance of unnecessary oseltamivir use. Formal implementation, with extension of the rapid test to 7 day per week availability resulted in good preparedness for an early and severe influenza season in 2019.


Biography:

Dr Michelle Porter is a microbiologist and infectious disease physician at PathWest Laboratory services in  Perth. Dr Porter provides microbiology , infection control and antimicrobial stewardship support to King Edward Hospital. King Edward Hospital is the tertiary referral obstetric hospital for WA.

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