PubMed Health⌕ Search

Biomedical subjects

S K Humbertson

Publications and source records attributed to S K Humbertson.

3 recordsLinked to original sources

Management of a point-of-care program. Organization, quality assurance, and data management.

Management of a POCT program can be difficult. Cooperation and communication are essential. Creating an interdisciplinary POCT committee is key to successful management. Each discipline through its expertise and common goal to provide quality patient care contributes to the success of the program. The development of a comprehensive QA program ensures that POCT results are accurate, reliable, and performed by competent personnel, and that regulatory compliance is achieved. Continuous quality improvement diminishes the POCT program's potential for undesirable outcomes. Ultimately, the patient benefits, with quality patient care and improved outcomes. Improved data management is necessary with the increased demands for point-of-care tests and the volume of data already generated to ensure quality of results and still meet regulatory guidelines. More automated systems are needed to eliminate labor- and time-intensive tasks. The function of downloading data requires complete automation and transparency for nursing and other testing personnel to gain complete cooperation. The future for data management, however, looks promising for meeting the needs of today.

Clinical Laboratory Information Systems↗

Clinical outcomes of point-of-care testing in the interventional radiology and invasive cardiology setting.

BACKGROUND: Point-of-care testing (POCT) can provide rapid test results, but its impact on patient care is not well documented. We investigated the ability of POCT to decrease inpatient and outpatient waiting times for cardiovascular procedures. METHODS: We prospectively studied, over a 7-month period, 216 patients requiring diagnostic laboratory testing for coagulation (prothrombin time/activated partial thromboplastin time) and/or renal function (urea nitrogen, creatinine, sodium, and potassium) before elective invasive cardiac and radiologic procedures. Overall patient management and workflow were examined in the initial phase. In phase 2, we implemented POCT but utilized central laboratory results for patient management. In phase 3, therapeutic decisions were based on POCT results. The final phase, phase 4, sought to optimize workflow around the availability of POCT. Patient wait and timing of phlebotomy, availability of laboratory results, and therapeutic action were monitored. Split sampling allowed comparability of POCT and central laboratory results throughout the study. RESULTS: In phase 1, 44% of central laboratory results were not available before the scheduled time for procedure (n = 135). Mean waiting times (arrival to procedure) were 188 +/- 54 min for patients who needed renal testing (phase 2; n = 14) and 171 +/- 76 min for those needing coagulation testing (n = 24). For patients needing renal testing, POCT decreased patient wait times (phases 3 and 4 combined, 141 +/- 52 min; n = 18; P = 0.02). For patients needing coagulation testing, wait times improved only when systematic changes were made in workflow (phase 4, 109 +/- 41 min; n = 12; P = 0.01). CONCLUSIONS: Although POCT has the potential to provide beneficial patient outcomes, merely moving testing from a central laboratory to the medical unit does not guarantee improved outcomes. Systematic changes in patient management may be required.

Cardiovascular Surgical Procedures↗