I agree with Jan Still - I think she covers the important issues.
We have had excellent experiences with some healthcare assistants (as
they were called) analysing blood gases and, in one case, of being
locally responsible for keeping the equipment in good order and
preventing untrained staff from having a bash. In all cases, though,
the individuals concerned were under our supervision and had been
trained and updated by us. Such staff may well be more reliable than
many junior doctors because they stick to procedures and don't try to
take short cuts.
A high proportion of POCT errors are pre-analytical, so Jan is right in
pointing out that operators need to understand good sample preparation.
They also need to have a clear understanding - and clear procedures in
place - of what to do about unexpected or abnormal results. The fact
that most POCT analytical procedures are now very simple is misleading
many people into thinking that the whole business of POCT is now a
doddle. Persuading some clinicians that however simple the analytical
procedure, junior doctors still need training, can be difficult. Good
pre-and post-analytical standards, understanding QC and EQA, keeping
rigorous records (as ISO 22870 requires) and trained and competent
operators are always going to be essential.
I therefore see no problem about "non-registered" staff (or
non-scientific staff such as AHPs) doing POCT as long as they are
throughly trained by the lab, all the above is in place, and there are
clear lines of responsibility for when things go wrong. Clinicians'
enthusiasm for POCT may well founder on this point.
Dr MJ Pearson
Department of Clinical Biochemistry & Immunology
Old Medical School
Leeds General Infirmary (Leeds Teaching Hospitals NHS Trust)
LEEDS LS1 3EX
UK
tel (44)-[0]113-392-3945
fax (44)-[0]113 392-3453.
http://www.leedsth.nhs.uk
>>> Turner Helen <[log in to unmask]> 22/07/2008 16:44 >>>
Dear all,
I wonder if anywhere has gone down the route of, or even seriously
considered allowing non registered healthcare professionals e.g.
portering staff, to perform Point of Care Testing e.g. the analysis of
samples for blood gases. (I am assuming that nowhere would countenance
them obtaining the sample or interpreting & acting on results!?)
Just trying to get a feel for any changes in common practice I may be
missing.
Regards
Helen Turner
Deputy Healthcare Scientist Service Manager
& Trust Point Of Care Testing Coordinator
Department of Chemical Pathology
Gloucester Royal Hospital
Gloucester Hospitals NHSF Trust
Tel 08454 225237
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