POINT OF CARE TESTING

1. POINT OF CARE TESTING Presented by: Benjamin Kuchta

2. OBJECTIVES • Describe Point Of Care Testing • Describe the technology associated with this trend • Assess the role and function of the nurse when using Point of Care Testing • Discuss the advantages and disadvantages from a nursing perspective • Discuss the future of this technology

3. DESCRIPTION • Point of Care testing - Diagnostic and Laboratory testing done at the patient’s bedside (Biology Online, 2005)

4. DESCRIPTION • Handheld system is portable, easy to use, and performs a complete panel of tests from a single platform (ABBOTT, 2009)

5. DESCRIPTION Tests Include: (ABBOTT, 2009) • Blood Gases • Electrolytes • Chemistries • Coagulation • Hematology • Cardiac Markers

6. HARWARE • Handheld computer analyzes and performs a comprehensive panel of critical tests in minutes • Disposable 1 ounce cartridges enable user to run a variety of critical tests at the patient’s bedside • Downloader available to review and store collected results and data • Printer to view instant results (Abbott, 2009)

7. Hardware Description • A few drops of blood are collected and placed into the self contained cartridge • Cartridge is then closed and placed into the portable handheld computer analyzer • Analyzer instantly processes the sample and results are available within 2 minutes.  (Abbott, 2009)

8. Software • Biosensor technology • Advanced microfluidics (Abbott, 2009)

9. Software description • Biosensor technology: An analytical device that converts the concentration of an analyte in an appropriate sample into an electrical signal by means of a biologically derived sensing element intimately connected to, or integrated into, a transducer. (“Biosensor,” 2009) • Advanced microfluidics: A nanotechnology developed for biochemical assays of minuscule samples. Typically cramming numerous electronic and mechanical components into a portable unit, they are especially useful for conducting rapid analysis in the field. (“Microfluidic system,” 2009)

10. Usability of Software • Ease of use: To perform a test, simply draw two drops of blood, close the cartridge, and insert it into the handheld analyzer. • Efficiency of use: Test takes two minutes for final results to display. • Fit of the system to the task: Nurses are able to obtain critical values within minutes. (Abbott, 2009)

11. Information System • Point of Care uses a clinical information system • Information is transferred from Point of care devices to the Data Management System • From the DMS, information is transferred to both the hospital information system and the laboratory information system • (Point of Care, 2009)

12. Information System Review • Clinical Information System • Used by physicians and nurses • Used for diagnosis and treatment • Point of Service configuration is used • Data standards used include: ANSI, HL7 • ICD-9 • Uses the Omaha System, NANDA Taxonomy, and ICNP for nursing practice standards • (Kost, 2002)

13. Advantages • Results in less than two minutes • Only a few drops of blood needed • Quicker treatment time • Processed at bedside • Simple user interface • Capable of processing wide array of tests • Reduces incidence mislabeled specimens (Abbott, 2009)

14. Disadvantages • Cost for tests not covered by some insurance companies • Requires frequent calibration • Cost of implementation of new system (Point of Care, 2009)

15. Ethical Issues • Use of POC despite limited insurance reimbursement • Higher cost of Point of care testing compared to central lab costs • Is quality compromised for convenience? (Point of Care,2009)

16. Informatics competancies • Be able to correctly operate hand held POC Analyzer • Be able to correctly obtain blood sample and apply to appropriate cartridge • Know normal lab values of POC tests • Be able to appropriately treat abnormal values • Be able to obtain current and saved POC data

17. Functions and Responsibilities of Informatics Nurse • Be an advocate for POC testing • Be able to implement POC system • Oversee proper orientation and education of system • Be able to troubleshoot any problems that may occur • Link to both nurses and management • Quality control and assurance

18. Summary • Point of care testing is a fast, efficient technology that can be done at the patient’s bedside. • The quick results allow nurses to quickly recognize and treat abnormal values. • The main objective of POC testing is to provide the best patient care possible

19. BIBLIOGRAPHY (2009). Biosensor. Retrieved from http://encyclopedia2.thefreedictionary.com/biosensor (2005). Point of Care systems. Biology Online. Retrieved (2009, September 15) from http://www.biology- online.org/dictionary/Point-of-care_systems. (2009). Abbott Point of Care Product Information. Retrieved (2009, September 15) from HTTP://www.ABBOTTPOINTOFCARE.COM/I STAT/www/products/index.asp microfluidic system. (2009). In Encyclopædia Britannica. Retrieved October 13, 2009, from Encyclopædia Britannica Online: http://www.britannica.com/EBchecke d/topic/1068812/microfluidic-system (2009). Point of care testing. Retrieved from http://www.bio- medicine.org/medicine-products/Point-Of-Care- Testing--28POCT-29-Information-System-10077-1/ .Kost, G. J. (2002). Principles & practice of point-of-care testing. 2002.