Impact of introduction of xpert flu assay for influenza PCR testing on obstetric patients: a quality improvement project

J Matern Fetal Neonatal Med. 2018 Apr;31(8):1016-1020. doi: 10.1080/14767058.2017.1306048. Epub 2017 Apr 2.

Abstract

Objective: The aim of this project was to assess the implementation of a quality improvement project regarding the introduction of on-site influenza PCR testing in a stand-alone obstetric hospital.

Methods: As part of a quality improvement project on the management of influenza in obstetric patients, the Xpert Flu assay (Cepheid Inc., Sunnyvale, CA) was introduced on-site and it replaced the previous method of PCR testing which was off-site. The main outcome measures were duration of antimicrobials, rate of admission and administration of oseltamavir in the emergency department.

Results: Twenty-eight patients were included in the pre-intervention period and 45 patients were included in the post-intervention period. Following the introduction of the test, there was a statistically significant reduction seen in commencement of antimicrobials (76% pre- and 33% post-intervention), and also rate of admission (88% pre- and 45% post-intervention) while there was a statistically significant improvement in the commencement of oseltamavir in the emergency department (72% pre-and 95% post-intervention) (p < .01 for all outcomes).

Conclusion: Introduction of on-site rapid influenza PCR testing can lead to a significant improvement in patient management and should be considered for introduction to other sites.

Keywords: GeneXpert; Influenza; PCR; Xpert Flu; obstetrics.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use
  • Female
  • Hospitals, Maternity / standards
  • Humans
  • Influenza, Human / diagnosis*
  • Influenza, Human / drug therapy
  • Oseltamivir / therapeutic use
  • Patient Admission / statistics & numerical data
  • Point-of-Care Systems*
  • Polymerase Chain Reaction
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Quality Improvement

Substances

  • Antiviral Agents
  • Oseltamivir