Testing for COVID-19 is a key strategy in Nova Scotia’s Public Health response to the 2020 pandemic. Persons are tested for COVID-19 for the following reasons:
In provincial assessment centres and other practice settings, regulated health care providers (i.e. Registered Nurses (RN), Physiotherapists (PT) and Registered Respiratory Therapists (RRT)) can independently follow one of two provincial Care Directives from Public Health to screen, assess and test persons for COVID-19. Other regulated health care providers, such as Licensed Practical Nurses and Dieticians, can also screen, assess and test persons for COVID-19 in collaboration with an RN, PT or RRT. Unregulated health care providers (UCPs) can be assigned the task of COVID-19 specimen collection from any regulated health care provider. UCPs are not permitted to screen or assess a person for COVID-19 symptoms or exposure criteria.
The main COVID testing offered at Primary Assessment Centres is PCR testing. During times of COVID surge, or as directed by Public Health, POCT testing may also be offered.
Also called a molecular test, this COVID-19 test detects genetic material of the virus using a lab technique called polymerase chain reaction (PCR). The preferred PCR test in Nova Scotia is obtained by collecting a specimen using a swab, via the nasopharyngeal route (NP). Other options include a throat/nare swab, or a saline gargle test (available for children 4 to 18). Results are available within 4-6 hours (stat), or routine in 24–72 hours. The PCR test is used as a diagnostic tool for COVID-19.
Point-of-care tests are performed at or near the place where a specimen is collected, and they provide results within minutes rather than hours. These may be molecular, antigen, or antibody tests. Rapid point-of-care tests provide results within minutes (depending on the test). In Nova Scotia, POCT are used as a screening tool only, as they are not adequately sensitive to rule out COVID-19 in symptomatic or exposed individuals.
COVID-19 PCR testing is available for adults via swab collection from the nasopharyngeal area or throat and nares. Children and youth from 4 to 18 also have the option of COVID-19 PCR testing via the saline gargle test. All health care providers must successfully complete the required education and skills practice prior to independently performing COVID-19 specimen collection. Education involves learning how to:
Patient education regarding test results and post-testing precautions is provided by regulated health care providers, but can be reinforced by UCPs (i.e. providing patient education pamphlet).
An Unregulated Care Provider (e.g., Emergency Support Aide) should seek assistance from a regulated health care provider in the following circumstances:
A college, association, board or other entity regulates the practice of the provider in the public interest by setting out the criteria for membership, a process for the investigation/resolution of complaints against members, and provides that persons who are not admitted as members may not engage in the scope of practice as defined in the governing statute. A regulated care provider has a governing statute, a scope of practice as defined in its governing statute, and is guided by standards of practice and a code of ethics.
Regulated care providers who are currently supported to participate in COVID-19 testing include the following: NSHA/IWK Registered Nurse (RN), Licensed Practice Nurse (LPN), Advanced and Critical Care Paramedics (ACP and CCP), Registered Respiratory Therapist (RRT), Physiotherapist (PT), NSHA Speech-Language Pathologist (SLP), NSHA/IWK Medical Laboratory Technologist (MLT), NSHA Dietitian with additional education and training in dysphasia, NSHA Graduate Nurse, NSHA Graduate Practical Nurse, and Victorian Order of Nurses (VON) RN and LPN.
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