{"title":"Point-of-Care Testing Abstracts From the 2019 American Association for Clinical Chemistry Annual Meeting","authors":"","doi":"10.1097/poc.0000000000000206","DOIUrl":"https://doi.org/10.1097/poc.0000000000000206","url":null,"abstract":"","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75329759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cristina Pizarro Sánchez, P. O. Sáez, P. Fernández-Calle, Marta Suescun Giménez, Ricardo Miguel Alonso Díaz, Erika Perez Zafra, Núria Estañ Capell, A. Buño Soto
{"title":"Analytical Evaluation of ABL90 Flex Plus Blood Gas Analyzer for Urea and Creatinine","authors":"Cristina Pizarro Sánchez, P. O. Sáez, P. Fernández-Calle, Marta Suescun Giménez, Ricardo Miguel Alonso Díaz, Erika Perez Zafra, Núria Estañ Capell, A. Buño Soto","doi":"10.1097/POC.0000000000000200","DOIUrl":"https://doi.org/10.1097/POC.0000000000000200","url":null,"abstract":"Background Acute kidney injury is a common complication among hospitalized patients. The availability of creatinine and urea measurements as point-of-care testing provides an alternative strategy to monitor renal function and develop prevention strategies, especially in the emergency services, where reducing waiting times and rapid clinical decisions may be required. Objective The aim of this study was to evaluate if creatinine and urea measurements are interchangeable between ABL90 Flex Plus and three common central laboratory methods. Methods With a multicenter design, creatinine and urea were first analyzed by ABL90 Flex Plus and then by laboratory method: Dimension Vista 1500, Cobas c702, and Architect c16000 according to Clinical and Laboratory Standards Institute EP09-A3 protocol. All measurements were performed in duplicate. Results were evaluated using Passing-Bablok regression and Bland-Altman comparison. Interchangeability of patient results was verified at different clinical decision levels. Results Passing-Bablok regression between the 3 central laboratory methods and ABL90 Flex Plus showed correlation coefficients over 0.998 for creatinine and 0.994 for urea, and despite the presence of proportional and/or constant bias observed in the study, estimated difference was lower than the allowable difference (±15.6% for urea and ±8.9% for creatinine) at clinical decision levels in all cases. Conclusion Creatinine and urea measurements are interchangeable using ABL90 Flex Plus blood gas analyzer compared with 3 central laboratory methods, ensuring no impact on patient care using indistinctly any analyzer.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":"41 1","pages":"37 - 42"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86437179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Integrating Competence Assessment, Internal Quality Control, and External Quality Assurance in a Large Point-of-Care Testing Network","authors":"C. Martin, A. StJohn, T. Badrick","doi":"10.1097/poc.0000000000000199","DOIUrl":"https://doi.org/10.1097/poc.0000000000000199","url":null,"abstract":"Abstract Point-of-care testing is widespread and requires a different form of quality control and quality assurance model to conventional laboratory testing because the types of error that occur are different. In many situations, the point-of-care instruments and operators are part of a broader organizational network. We have developed a different model for the provision of a quality framework for these situations. The quality of the instrument cartridges is checked centrally, and the quality assurance is wider in concept assessing the operator competence and instrument operation. Centralizing some of the quality control reduces errors and allows for greater confidence in the results.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":"55 43 1","pages":"1 - 3"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90638034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reliability of Point-of-Care International Normalized Ratio Measurements in Various Patient Populations","authors":"Kim Arline, C. Rodriguez, K. Sanchez","doi":"10.1097/poc.0000000000000197","DOIUrl":"https://doi.org/10.1097/poc.0000000000000197","url":null,"abstract":"Purpose The aim of this study was to determine if the Coagsense point-of-care (POC) instrument provides more reliable international normalized ratio (INR) measurements than Coagucheck XS POC in comparison to the Stago laboratory instrument in different disease states. Methods This was a prospective study of outpatient warfarin patients comparing venous Stago INR to fingerstick INR on the Coagsense and Coagucheck XS POC meters. Patients were invited to study if they had an of INR 2.0 to 5.0 and had a medical history of antiphospholipid syndrome, hypercoagulable disorder, autoimmune condition, peripheral vascular disease, mechanical heart valve, atrial fibrillation, or deep vein thrombosis/pulmonary embolism/cerebrovascular accident history. Results Seventy-seven patients were enrolled. Coagsense correlated well (92% of INRs within 20% of Stago, 64% of INRs within 0.2 of Stago, overall INR bias of 0.1 or 4%). Six patients had greater than 20% POC INR bias, which could have resulted in 4 warfarin dosing errors. Coagucheck XS INRs correlated poorly (49% within 20% of Stago, 10% of INRs were within 0.2 of Stago, overall INR bias of 0.66 or 25.7%). Forty-one patients had greater than 20% POC INR bias in all diseases, which could have resulted in 28 warfarin dosing errors. The average Coagucheck XS INR bias (0.46–1.3 INR) increased with each 0.5 increase in laboratory INR, whereas Coagsense bias remained stable (0.1–0.25) as INR increased up to 4.3. Two patients correlated well on Coagucheck XS but not Coagsense. Conclusion Coagsense correlated better than Coagucheck XS and did not show increasing bias as INR increased. Both POC instruments had higher INR variability in 4 disease states (antiphospholipid syndrome, autoimmune, peripheral vascular disease, and hypercoagulable). Patient-specific laboratory correlations may be needed on each POC device.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":"76 1","pages":"12 - 18"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83869448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Optimizing Quality Practices in Point-of-Care Testing","authors":"S. Sengupta, A. Handoo","doi":"10.1097/poc.0000000000000198","DOIUrl":"https://doi.org/10.1097/poc.0000000000000198","url":null,"abstract":"Abstract With testing in health care becoming more decentralized to include the patient bedside, quality assurance in point-of-care testing (POCT) assumes immense significance in optimizing clinical outcomes. However, complex regulatory requirements, training of testing personnel, and implementation of a uniform quality policy in varied locations across the hospital pose the greatest challenges in achieving the desired result. Although 70 POCT instruments were being used across our hospital, there was no structured program in place. In accordance with the requirements of the Joint Commission (JCI) accreditation, efforts were made to bring the supervision of POCT under the supervision of the laboratory. Initial internal audits revealed absence of quality assurance policies, inadequate documentation, and lack of uniformity in POCT practices across the hospital. Standard operating procedures on uniform POCT practice, quality control, and critical values were formulated. Training of testing personnel was conducted. Internal quality control and proficiency testing programs were designed and implemented. Periodic evaluation revealed a paradigm shift in the attitude of the testing personnel and the treating physicians toward POCT. It helped in ensuring strict adherence to quality practices in POCT and increased confidence in the reported results. This impacted positive clinical outcomes. Although, on one hand, the implementation of a structured POCT program facilitated the accreditation by the Joint Commission, it also helped us achieve uniformity and a high level of quality in POCT across the hospital. A multidisciplinary organizational approach for POCT under the direct supervision of the laboratory improved the quality of patient care.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":"52 1","pages":"11 - 4"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91521810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Status of Point-of-Care Testing and Coordinators in Vietnam","authors":"Thuy Nguyen, G. Kost","doi":"10.1097/poc.0000000000000196","DOIUrl":"https://doi.org/10.1097/poc.0000000000000196","url":null,"abstract":"Supplemental digital content is available in the text. Objectives The goals of this study were as follows: (a) to enhance point-of-care testing (POCT) and improve standards of care throughout Vietnam; (b) to educate point-of-care (POC) coordinators who provide leadership, oversight, and quality assurance; and (c) to promote international dialog and knowledge of POCT in limited-resource settings. Methods Needs assessment of 16 provincial hospitals, 2 each randomly chosen from the 8 geographic regions of Vietnam, was performed. In Ho Chi Minh City, 10 referral, 5 provincial, and 7 district hospitals, and 8 community medical stations were surveyed. Emergency and intensive care unit nurses and doctors, and laboratorian were respondents. Results Glucose meters and blood gas analyzers were the most frequent POC devices in the 16 provincial hospitals. Cardiac biomarker, coagulation, and human immunodeficiency tests were the highest needs. Biomedical engineers managed locations and quality. Point-of-care coordinators were deficient. Generally, hospitals with POCT had no laboratory oversight. Users performed POCT without internal or external quality control (QC). In Ho Chi Minh City, coagulation and cardiac biomarker tests were most desired. Conclusions Clinicians were poorly informed about the availability of urgent, emergency department, and bedside POC tests. No provincial hospitals surveyed offered cardiac biomarker testing, despite the high prevalence of acute coronary syndromes. Challenges to the implementation of POCT comprise: (a) the quality assurance burden for non laboratory personnel; (b) limited human resources to support POCT programs, including virtually total absence of POC coordinators; and (c) no national POCT policy and guidelines. To rectify these deficiencies, we recommend fundamental education at all levels, promotion of POC coordinator user groups, heightened awareness of available POCT, and vigorous international exchanges to enhanced standards of care in Vietnam.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":"15 1","pages":"19 - 24"},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80731523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"AACC Presents: 27th International CPOCT Symposium The Role of Point-of-Care Testing in a Value-Based Healthcare Landscape","authors":"","doi":"10.1097/poc.0000000000000195","DOIUrl":"https://doi.org/10.1097/poc.0000000000000195","url":null,"abstract":"","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89186152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Usability of IBDoc, a Novel Fecal Calprotectin Home-Based Rapid Test in Clinical Practice","authors":"M. Røer, M. Småstuen, A. Røseth","doi":"10.1097/POC.0000000000000192","DOIUrl":"https://doi.org/10.1097/POC.0000000000000192","url":null,"abstract":"Abstract The aim of this study was to examine sustained usability and adherence to a fecal calprotectin (FC) home-based rapid test in an inflammatory bowel disease (IBD) monitoring program in clinical practice. Methods In total, 59 consecutive IBD outpatients were recruited. The participants were asked to measure FC with a home-based rapid test, IBDoc, every second month for a period of 14 months. At start and termination of this time period, they were invited to answer a questionnaire concerning the IBDoc device. The participants were also asked to deliver one stool sample for FC to be analyzed with enzyme-linked immunosorbent assay and analyze the same sample with the home-based FC test at start and termination. Results In total, one-third (34%) of the participants were adherent to the IBDoc program. No patient characteristics were significantly associated with being adherent. The home-based test correlated well with enzyme-linked immunosorbent assay method (Spearman rank correlation coefficient was 0.92, P < 0.001 and 0.74, P < 0.001, at study start and termination, respectively). After having used the IBDoc for over a year, all except for 1 of the 36 participants answering the follow-up questionnaire completely agreed with the statement “I would like to use IBDoc in the future.” Conclusions We found a low adherence to home-based FC measurements every second month for a period of 14 months. Nevertheless, all but 1 of the 36 participants who answered the follow-up questionnaire were interested in continuing using the IBDoc test.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":"32 1","pages":"85 - 91"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88965109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Beyond Price and Functionality","authors":"Becky Clarke","doi":"10.1097/POC.0000000000000194","DOIUrl":"https://doi.org/10.1097/POC.0000000000000194","url":null,"abstract":"","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":"124 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88808502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiguang Liu, Xiangzhi Zhu, G. Kost, John Liu, Jing Huang, Xin Liu
{"title":"The Creation of Point-of-Careology","authors":"Xiguang Liu, Xiangzhi Zhu, G. Kost, John Liu, Jing Huang, Xin Liu","doi":"10.1097/POC.0000000000000191","DOIUrl":"https://doi.org/10.1097/POC.0000000000000191","url":null,"abstract":"Goals The objectives of this study were to improve awareness of point-of-care testing as a new medical field, to solidify relationships among point-of-care professionals and other medical disciplines, and to identify potential for advancing medical applications, economic benefits, and patient impact through timely decision-making for evidence-based medicine. Methods Literature review, comprehensive analysis, focused analysis, inductive logic, general summary of international outcomes, and comparative advances that improve point-of-care impact in China and other countries in need of rapid response were performed in this study. Results The creation of point-of-careology comprised the following: (a) introduction of its research and practical scope, (b) appropriate definition of this new field, (c) description of the range of applications, and (d) identification of relationships with other disciplines. Conclusions Point-of-care testing now is being written into a professional textbook in medical schools in China. Point-of-careology is the outcome of evolution in intelligent diagnostics. Notable achievements in critical care medicine, emergency response, and general practice have resulted from the implementation of point-of-care testing over the past 4 decades. As a new discipline, point-of-careology will contribute to key medical areas, such as disaster preparedness and public health, which we explore. The creation of this new specialty is justified by trends in modern medicine with improved service to the public and by parallel technological advances that empower health care providers at sites of need to deliver complete care cycles quickly and effectively.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":"71 1","pages":"77 - 84"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85149786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}