To amplify Jonathan's response
The PCx system works fine, but that's the easy bit.  The users like the
sytem and we have no difficulty migrating from traditional meters.  The key
to success is an effective training programme.  This is very difficult in
large complex organisations with very busy staff.  So we (i.e a
multidisciplinary team) have put a lot of effort into training programmes.
The hospital's diabetes training pack for nurses was re-written by our nurse
colleagues in parallel with introduction of networked meters.  The meters
are just part of the initiative to improve diabetes management.

It's great to have daily QC regulated at the point of care by the meters.
This part falls within the lab's responsibility and so is 'easy' to achieve.

We've had to wait for barcoded patient wristbands to become available.
Initially we had problems with uptake of barcoded wristbands.  This is
largely a communication problem, we believe, and we're addressing this.
Yesterday's practical teaser - who's job is it to put a new ribbon in the
Medical Assessment Unit barcode printer when required?  This is an example
of the aaaarghhhh factor.
Staff ID entry from barcodes on ID badges is next - again we've had to wait
for the Trust to introduce this facility but patience is a virtue.

Effective human communication is a prerequisite for effective electronic
networking.

Richard Taylor
Clinical Biochemist


> ----------
> From:         Jonathan Kay
> Reply To:     ACB Point of Care Testing List
> Sent:         Wednesday, October 9, 2002 13:25 PM
> To:   [log in to unmask]
> Subject:      Re: EPR OF POCT's
>
> Autoidentification issues
> * Reagents, QC materials etc: no real problems
> * Staff: we have gone for barcoded staff badges ith the staff ID number
> in a 1-D barcode
> * Patients: We have gone for barcoded wristbands with the PAS number in
> a 1-D barcode. Originally issued from Clinical Biochemistry, now by ICT.
> No data entered other than PAS number.
>
> Connectivity:
> Meters to control software: limiting factor was getting the network
> points installed. lab now has cordless drill
> Control software to LIMs: no real problems, just like an in-laboratory
> analyser. But we do have a lot of skill and an in-house LIMS...
>
> Making it happen:
> Aaaarghhhh!
>
>
> So our conclusions are:
> * Get all the technology ready (as above), get this done really early
> before trying to use it all "joined up"
> * Then spend all your time with the ward staff, mostly the nurses in
> making it happen. But autoID and data-networking is not a killer
> application for these staff. Of course it is for quality and
> accountability (currently known as clinical governance. Don't expect
> them to understand our approach to SOPs, IQC, EQA etc. You need to get
> them engaged and then build up from there.
>
> Jonathan
>
> http://oxmedinfo.jr2.ox.ac.uk/oxpoct/
>
> (Abbott PCx meters and control software)
>
>
> On Wednesday, October 9, 2002, at 09:57 , Knowles Derek (RR9) Pathology
> wrote:
>
> > I carryout a yearly audit of ou Near Patient testing support service
> > within
> > my patch and one of the weaknesses is the inability to record or
> > standardise
> > the recording of bood glucose and blood gas results against a positive
> > patient id. In the case of glucose we provide documentation sheets that
> > should provide this information but these are completed in only 30% of
> > all
> > tests performed(pressure of work is the reason provided for the poor
> > compliance). With blood gas analysis access is denied unless the tester
> > input password, operator id and hospital number/patient name. This gives
> > them access but in most cases it is impossible to id patients.  A mix of
> > information including 'bed1, arrest'  and other inappropriate
> > information is
> > used. The gas analysers are not linked to his or path information
> > systems.
> > New CPA(UK) standards to be introduced next year and local clinical
> > governance interest supports the need to change to a system that
> > povides an
> > audit trail of all patient results irrespective of whether they are
> > performed at the bedside or in Pathology. My view is to introduce epr at
> > ward level to reduce manaul input of patient information and results
> > to a
> > minimum.
> > Has anyone tackled this issue and if so would you like to share 'the
> > experience'? or failing that has anyone any ideas!
> > We currently use Advantage meters and Synthesis gas analysers supported
> > with
> > a lab based Impact DMS used to monitor the 4 analysers.
>
>