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Point of Care

'Near-patient testing' (NPT) and 'Point of care testing' (POCT) are used to describe analytical procedures performed for patients by healthcare professionals outside of the laboratory. Recent advances in analytical and information technology have led to rapid growth in the availability and use of POCT including biochemistry, haematology and microbiology tests, in patient care.

The growth in POCT has increased awareness of the need to delivery POCT safely and competently. This in turn has led to increased legislation, comprehensive guidelines and agreed best practice to ensure that POCT is safe and effective. The drivers for change are impacting positively on POCT thus POCT suppliers need to be aware of current trends and able to respond appropriately.

Legislation and Guidelines

The Department of Health and several professional bodies have issued guidance on the safe and effective use and management of POCT as well as notices that highlight the need for cooperation between POCT providers and Pathology laboratories. Consequently bodies such as the Associaton and Clinical Biochemists, Institute of Biomedical Scientists and the Royal College of Pathologists have become key stakeholders in the ongoing development of guidelines that informk best practice in POCT.

Recently, the Medicines and Healthcare Products Regulatory Agency (MHRA) and United Kingdom Accreditation Service (UKAS) in partnership with Clinical Pathology Accreditation (CPA) has developed the first accreditation process and award for organizations providing point-of-care testing. This is a significant milestone for all stakeholders involved in the provision of point-of-care services.

The need for cost savings

There has never been a greater need to find and demonstrate cost savings in the NHS. The PocH-100i in a point of care setting enables cost savings via many routes:

  • Quicker turnaround times for results enabling better patient management in the acute setting and earlier release of the patient. 
  • Instant results availablity leading to improved management of blood product usage and subsequent cost savings with more appropriate use of expernise blood products.
  • The ability to deliver lab qaulity results in a near patient setting (e.g. GPs and community health centres) removes the requirement to transport patients at significant cost to secondary centres and avoids unnecessary secondary referrals.

Security System

As the quality, reliability and ease-of-use improves with the current generation of POC analysers, the focus for improved delivery is switching to the IT solutions that accompany the analysers. The requirements for IT performance are driven by accreditation, new POC testing guidelines and the changing demands in relation to patient record security. Additionally, there is a growing desire for flexible, simplified data flow solutions and validation, plus secure result requirements:

  • POC devices integrating with laboratory and hospital healthcare information systems linked to decision support systems.
  • Devices and their results properly integrated into the process of care.
  • User ID security and management.
  • Compliance with internal quality control and external quality assessment guidelines.
  • Comprehensive logs of activity, user actions, events, errors and results.
  • Operator competency testing.
  • Compliance with national standards.

Staff Education and Development

Modern POCT equipment is designed for ease of use however this can encourage clinical staff to assume that user training is unnecessary. It is essential that users of even the simplest equipment understand that they must be appropriately trained. Training must be provided by a scientifically or technically qualified person and a record kept of trained staff, dates of trainiing and any subsequent updates.

Training should be based on pre-analytical and post-analytical variables and should be in line with current standards set by the CPA, MHRS and UKAS. There should be provision for periodic competency testing as part of an ongoing quality programme for all POCT operators.

Quality and Audit

POCT administrators and users should undertake daily internal quality assessment (IQA) procedures under the guidance and supervision of a designated POCT officer. IQA ensures equipment is funtioning correctly, producing reliable results ad that the user is following the correct analytical procedure. The POCT sevice should also participate in an external quality assessment (EQA) scheme, which is accredited by the CPA, in order to benefit from peer comparison. EQA should be managed in conjunction with the laboratory where advice is available. Results from these schemes should be reviewed regularly at quality assurance meetings which should include medical, laboratory and nursing staff.

The Sysmex Solution

The Perfect Partner

It is imperative to select the right partner when implementing POC projects; a partner that will deliver the best hardware and saftware solutions and help you meet the challenges of maintaining a safe and effective POC service.

Sysmex provide haematology analysers designed for us in a point-of-care setting which deliver results of laboratory quality in a reliable and robust package. The analyser chosen is complimented with a fully comprehensive service provision and an end-to-end solution to meet and manage all POC needs.

The Sysmex POCT team is highly experienced in the implementation and running of a truly compliant and safe POCT service and will be on hand to support you at any stage of the process. 

Pre-Installation

 The Sysmex POC team will carry out a site survey to ensure that all criteria for installation are met and to ensure that appropriate system design is chosen in regard to location of the analyser, IT requirements, training, support and reagent supply.

Training and Installation

 Sysmex UK will provide full certified training for two operators per analyser (further training courses are available if required) and a full set of support material and manuals. Support tools are provided to enable further on-site training for additional system users.

As part of the need to provide ongoing competency assessment, Sysmex UK has developed a unique online scheme that enables its POC customers to participate in web based learning and competency assessment.

All analysers are installed by a trained service engineer to ensure trouble-free installation and rapid availability of the analyser.

Post Installation and Ongoing Support

 Sysmex has implemented a comprehensive support scheme to enable all POC customers to receive a rapid response to any query via a dedicated POC hotline.

Reagent Management and Deliveries

 Sysmex UK will work with the POC customer to ensure that appropriate quantities of reagents and control materials are delivered promptly, via a regular standing order arrangement. Regular stock review is also available.

IT Connectivity Solution

 Sysmex UK can provide the ideal IT solution to accompany chosen POC analysers via MidLynx Middleware. MidLynx delivers connectivity between POC locations and the central laboratory. Ot provides safe and secure solutions to ensure that compliance is met at any POC location and that only competent operators are able to perform POC tests.

MidLynx also offers a number of important security features such as QC lock out, operator Dallas button entry and electronic health record (EHR) compatibility.

PocH-100i

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