Back to Top Skip to main content Skip to sub-navigation

Airman uses SBAR to improve COVID-19 swab technique

Image of Military personnel in full PPE at a car window demonstrating a swabbing technique. U.S. Air Force Tech. Sgt. Steve Zavala, 422nd Medical Squadron medical operations flight chief and trusted care champion, demonstrates COVID-19 testing procedures at RAF Croughton, England, August 3, 2020. Zavala discovered a COVID-19 testing technique that needed to be changed, so he elevated the concern and impacted testing procedures across the Department of Defense. (U.S. Air Force photo by Airman 1st Class Jennifer Zima).

Recommended Content:

Coronavirus | Coronavirus

Recently, an Air Force medical technician at RAF Croughton in England uncovered a COVID-19 testing technique that needed to be changed, so he elevated the concern and impacted testing procedures across the entire Department of Defense (DOD).

Air Force Tech. Sgt. Steve Zavala, 422nd Medical Squadron medical operations flight chief and trusted care champion, along with three fellow medical technicians, have been testing patients for COVID-19 at the 422nd MDS using the same testing procedure used for the seasonal flu.

“The particular method to collect the COVID-19 swabs is called the nasopharyngeal swab,” said Zavala. “The training that we received is dictated down from DHA [Defense Health Agency]. The DOD Global Respiratory Pathogen Surveillance questionnaire lays out step by step how to do a nasopharyngeal swab.”

One of the steps when collecting a sample, is to first have the patient blow their nose into a tissue. However, while watching COVID-19 testing on the news, Zavala noticed other medical professionals were not having their patients blow their noses before collecting samples.

“I was pretty confident we were doing something wrong here, something just didn’t seem right to me.” said Zavala. “I did some research and finally came across a step-by-step guideline according to the CDC [Centers for Disease Control and Prevention] on what you should do for nasopharyngeal swabs.”

Zavala noticed there were no recommendations stating that patients have to blow their noses. He then searched the Air Force Medical Service Knowledge Exchange COVID-19 page but didn’t find any recommendations for this there as well.

“There’s this big push for medical Trusted Care, not only in the Air Force but across DOD,” said Zavala. “We’re trying to mirror the reliability that the nuclear industry and commercial aircrafts have. Let’s take the naval aircraft carriers for instance. You have jets landing and taking off all the time on these little precise aircraft carriers, and how many times do we hear accidents happening with that? It’s few and far between that stuff happens in the airline and the nuclear industries. Medical has been trying to adopt the principles that those industries have, and we call it Trusted Care.”

Trusted Care is not a program, but a type of culture focused on improved communication.

“It took us three years to get to the point where we’re starting to see some of the positives from doing all of the Trusted Care work. Every department has their own daily huddle. That’s the time to bring up any safety concerns – it’s all safety driven. Every meeting that we have starts with safety moments and safety stories. It’s hard for people sometimes. They just fix things on the fly – they don’t think of things as a safety moment. The way that people learn the best is from stories. It’s to get people to look at things in a different way and maybe it will trigger that story in their mind when they see something else. In a hospital anyone can find something that can be a huge issue.

A Situation, Background, Assessment, Recommendation (SBAR) report is part of Trusted Care. It’s a technique used in healthcare to facilitate in communicating recommendations to improve patient care.

“You’re recommending an action be taken,” said Zavala. “You’re not just complaining about something wrong, but you’re recommending up to the highest levels.”

Zavala sent an SBAR report to his leadership, explained the situation and asked for clearer guidance on testing procedures in order to have more accurate results. They sent the SBAR, and the recommendations to discontinue nose-blowing, to the U.S. Air Forces in Europe Trusted Care Regional and head laboratories. From there, the report gained Air Force level attention.

“The form that is DOD-wide is going to be changed to match the CDC,” said Zavala.

“Speak up if you see something that doesn’t jive with what you’ve been taught,” said Zavala. “A big thing in Trusted Care is to exercise a questioning attitude. It’s always good to ask people for a cross check ‘hey, does this seem right to you?’ It ties into our core value of excellence in all we do. Why are we taking the time to do this, if you feel it’s not the best method?”

You also may be interested in...

Learn the Most Recent Age Requirements for COVID-19 Vaccines and Boosters

Article
8/10/2022
A man fist bumps a child.

The best way to prevent the spread of COVID-19 is to get your vaccines and booster shots.

Recommended Content:

Coronavirus | Getting the COVID-19 Vaccine

Telemedicine Privilege by Proxy Expands Access to MHS Care

Article
8/10/2022
Infographic featuring Lt Col Legault

MHS has Telemedicine Privilege by Proxy: A fast, efficient process that enables providers to file one application and get permission to virtually treat patients anywhere in the MHS.

Recommended Content:

Coronavirus | Telehealth Program

DHA- IPM 20-004: Department of Defense (DOD) Coronavirus Disease 2019 (COVID-19) Vaccination Program Implementation

Policy

Establishes the Defense Health Agency’s procedures to implement instructions, assign responsibilities, and prescribe procedures for the DHA’s implementation of the DOD’s COVID-19 Vaccination Program.

Future of Nursing: Telehealth, More Innovation and Maybe Some Robots

Article
5/13/2022
Second Lt. Nina Hoskins, 81st Surgical Operations Squadron operating room nurse, briefs Col. Debra Lovette, 81st Training Wing commander, and other base leadership on robotics surgery capabilities inside the robotics surgery clinic at the Keesler Medical Center June 16, 2017. (Photo: Kemberly Groue, U.S. Air Force)

The future of nursing is here due in part to changes brought by the COVID-19 pandemic.

Recommended Content:

Nursing in the Military Health System | Coronavirus

How One Military Nurse Persevered Through the COVID-19 Response

Article
5/5/2022
Air Force Capt. Courtney Ebeling, a medical-surgical nurse at Joint Base San Antonio-Randolph Family Health Clinic, Texas, was deployed to support the COVID-19 response in Afghanistan in 2021. They administered vaccinations to U.S. citizens, service members, and foreign military members as well as supported the preparation to withdraw from the country. (Photo: Courtesy of Air Force Capt. Courtney Ebeling)

Nurses across the Military Health System have played a vital role in providing routine patient care and meeting the needs of the COVID-19 pandemic.

Recommended Content:

Coronavirus | Nursing in the Military Health System

‘I Love the Intensity’ – One Nurse Recalls Three COVID-19 Deployments

Article
5/5/2022
In 2020, Air Force 1st Lt. Tiffany Parra, an ICU nurse at the 633rd Medical Group, on Joint Base Langley-Eustis, Virginia, was deployed to a North Dakota hospital to support a FEMA COVID-19 mission. In the photo, she trains on equipment used for critical patients in a North Dakota ICU. (Photo: Courtesy of Air Force 1st Lt. Tiffany Parra)

Nurses are unique, they follow a calling to care for others. Military nurses do that as well as serve their nation. For Nurses Week, the MHS highlights some of their own.

Recommended Content:

Nursing in the Military Health System | Coronavirus

Pandemic Spotlights the Vital Role of Military Lab Workers

Article
5/2/2022
U.S. Air Force Staff Sgt. Ashley Solomon, 18th Medical Support Squadron NCO in charge of microbiology, unloads blood samples from a centrifuge at Kadena Air Base, Japan, Jan. 31, 2019. (Photo: Tech. Sgt. Matthew B. Fredericks, U.S. Air Force)

MHS clinical labs produce results.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus

Helping Your Child to Cope with Grief and Losses Related to COVID-19

Article
4/28/2022
Shirley Lanham Elementary School students perform Taiko drumming during a Month of the Military Child celebration aboard the Naval Air Facility Atsugi, Japan, April 6, 2022. (Photo: Petty Officer 2nd Class Ange-Olivier Clement, Naval Air Facility Atsugi)

Many military children have lost loved ones to COVID-19. How parents can help with the grief.

Recommended Content:

Month of the Military Child - Celebrating Military Kids | Children's Health | Psychological Fitness | Coronavirus and the COVID-19 Vaccine | Coronavirus

How to Help Military Children Reconnect After Two Years of the Pandemic

Article
4/25/2022
Airman 1st Class Rocio Romo, Space Launch Delta 30 public affairs specialist, and her son pose for a photo at Cocheo Park on Vandenberg Space Force Base, California, March 25, 2022. During the month of April, we celebrate Month of the Military Child to highlight the sacrifices military children make on the home front while their parents serve the United States. (Photo: Airman Kadielle Shaw, Space Launch Delta 30 Public Affairs)

How parents can help children stressed by more than two years of COVID-19.

Recommended Content:

Month of the Military Child - Celebrating Military Kids | Children's Health | Psychological Fitness | Coronavirus and the COVID-19 Vaccine | Coronavirus

COVID-19 Booster Effectiveness Remained High During Omicron Surge

Article
4/18/2022
Hospital Corpsman 1st Class Mary Ashcraft, assigned to the combat ship USS Tulsa, administers a COVID-19 vaccine booster to Aviation Machinist Mate 1st Class Anthony Johnson Jan. 10, 2022, at Apra Harbor, Guam. (Photo: Mass Communication Specialist Petty Officer 1st Class Devin M. Langer, Command Destroyer Squadron 7)

Two new studies of active-duty service members show COVID-19 booster vaccines are effective, but uptake rates in the military community lagged behind the civilian population.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus | COVID-19 Vaccine Efforts

8 Tips to Help Kids Adjust to Change during the New Pandemic Phase

Article
4/15/2022
A parent comforts his child while she receives a pediatric dose of the COVID-19 vaccine at Kadena Air Base, Japan, Jan. 28, 2022. (Photo: Airman 1st Class Anna Nolte, 18th Wing Public Affairs)

Parents should prepare their kids for the new normal of the ongoing pandemic, recognizing that the status of the disease can change quickly as new variants of COVID-19 emerge.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus | Children's Health

Military Medical Officials Back FY 23 Budget Before Senate Appropriations Committee

Article
4/6/2022
Marines with Marine Wing Headquarters Squadron, 3rd Marine Aircraft Wing take precautionary measures by cleaning and disinfecting their hands during field day on Marine Corps Air Station Miramar, Calif., March 20, 2020, to mitigate the spread of COVID-19 while continuing to perform mission-essential tasks. (Photo: Marine Corps Lance Cpl. Jaime Reyes)

Military Medical officials, including Army Lt. Gen. (Dr.) Ronald J. Place, Defense Health Agency director, back FY 23 Budget before the Senate Appropriations Committee, March 29, 2022.

Recommended Content:

Public Health | Coronavirus

How COVID-19 Made the Military Medical Community Stronger

Article
3/21/2022
Image of a service member being treated

Lessons learned from the COVID-19 pandemic has made the military medical community stronger and will help when confronting the next crisis, whether that’s another pandemic, a new conflict or natural disaster

Recommended Content:

Health Readiness & Combat Support | Coronavirus and the COVID-19 Vaccine | Coronavirus

COVID-19 Responses Underscore Importance of Patient Safety

Article
3/14/2022
Every day, patient safety is one of the top priorities for the Defense Health Agency. Patient safety means providing ready, reliable care to service members, veterans, and dependents no matter the circumstances. (Photo: Defense Health Agency)

Patient safety is a topmost concern of MHS, and Patient Safety Awareness Week 2022 focuses on Ready, Reliable Care.

Recommended Content:

Patient Safety | Patient Safety Awareness Week | Coronavirus and the COVID-19 Vaccine | Coronavirus | Patient Safety Awareness Week

Answering Your Questions About COVID-19 Testing

Article
2/25/2022
Military personnel performing a COVID-19 Test

COVID-19 continues to spread, now as the Omicron variant. Getting vaccinated is the most effective way to protect you and your family from getting seriously ill, getting hospitalized, or dying. You should also make sure you’re up to date with your vaccines. Testing is another important step you can take to protect yourself and others.

Recommended Content:

Coronavirus and the COVID-19 Vaccine | Coronavirus | At-Home COVID-19 Tests
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 26
Refine your search
Last Updated: August 15, 2022

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.