Nurses were trained to take blood samples and use the POCT equipment.
The central laboratory personnel validated the POCT instruments, and their diagnostic accuracy was agreed to be at a clinically acceptable level. įocusing on the process management point of view, we hypothesized that POCT would reduce LOS in emergency department (ED) when compared to central laboratory testing and be a factor in patient discharge destination home or hospital. When properly used, POCT can result in a number of benefits in the quality and efficiency of care.
Poct istat gen pnl full#
The full benefit of POCT is acquired when it is implemented together with process redesign. Most studies on POCT focus on diagnostic accuracy instead of process improvement. Some have also reported that POCT strategy alone has not necessarily improved LOS or that it has had effect on only a certain group of patients. focusing on critical care patient population reported reduced LOS using similar iSTAT POCT equipment as used in this study. Many studies on POCT, focused on selected tests and limited patient populations, have suggested reduced length of stay (LOS). The laboratory turn-around time for results from central laboratories (CL) can be over 60 min, compared to 10 to 15 min for point-of-care bedside testing (POCT). Blood testing and diagnostic imaging are essential routines of ED, and especially blood testing is associated with prolonged length of stay. High quality and patient-centered care requires early diagnosis, which is achieved by eliminating unnecessary pre- and post-analytical delays. Thus, with proper training and education of the ED care team, POCT can be used as an effective tool for improving patient flow. This allowed patients to be discharged home quicker. POCT shortened the laboratory process and made results available faster than the central lab. Similar reduction in sampling time and LOS was not seen among those admitted to hospital. When imaging was not required, patients in POCT group were discharged home 55 min faster (4:57 (95% CI 3:59–6:17) vs. POCT results were available faster in both discharge groups, as expected. Median waiting time for blood sampling was 19 min less in POCT than central laboratory (0:52 (95% confidence interval (CI) 0:46–1:02) vs. Resultsĭuring the 4-week study period, 1759 patients underwent sample testing (POCT: n = 160, central lab: n = 951 both n = 648). Blood draw and POCTs were performed by experienced nurses.
Blood testing was performed either with POC instruments for blood gases and chemistry panel, full blood count, and CRP, or at central laboratory, or as a combination of both. MethodsĪ single centre observational study was performed in ED non-ambulatory patients. To avoid confusion, any advice given to clinical staff regarding their analysers should be clear, concise, and above all else, consistent.In this study, we hypothesized that point of care testing (POCT) would reduce length of stay (LOS) in emergency department (ED) when compared to central laboratory testing and be a factor in patient discharge destination. Clinical users of a combined PoCT system are principally interested in the generation of good quality results. Test management issues should be resolved by taking the view that it is a 'point-of-care' test, and by looking at the specific test technology and method involved, rather than by just assuming it is a 'haematology' or a 'chemistry' test. These views must be considered when designing an overall PoCT management plan. Specialties other than clinical chemistry may have differing views on traditional test management, particularly with regard to quality control (QC), quality assurance (QA), and training.
Such analysers, however, are invaluable in some clinical settings. The appearance on the market of small, light, inexpensive, multi-purpose, point-of-care analysers, which combine a number of widely differing analytes, has to some degree upset this paradigm. Point-of-care testing (PoCT) is traditionally considered a branch or offshoot of clinical chemistry.
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