Implementation of point-of-care testing: current applications and the impact on patient experience

Miller, Louise Kimberley (2016) Implementation of point-of-care testing: current applications and the impact on patient experience. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Introduction: Point-of-Care Testing (POCT) also widely known as Near Patient Testing (NPT), is pathology testing performed at or near the site of patient care, offering several advantages over traditional pathology testing: it is portable, provides rapid results, uses smaller sample sizes and can be used for patient self-testing (PST). Due to these differences, it is conceivable that the implementation of POCT in place of laboratory testing could have an impact on patient experience; therefore, the aim of this research was to investigate this impact. The specific objectives of the study are to identify where and how POCT is currently used, to assess its impact on patient outcome and experience within a community setting and to evaluate its performance in the community setting. Methods: A survey was performed to gain insight on the extent to which POCT is used within UK primary care, how well established it is and general attitudes toward its use. A cross-sectional study, employing both quantitative and qualitative methods was conducted with patients receiving local authority provided NHS Health Checks in the community, where POCT is used to measure cholesterol and glucose. The analytical and operator performance of the POCT used was also assessed. Results: UK primary care staff were aware of POCT; 86% of respondents reporting that their surgery used some form of POCT on a regular basis. It appeared, however, that POCT operators were not always trained and that the quality of results obtained was not always considered. The use of POCT in community-based NHS Health Checks was well received and enabled the screening of individuals who would not normally access healthcare. However, the programme as a whole did not instigate significant improvements in the cardiovascular health of the participants, unless the participant was referred for further testing. The POCT used produced results that were significantly different from the reference value, producing clinically significant changes in outcome. Conclusion: The use of POCT should be tightly managed in every setting, including the community. This management should include regular quality checks to ensure patient results are accurate and that clinical management decisions are appropriate.