#POTASSIUM POC ISTAT TRIAL#

For older patients living with frailty who develop acute illness, assessments by OOH clinicians are frequently made in patients’ homes, making this an ideal setting to trial point of care blood tests. Out of Hours (OOH) Primary Care involves high risk decision making, as clinicians assess patients who are more likely to have acute illness, without prior knowledge of the patient and with limited access to diagnostic tests or medical records. This technology is a relatively expensive additional tool which has not previously been available to clinicians undertaking urgent care out of hours home visits. POC blood testing technology is increasing in scope and reducing in size, meaning that it is now possible for clinicians to have immediate access to some blood test results in patient’s homes. Īn intervention which could enable the expansion of acute care capabilities in the community is improved access to diagnostic technologies previously only available in hospital settings. Point of care (POC) testing is identified as a technology that could facilitate community-based care. Implementing initiatives which transfer care from hospital to other settings requires consideration of organisational and individual factors which determine their feasibility and effectiveness. ConclusionĬlinicians described a discriminatory approach to using POC tests, considering carefully in which situations they were likely to add value to clinical decision-making.Ĭurrent healthcare policy for the NHS in England seeks to treat more people in their homes, as an alternative to hospitalisation, thus shifting the balance of care to the community. Clinicians who had used POC tests described benefits, including planning onward care trajectories, and facilitating communication, both between professionals and with patients and their families. The challenges of using the equipment in patients’ homes was a potential barrier, though could become easier with familiarity and experience. The clinicians reflected on their decision-making to use (or not use) POC tests, including considering which clinical scenarios were “appropriate” and balancing the resources and time taken to do POC tests against what were perceived as likely benefits. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Our sample included 7 GPs (4 interviewed once, 3 interviewed twice - earlier and later during the study), 6 emergency practitioners (EPs) including advanced nurse practitioners and paramedics, 1 Healthcare Assistant, and 2 ambulatory care physicians. To explore evolving perspectives over time, including experience and exposure to POC tests, we offered clinicians the opportunity to be interviewed twice throughout the study period. We conducted 19 Semi-structured interviews with clinicians working in OOH, including those who had and had not used the POC tests available to them. To explore clinicians’ perspectives on having POC tests available during OOH home visits, we undertook a qualitative study with clinicians working in Oxfordshire OOH home visiting teams. During a service improvement project, POC tests (including creatinine, electrolytes, haemoglobin and lactate) were made available to clinicians undertaking OOH home visits, with the clinicians allowed absolute discretion about when and whether they used them. Little is known about clinicians’ perspectives on the use of point of care (POC) tests in assessment of acute illness during primary care out of hours (OOH) care.

Potassium poc istat