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Near patient testing in general practice: attitudes of general practitioners and practice nurses, and quality
1Division of General Practice and Primary Care, St George's Hospital Medical School, University of London.
Background:
The evaluation of near patient testing in British general practice has largely been confined to studies examining individual tests or comparing equipment.
Aim:
This study set out to determine the attitudes of practice staff to near patient testing, and the extent to which staff undertook quality assessment.
Method:
Four types of near patient testing machines were introduced into 12 general practices in two regions of England, south west Thames and west Midlands. General practitioner and practice nurse attitudes to near patient testing were assessed by semi-structured interview before and six months after the introduction of the machines. The extent to which routine quality assurance procedures were carried out within the surgery and as part of local and national schemes was examined.
Results:
Although 80% of general practitioners anticipated changing patient management with near patient testing, only two fifths reported having done so after six months. Nurses generally were enthusiastic at the outset, although one third were unhappy about incorporating near patient testing into their work schedules. Time pressure was the most important factor restricting uptake of near patient testing. Nurses performed quality control regularly but complete local external quality assurance procedures were established in only half the practices. All the practices participated in a national scheme for cholesterol assays.
Conclusion:
General practitioners in this study did not find near patient testing a very useful addition to their resources. Pressure on nurses' time was the most frequently reported limitation.