Point-of-care blood tests during home visits by out-of-hours primary care clinicians; a mixed methods evaluation of a service improvement: Objectives
We aimed to evaluate test usage and patient and clinician experience following the introduction of point-of-care (POC) blood tests into a primary care out-of-hours service.
Design
A mixed methods service evaluation comprising quantitative records of the clinical contexts of tests taken and qualitative interviews with clinicians. Research permissions and governance were obtained for patient interviews.
Setting
Out-of-hours primary care.
Participants
All patients requiring home visits from the service during the implementation period.
Interventions
The i-STAT POC blood test platform was introduced to two bases providing home visits for a period of 8 months. Venous blood samples were used and two cartridges were available. The CHEM8 cartridge measures sodium, potassium, chloride, total carbon dioxide (TCO2), anion gap, ionised calcium, glucose, urea, creatinine, haematocrit and haemoglobin. The CG4 cartridge measures lactate, pH, PaO2 and PCO2, TCO2, bicarbonate, base excess and oxygen saturation.
Primary and secondary outcome measures
The proportion of home visits where tests were taken, the clinical contexts of those tests, the extent to which clinicians felt the tests had influenced their decisions, time taken to perform the test and problems encountered. Clinician and patient experiences of using POC tests.
Results
i-STAT POC tests were infrequently used, with successful tests taken at just 47 contacts over 8 months of implementation. The patients interviewed felt that testing had been beneficial for their care. Clinician interviews suggested barriers to POC tests, including practical challenges, concerns about time, doubt over whether they would improve clinical decision making and concern about increased medicolegal risk. Suggestions for improving adoption included sharing learning, adopting a whole team approach and developing protocols for usage.
Conclusions
POC tests were not successfully adopted by an out-of-hours home visiting service in Oxfordshire. While some clinicians felt they could not add value, in other cases they resulted in improved patient experience. Adoption could be promoted by improving technical, team and education factors.
Medicine RSS-Feeds by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com
Πληροφορίες
Τετάρτη 15 Ιανουαρίου 2020
Point-of-care blood tests during home visits by out-of-hours primary care clinicians; a mixed methods evaluation of a service improvement
Αναρτήθηκε από
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
στις
10:51 μ.μ.
Ετικέτες
00302841026182,
00306932607174,
alsfakia@gmail.com,
Anapafseos 5 Agios Nikolaos 72100 Crete Greece,
Medicine by Alexandros G. Sfakianakis,
Telephone consultation 11855 int 1193
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Αρχειοθήκη ιστολογίου
-
►
2023
(366)
- ► Φεβρουαρίου (184)
- ► Ιανουαρίου (182)
-
►
2022
(2814)
- ► Δεκεμβρίου (182)
- ► Σεπτεμβρίου (213)
- ► Φεβρουαρίου (264)
- ► Ιανουαρίου (262)
-
►
2021
(3815)
- ► Δεκεμβρίου (229)
- ► Σεπτεμβρίου (276)
- ► Φεβρουαρίου (64)
-
▼
2020
(5754)
- ► Δεκεμβρίου (401)
- ► Σεπτεμβρίου (365)
- ► Φεβρουαρίου (754)
-
▼
Ιανουαρίου
(894)
-
▼
Ιαν 15
(86)
- Journal of Maxillofacial and Oral Surgery
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
- 35 JOURNALS
- MDPI
- MDPI
- Frequency and distribution of polyQ disease interm...
- Extraluminal Duodenal Gangliocytic Paraganglioma P...
- Surgical Resection of Multiple Small Bowel Neuroen...
- Pyoderma Gangrenosum in Inflammatory Bowel Disease...
- Mutational Mosaics of Cell-Free DNA from Pancreati...
- Polyp Detection Rate Correlates Strongly with Aden...
- iASPP-Mediated ROS Inhibition Drives 5-Fu Resistan...
- Early Treatment Uptake and Cost Burden of Hepatiti...
- IntraMed
- Lichen planus related to transforming growth facto...
- CD10 and P63 Expression in a Sarcomatoid Undiffere...
- Cutaneous “Fibroma‐Like” Perivascular Epithelioid ...
- Experimental+Biology+and+Medicine
- Adhesive Hydrogels for Maxillofacial Tissue Regene...
- Improving Quantum Yield of a NIR‐II Dye by Phenyla...
- Synthetic Polymers Provide a Robust Substrate for ...
- Bioinspired Biomaterials with a Brick‐and‐Mortar M...
- Control of Astrocyte Quiescence and Activation in ...
- Design and Analysis of Elimination Surveys for Neg...
- Progesterone Receptor Gene Variants in Metastatic ...
- Europe PMC
- Novel technique of fixing intracorneal rings segme...
- Volatile anaesthetic for treatment of respiratory ...
- Cyclophosphamide, bortezomib and dexamethasone (Cy...
- Successful liver transplantation for drug-induced ...
- Rare case of bilateral wrist and foot drop from SL...
- Rupture of mitral valve papillary muscle: a rare c...
- Terlipressin-induced ischaemic skin necrosis
- Lung Cancer
- The effect of eHealth-based falls prevention progr...
- Improving the quality of life of patients with bre...
- Impact of transforming mental health services for ...
- Point-of-care blood tests during home visits by ou...
- Enhanced recovery following hip and knee arthropla...
- Cost-effectiveness of total knee replacement in ad...
- Oral propranolol for treatment of the subgroups of...
- Womens leadership in academic medicine: a systemat...
- MedWorm Allergy & Immunology Research
- Climatic Change
- IL-9 blockade attenuates inflammation in a murine ...
- Etiology and Outcome of Candidemia in Neonates and...
- New GEO Series
- Environmental+Science+and+Pollution
- GEO series published today
- Trace elements, polycyclic aromatic hydrocarbons, ...
- Insulin resistance is an independent risk factor f...
- Subthalamic nucleus deep brain stimulation in two ...
- Frequency and distribution of polyQ disease interm...
- Novel mutations in SPEF2 causing different defects...
- Foxn1 and Prkdc genes are important for testis fun...
- A20-OVA Nanoparticles Inhibit Allergic Asthma in a...
- MicroRNA-486-5p Promotes Acute Lung Injury via Ind...
- PNU-282987 Attenuates Intestinal Epithelial Barrie...
- Ossiculoplasty for Tympanosclerosis
- Targeted Biologic Therapies in Allergic Disease
- Elevated omentin-1 levels, their clinicopathologic...
- Recurrent Multifocal Cellulitis
- Cell adhesion in cancer: Beyond the migration of s...
- Estrogen-induced FOS like 1 regulates matrix metal...
- The basis for non-canonical ROK family function in...
- ALS-derived fibroblasts exhibit reduced proliferat...
- Brain MRI of multiple system atrophy of cerebellar...
- A pooled meta-analysis of GPi and STN deep brain s...
- Assessing heavy metal pollution by biomonitoring h...
- Acute ecotoxicity and genotoxicity assessment of t...
- Environmentally relevant exposures of male mice to...
- “Modern agriculture” transfers many pesticides to ...
- Plastic floating debris along a summer-winter estu...
- Phosphorus removal from wastewater by waste concre...
- Exposed to endocrine active riverbed sediments
- Influence of graphene oxide nanosheets on the cotr...
- Trace elements, polycyclic aromatic hydrocarbons, ...
- Distribution and risk analysis of heavy metals in ...
- Protocol for intubation with introducer guide
- Videolaryngoscopes
- Supraglottic Airway Devices (SADs)
- Wilson risk score
- Airway Assessment
- Ear, Nose & Throat Journal
- Voice
- Medicine by Alexandros G. Sfakianakis,Anapafseos 5...
-
▼
Ιαν 15
(86)
-
►
2019
(146)
- ► Δεκεμβρίου (19)
- ► Σεπτεμβρίου (54)
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου