Monitoring and optimization of POCT devices in a multi-specialty hospital in Poland: usage trends, quality assurance, and clinical impact (2017-2024).

Abstract

Rapid access to blood laboratory test results is crucial for diagnosing and treating patients in life-threatening conditions. Oxygenation status and acid-base balance are determined on arterial blood gasometry and are vital components of modern treatment algorithms for critically ill patients, similar to capillary blood glucose level measurement. The aim of this study is to present a modern method of reporting the work of critical parameter analyzers and glucometers in a multi-speciality hospital. The material for the analysis consisted of data obtained during the supervision of POCT devices in the clinics/departments/institutes of MIM-NRI from 2017 to 2024. Analyzing the use of glucometers in MIM-NRI from 2017 to 2024, it was noted that their usage significantly increased during the COVID-19 pandemic compared to the previous period. Currently, 112 devices are continuously used in both locations. All of them are subject to international and national quality testing, as well as daily internal calibration checking at their workplaces. There are currently 13 analyzers of critical parameter in the clinics and departments of MIM-NRI. All operate within the AQURE system, which allows for monitoring the correct operation of these devices and helps in quickly identifying analytical problems and reporting in real-time about the device's operational status. In the first half of 2024, 40,082 blood sample tests were performed on patients. Analysis of correctly performed gasometric tests conducted in clinics and laboratories shows similar values, ranging from 84.17% to 86.38%. In addition to external control, critical parameter devices must necessarily undergo daily internal laboratory control and calibration. The highest number of correctly performed calibrations, 9,239, was recorded in the Cardiac Surgery Clinic's Intensive Therapy Unit, accounting for 29% of all correctly performed calibrations for these devices. In the analyzed period of 2024, the rate of correctly performed quality checking's was 82.26%. The highest number of correct analyses, 636, was conducted in the Intensive Therapy Unit of the hospital in Legionowo, accounting for 10.32% of all controls performed. The demand for POCT tests in Polish hospitals is steadily growing due to their enormous potential and the time savings associated with performing tests directly at the patient's bedside. The greatest advantage of POCT is that by providing quick access to test results, diagnosis can be accelerated, and treatment initiated more rapidly. Additionally, POCT tests conducted in emergency rooms or hospital emergency departments can help to reduce the number of unnecessary hospitalizations or costly imaging tests. Having an appropriate POCT data management system in a multi-specialty hospital and ensuring IT communication is currently indispensable for proper patient care.