1. Hamm, Randy DNP, RN, CEN
  2. Komansky, Brittany MHA, BSN, RN, CEN
  3. Beck, Emily BSN, RN, CEN

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Along with many other hospital organizations around the country, WakeMed Health & Hospitals in Raleigh, North Carolina, faced difficult decisions when the COVID-19 pandemic emerged. How can a hospital uphold guidelines set by the Centers for Disease Control and Prevention while providing safe and effective care to patients, all while conserving personal protective equipment? Furthermore, how can the organization help alleviate some of the stress and anxiety that the nurses and care teams are experiencing during this trying time? After careful planning, the leadership team of the emergency services departments developed and implemented an Emergency Services Swab Resource Team.


The collection of specimens from the surface of the respiratory mucosa with a nasopharyngeal swab is the standard procedure used for the COVID-19 diagnosis in adults and children (Centers for Disease Control and Prevention, 2020). However, proper collection of the specimen is essential to minimize false-negative results, and that depends on the expertise and training of those performing the procedure (Patel, 2020). The Emergency Services Swab Resource Team, composed of nurses nicknamed "super swabbers," received additional training in the appropriate collection of nasopharyngeal specimens. This training included viewing a video on the specifics of swab collection, followed by a written competency validation test.


The super swabber, available 24/7, carries a hospital-issued cellular device and, when requested, responds and collects every COVID-19 test for all inpatient and outpatient units. Whether in the emergency department, medical unit, or intensive care unit, the super swabber brings all of their own personal protective equipment conserving floor stock, collects the swab using appropriate procedure and technique, and sends the swab for analysis. There is no need for the primary nurse of the patient to enter the room during this swabbing since it is a high-risk procedure that could induce a patient to cough or sneeze, providing a little feeling of extra security to that primary nurse.


Utilizing current nurses as super swabbers allow bedside nurses to continue doing what they do best, providing excellent care, but it also allows for nursing positions to be reallocated and reassigned at a time when the overall hospital census is low. The program, well-received by nurses, patients, and leaders, has received complete support from hospital administrators. The resource team not only supports the nursing staff and patients of WakeMed Health & Hospitals but also provides consistency in nasopharyngeal swab testing, allowing for more accurate test results that can be tracked nationwide.


During this time of uncertainty, hospital systems must take drastic steps to provide safe care to their patients while remaining fiscally responsible, but the mental and physical well-being of the healthcare delivery teams cannot be forgotten. Even if this extra support seems minimal, anything that can be done to curtail anxiety and fear is very much appreciated by our frontline workers.




Centers for Disease Control and Prevention. (2020). Interim guidelines for collecting, handling, and testing clinical specimens from persons for Coronavirus Disease 2019 (COVID-19). Retrieved May 31, 2020, from [Context Link]


Patel Z. (2020). Reflections and new developments within the COVID-19 pandemic. International Forum of Allergy & Rhinology, 10(5), 587-588. . [Context Link]