ABSTRACT
OBJECTIVES: New molecular tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are being rapidly launched in response to the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to evaluate the analytical and clinical performance of the VIASURE SARS-CoV-2 S gene RT-PCR Kit on the BD Max™ system and to compare results with those obtained with the cobas® SARS-CoV-2 test on the cobas® 6800 system. METHODS: For testing the analytical performance, reference material was used. Clinical samples (n = 101) obtained from individuals with symptoms compatible with COVID-19 were studied. Oropharyngeal and nasopharyngeal swabs were collected by using either ESwab™ or UTM™ collection systems. RESULTS: When the analytical performance was evaluated, the sample containing the lowest SARS-CoV-2 concentration tested negative with the VIASURE test whereas results obtained with the cobas® test were found to be concordant with the results expected. Six out of the 101 clinical samples (5.9%) showed an inhibition with the VIASURE test. When analysing the remaining 95 clinical samples, 27 were found to be negative with both assays. Of 68 samples that were positive with the cobas® test, the VIASURE test missed 21 (30.9 %) samples. All of those 21 samples had shown Ct values ≥ 31 with the cobas® 6800 system. None of the samples tested positive with the VIASURE test and negative with the cobas® test. CONCLUSIONS: The VIASURE test was impaired by a lack of sensitivity and a relatively high number of invalid results. When using the VIASURE test for routine testing, a significant number of COVID-19-positive samples would have been missed.
Subject(s)
Betacoronavirus/genetics , Clinical Laboratory Techniques/methods , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Reverse Transcriptase Polymerase Chain Reaction/methods , Spike Glycoprotein, Coronavirus/genetics , COVID-19 , COVID-19 Testing , COVID-19 Vaccines , Case-Control Studies , Coronavirus Infections/virology , False Negative Reactions , Humans , Nasopharynx/virology , Oropharynx/virology , Pandemics , Pneumonia, Viral/virology , SARS-CoV-2 , Sensitivity and Specificity , Severity of Illness IndexABSTRACT
OBJECTIVES: To describe the essence of the nurses' lived experience and explore the meaning of their involvement in end-of-life care after a do-not-resuscitate decision has been made. RESEARCH METHODOLOGY/DESIGN: The research design embraced qualitative, exploratory and descriptive approaches utilising aspects of phenomenology. Purposive sampling of twenty-six registered nurses was used. Data was collected using the reflective journaling technique and were analysed using an integrated approach. Field notes were also used as a mean to enrich the description of the findings contextually. SETTING: Medical units in Saudi Arabia. RESULTS: Three main themes emerged: exhausted medical treatment, continuity of nursing care and cultural considerations in nursing care. Related sub-themes were also identified as an extension to the description of the main themes. CONCLUSION: The findings affirm that nurses working on medical units continue to maintain a constant level of care for patients and families after the do-not-resuscitate decision. Nurses found that caring for dying patients was a rewarding and worthwhile experience, albeit a challenging and demanding one. The findings suggest that improvement in end-of-life care would be best achieved by collaborative and interdisciplinary practices amongst the health care team members.
