Current nursing practice of point-of-care laboratory diagnostic testing in critical care units

1995 ◽  
Vol 4 (6) ◽  
pp. 429-434 ◽  
Author(s):  
Lamb LSJr ◽  
RS Parrish ◽  
SF Goran ◽  
MH Biel
Keyword(s):  
Critical Care ◽  
Patient Care ◽  
Laboratory Testing ◽  
Point Of Care ◽  
Diagnostic Testing ◽  
Critical Care Nurses ◽  
Point Of Care Testing ◽  
Critical Care Units ◽  
In Vitro Diagnostic

BACKGROUND: The development of user-friendly laboratory analyzers, combined with the need for rapid assessment of critically ill patients, has led to the performance of in vitro diagnostic testing at the point of care by personnel without formal laboratory training. OBJECTIVES: To determine the range of laboratory testing performed by critical care nurses and their attitudes toward this role. METHODS: A survey of critical care nursing consultants was conducted, using a modified Likert scale, to assess objective measures of point-of-care testing practice in critical care units and to determine nurses' attitudes toward the practice of point-of-care testing. Statistical analysis was performed to determine significant trends in responses. RESULTS: Of the units responding to the survey, 35% used critical care nurses exclusively to perform point-of-care testing, 32.5% used laboratory technicians and critical care nurses, and 25% used other personnel. Of critical care nurses performing laboratory testing, 95.5% performed blood glucose analysis; 18.7%, arterial blood gas analysis; 4.5%, electrolyte analysis; 4.5%, hematology profiles; and 22.7%, other testing. Most agreed that stat tests were not reported promptly, thereby necessitating bedside testing. Respondents indicated that they would prefer that laboratory personnel operate in vitro diagnostic equipment and that requirements for critical care nurses to perform laboratory testing detracted from other patient care duties. CONCLUSIONS: Most nurses who perform point-of-care testing responded that it was necessary and helpful in patient management. However, they would prefer, because of their other patient care responsibilities, that laboratory personnel take this responsibility.

Clinical governance: implications for point-of-care testing

2002 ◽  
Vol 39 (5) ◽  
pp. 421-423 ◽  
Author(s):  
Danielle B Freedman
Keyword(s):  
Point Of Care ◽  
Clinical Governance ◽  
Management Support ◽  
Point Of Care Testing ◽  
Financial Perspective ◽  
National Guidance ◽  
In Vitro Diagnostic ◽  
The Uk ◽  
Based Medicine

With the introduction of clinical governance in the UK during 1997 and the shift in focus from a purely financial perspective to one of quality, it has become even more important that laboratories become involved with in vitro diagnostic devices (IVDs) used outside the laboratories by non-laboratory personnel, namely, point-of-care testing (POCT). The demand for POCT is increasing and its growth will continue with advances in technology, increasing pressure to shorten patient length of stay and requirements to decrease turnaround times, alongside the national initiatives to consolidate laboratories. However, clinical governance is about practising evidence-based medicine, and both the clinical and cost-effectiveness of POCT continue to be debated. Accountability and leadership are pivotal in the implementation of clinical governance. Thus, the onus is on laboratories to take the lead for POCT and ensure that there is a robust risk management strategy to protect not only the staff, but, importantly, the patient. A rigorous POCT policy and national guidance must be adhered to. For a high quality POCT service to be delivered, fulfilling the requirements of clinical governance, a multidisciplinary local group must be established with recognized accountability, appropriate resources and, importantly, management support.

Point-of-care laboratory testing in critical care

1999 ◽  
Vol 8 (2) ◽  
pp. 72-83 ◽  
Author(s):  
MA Harvey
Keyword(s):  
Critical Care ◽  
Point Of Care ◽  
Standard Of Care ◽  
Successful Implementation ◽  
Point Of Care Testing ◽  
Laboratory Equipment ◽  
Critical Care Units ◽  
Respiratory Therapists ◽  
Advantages And Disadvantages ◽  
Outcomes Of Care

BACKGROUND: Critical care practitioners are searching for ways to improve the quality and outcomes of care while decreasing cost and length of stay. One technological advance that may facilitate meeting these objectives is bedside or point-of-care laboratory equipment. Evaluation of point-of-care testing for application in each institution requires information about the devices available; knowledge of the advantages and disadvantages of the technologies, the clinical impact, and cost of the process change; and strategies for successful implementation. OBJECTIVES: To review the literature on point-of-care testing and the experience of healthcare professionals who have already successfully implemented this type of testing. METHODS: A total of 81 relevant published articles were reviewed, and 21 critical care units in 8 facilities that use point-of-care testing were visited. Open-ended interviews were conducted with 83 subjects: 56 nurses, 14 laboratory personnel, 9 respiratory therapists, and 4 others. CONCLUSIONS: Point-of-care testing is a technological innovation with the potential for improving patients' care without increasing costs. It most likely will soon become part of the standard of care.

scholarly journals Types of Assays for SARS-CoV-2 Testing: A Review

2020 ◽  
Vol 51 (5) ◽  
pp. e59-e65 ◽  
Author(s):  
Marie C Smithgall ◽  
Mitra Dowlatshahi ◽  
Steven L Spitalnik ◽  
Eldad A Hod ◽  
Alex J Rai
Keyword(s):  
Patient Care ◽  
Laboratory Testing ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Direct Patient Care ◽  
Point Of Care Testing ◽  
Clinical Laboratories ◽  
Novel Coronavirus ◽  
Outpatient Settings ◽  
Clinical Laboratory Testing

Abstract Clinical laboratory testing routinely provides actionable results, which help direct patient care in the inpatient and outpatient settings. Since December 2019, a novel coronavirus (SARS-CoV-2) has been causing disease (COVID-19 [coronavirus disease 2019]) in patients, beginning in China and now extending worldwide. In this context of a novel viral pandemic, clinical laboratories have developed multiple novel assays for SARS-CoV-2 diagnosis and for managing patients afflicted with this illness. These include molecular and serologic-based tests, some with point-of-care testing capabilities. Herein, we present an overview of the types of testing available for managing patients with COVID-19, as well as for screening of potential plasma donors who have recovered from COVID-19.

Accuracy and precision of point-of-care testing for glucose and prothrombin time at the critical care units

2001 ◽  
Vol 307 (1-2) ◽  
pp. 119-123 ◽  
Author(s):  
Cecilia Yuoh ◽  
M Tarek Elghetany ◽  
John R Petersen ◽  
Amin Mohammad ◽  
Anthony O Okorodudu
Keyword(s):  
Critical Care ◽  
Prothrombin Time ◽  
Point Of Care ◽  
Point Of Care Testing ◽  
Critical Care Units ◽  
Accuracy And Precision

Adverse Events Reporting System as Experienced by Critical-Care Nurses in KwaZulu-Natal, South Africa

2018 ◽  
Vol 20 (1) ◽  
Author(s):  
Thusile Mabel Gqaleni ◽  
Busisiwe Rosemary Bhengu
Keyword(s):  
South Africa ◽  
Critical Care ◽  
Adverse Events ◽  
Patient Care ◽  
Family Involvement ◽  
Reporting System ◽  
Legal Framework ◽  
Critical Care Nurses ◽  
Kwazulu Natal ◽  
Life Threatening

Critically ill patients admitted to critical-care units (CCUs) might have life-threatening or potentially life-threatening problems. Adverse events (AEs) occur frequently in CCUs, resulting in compromised quality of patient care. This study explores the experiences of critical-care nurses (CCNs) in relation to how the reported AEs were analysed and handled in CCUs. The study was conducted in the CCUs of five purposively selected hospitals in KwaZulu-Natal, South Africa. A descriptive qualitative design was used to obtain data through in-depth interviews from a purposive sample of five unit managers working in the CCUs to provide a deeper meaning of their experiences. This study was a part of a bigger study using a mixed-methods approach. The recorded qualitative data were analysed using Tesch’s content analysis. The main categories of information that emerged during the data analysis were (i) the existence of an AE reporting system, (ii) the occurrence of AEs, (iii) the promotion of and barriers to AE reporting, and (iv) the handling of AEs. The findings demonstrated that there were major gaps that affected the maximum utilisation of the reporting system. In addition, even though the system existed in other institutions, it was not utilised at all, hence affecting quality patient care. The following are recommended: (1) a non-punitive and non-confrontational system should be promoted, and (2) an organisational culture should be encouraged where support structures are formed within institutions, which consist of a legal framework, patient and family involvement, effective AE feedback, and education and training of staff.

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