I would be most grateful for discussion/advice on the following:-
AS those in the UK may know CPA (the majot accreditation organisation for
medical laboratories in the UK) often carries out an indspection of the
near-patient (point-of-care) testing services of the hospital served by the
laboratory. If these services are organised and run in accordance with the
receommendations of the Joint Working Group for Quality Assurance, the
service is accredited in addition to the services provided by the individusl
specialities within the laboratory. If the NPQ service is not run in
accordance with these guidelines the it is not accredited, but this does not
affect the accreditaion status of the laboratory specialties (it being felt
that the laboratory should not suffer from the maverick activities of some
of the less well-controlled clinicians or wards).
The NPT services that are accredited in this way usually comprise blood-gas
analysers in specialist wards, blood glucose anaysers in many wards and
outpatients' clinics, and other equipment such as paediatric
bilirubinometers. Some of these analysers are noe growing more complex and
include other tests such as electrolyes and haemoglobin in some blood gas
analysers. We are relatively happy with what we currently do in this
respsct.
But I have been just asked what is CPA's position regarding 'stick' testing
that is not associated with instrumentation.
This includes urine glucose testing and/or multitest stcks usage widely used
in a variety of outpatient clinics and some ward situations. Occasional QC
forays into this area have sometimes shown very poor QC performance, but
these very time-consuming and unrewarding exercises usually fizzle out for
these reasons. Should these "analyses" be subject to the same
recommendations that we apply to ward and out-patient instruments? Should
CPA refuse to accredit such a service unless these ephemeral investigations.
Or are these tests rarely used seriously and never acted upon in the
clinical situation?
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