Accuracy of Healthcare Professionals Nasopharyngeal Swab Technique in SARS-CoV-2 Specimen Collection

Woods, R.; Walsh, M.; Nwaokorie, K.; Crowley, J.; Lacy, P.; de Barra, E.

Background: The COVID-19 pandemic has caused huge pressure on healthcare systems worldwide. Public health measures to control the virus are reliant on testing, including appropriate collection of specimens for analysis. Methods: A prospective study of nasopharyngeal swab technique by staff in an academic tertiary referral centre was carried out. Nasopharyngeal swab technique was evaluated by a novel design of a navigated swab on a three-dimensional model head. Results: Swab technique of 228 participants was assessed. Technique was poor, with a success rate of nasopharyngeal swabbing at 38.6%. Angle and length of insertion were significantly different between those with successful and unsuccessful technique. Doctors were significantly more accurate than nurses and non-healthcare professionals (p<0.01). Conclusion: Inaccurate specimen collection from poor swab technique could contribute to false negative rate of testing for SARS-CoV-2. Specific training in nasopharyngeal anatomy and swab technique may improve the accuracy of nasopharyngeal swabbing.