Comparison of the use of comprehensive point-of-care test panel to conventional laboratory process in emergency department

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Kankaanpää , M , Holma-Eriksson , M , Kapanen , S , Heitto , M , Bergström , S , Muukkonen , L & Harjola , V-P 2018 , ' Comparison of the use of comprehensive point-of-care test panel to conventional laboratory process in emergency department ' , BMC Emergency Medicine , vol. 18 , 43 . https://doi.org/10.1186/s12873-018-0198-x

Title: Comparison of the use of comprehensive point-of-care test panel to conventional laboratory process in emergency department
Author: Kankaanpää, Meri; Holma-Eriksson, Marika; Kapanen, Sami; Heitto, Merja; Bergström, Sari; Muukkonen, Leila; Harjola, Veli-Pekka
Contributor: University of Helsinki, HUS Emergency Medicine and Services
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, HUSLAB
University of Helsinki, Clinicum
Date: 2018-11-19
Language: eng
Number of pages: 6
Belongs to series: BMC Emergency Medicine
ISSN: 1471-227X
URI: http://hdl.handle.net/10138/299361
Abstract: Background: In this study, we hypothesized that point of care testing (POCT) would reduce length of stay (LOS) in emergency department (ED) when compared to central laboratory testing and be a factor in patient discharge destination. Methods: A single centre observational study was performed in ED non-ambulatory patients. Blood testing was performed either with POC instruments for blood gases and chemistry panel, full blood count, and CRP, or at central laboratory, or as a combination of both. Blood draw and POCTs were performed by experienced nurses. Results: During the 4- week study period, 1759 patients underwent sample testing (POCT: n = 160, central lab: n = 951; both n = 648). Median waiting time for blood sampling was 19 min less in POCT than central laboratory (0: 52 (95% confidence interval (CI) 0:46-1:02) vs. 1:11 (95% CI 1:05-1:14), p <0.001). POCT results were available faster in both discharge groups, as expected. When imaging was not required, patients in POCT group were discharged home 55 min faster (4:57 (95% CI 3:59-6:17) vs. 5:52 (95% CI 5:21-6:35), p = 0.012) and 1 h 22 min faster when imaging was performed (5:48 (95% CI 5: 26-6: 18) vs. 7:10 (95% CI 6:47-8:26), p = 0.010). Similar reduction in sampling time and LOS was not seen among those admitted to hospital. Conclusions: POCT shortened the laboratory process and made results available faster than the central lab. This allowed patients to be discharged home quicker. Thus, with proper training and education of the ED care team, POCT can be used as an effective tool for improving patient flow.
Subject: Laboratory testing
Point-of-care testing
Emergency department
Length of stay
Discharge
STAY
TIME
IMPACT
3126 Surgery, anesthesiology, intensive care, radiology
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