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Point-of-care testing in Paediatric settings in the UK and Ireland: a cross-sectional study
Meenu Pandey1, Mark D Lyttle2,3, Katrina Cathie4
1Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Children's Emergency Department, Leicester Royal Infirmary, Leicester, UK.
Insights
Point-of-care testing (POCT) is widely used in the UK and Ireland for common tests like blood sugar and urinalysis. However, newer biomarker POCT implementation faces challenges due to resources and lack of national guidance.
Area of Science:
- Paediatric Medicine
- Clinical Diagnostics
- Health Services Research
Background:
- Point-of-care testing (POCT) involves diagnostic tests performed near the patient.
- Understanding current POCT capacity is crucial for implementing new evidence-based practices.
Purpose of the Study:
- To assess the current capacity and scope of POCT in UK and Ireland paediatric settings.
- To identify barriers to the implementation of new POCT.
Main Methods:
- A cross-sectional online survey was conducted among paediatric research networks in the UK and Ireland.
- Data were collected from 139 units between January and February 2020.
Main Results:
- High utilization of POCT for blood sugar (98.6%), urinalysis (96.4%), and blood gas analysis (95%).
- Low utilization of POCT for Influenza/RSV (32.4%/29.5%), CRP (9.4%), PCT (1.4%), and Group A Streptococcus (3.6%).
- Key obstacles included resources, infrastructure, and quality assurance for new POCT.
Conclusions:
- POCT practice shows consensus but inequity exists for newer biomarkers lacking national guidance.
- A strategy addressing funding, evidence, and standardization is needed for wider POCT implementation.
Background:
Point-of-care testing (POCT) is diagnostic testing performed at or near to the site of the patient. Understanding the current capacity, and scope, of POCT in this setting is essential in order to respond to new research evidence which may lead to wide implementation.
Methods:
A cross-sectional online survey study of POCT use was conducted between 6th January and 2nd February 2020 on behalf of two United Kingdom (UK) and Ireland-based paediatric research networks (Paediatric Emergency Research UK and Ireland, and General and Adolescent Paediatric Research UK and Ireland).
Results:
In total 91/109 (83.5%) sites responded, with some respondents providing details for multiple units on their site based on network membership (139 units in total). The most commonly performed POCT were blood sugar (137/139; 98.6%), urinalysis (134/139; 96.4%) and blood gas analysis (132/139; 95%). The use of POCT for Influenza/Respiratory Syncytial Virus (RSV) (45/139; 32.4%, 41/139; 29.5%), C-Reactive Protein (CRP) (13/139; 9.4%), Procalcitonin (PCT) (2/139; 1.4%) and Group A Streptococcus (5/139; 3.6%) and was relatively low. Obstacles to the introduction of new POCT included resources and infrastructure to support test performance and quality assurance.
Conclusion:
This survey demonstrates significant consensus in POCT practice in the UK and Ireland but highlights specific inequity in newer biomarkers, some which do not have support from national guidance. A clear strategy to overcome the key obstacles of funding, evidence base, and standardising variation will be essential if there is a drive toward increasing implementation of POCT.
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